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Saavedra JM, Lefferts EC, Song BK, Lee DC. The associations of daily steps and body mass index with incident gastroesophageal reflux disease in older adults. Front Sports Act Living 2024; 6:1384845. [PMID: 38645729 PMCID: PMC11026570 DOI: 10.3389/fspor.2024.1384845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 03/26/2024] [Indexed: 04/23/2024] Open
Abstract
Background High body mass index (BMI) is a major risk factor of gastroesophageal reflux disease (GERD), a prevalent morbidity of older adulthood linked to lower quality of life and an increased risk of esophageal cancers. Daily stepping behavior, the most common physical activity of older adulthood, is associated with an array of favorable health outcomes, sometimes independent of high BMI. Whether stepping behavior is associated with the incidence of GERD independently or in combination with BMI is currently unclear. Materials and methods We followed 442 individuals (58.4% female) aged 65-91 years enrolled in the Physical Activity and Aging Study. Baseline steps were obtained by pedometer and categorized by tertiles (lower, middle, upper), while BMI was categorized into normal weight, overweight, and obesity. To explore joint associations, daily steps were dichotomized into "high steps" (middle/upper tertiles) and "low steps" (lower tertile), while BMI was dichotomized into normal weight and overweight/obesity. The joint exposure categories included "low steps and overweight/obesity," "low steps and normal weight," "high steps and overweight/obesity," and "high steps and normal weight." Results We identified 35 (7.9%) cases of GERD over a mean follow-up of 2.5 years. Compared to the lower tertile of steps, the hazard ratios (HRs) [95% confidence intervals (95% CIs)] of GERD were 0.44 (0.20-0.96) and 0.17 (0.05-0.54) for the middle and upper tertiles, respectively, after adjusting for confounders (including BMI). Compared to normal weight, the HRs (95% CIs) of GERD were 1.35 (0.54-3.37) and 3.00 (1.19-7.55) for overweight and obesity, respectively, after adjusting for confounders (including steps). In a joint analysis, compared to "low steps and overweight/obesity," the HRs (95% CIs) of GERD were 0.32 (0.10-1.00), 0.23 (0.10-0.54), and 0.20 (0.07-0.58) for "low steps and normal weight," "high steps and overweight/obesity," and "high steps and normal weight," respectively. Conclusion Higher daily steps were associated with a lower risk of GERD in older adults, independent of BMI. Since accumulating steps through walking is an achievable and acceptable modality of physical activity in older adulthood, future lifestyle interventions designed to achieve high daily steps counts may have favorable implications for the development of GERD in older adults of any BMI status.
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Affiliation(s)
- Joey M. Saavedra
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | | | - Bong Kil Song
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
| | - Duck-chul Lee
- Department of Kinesiology, Iowa State University, Ames, IA, United States
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Lefferts EC, Ranadive SM. Vascular Responses to Acute Induced Inflammation With Aging: Does Fitness Matter? Exerc Sport Sci Rev 2024; 52:68-75. [PMID: 38377185 DOI: 10.1249/jes.0000000000000334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Acute inflammation impairs vascular function in an age-dependent manner and affects cardiovascular event risk. Regular aerobic exercise preserves vascular function with aging and potentially modifies how acute inflammation affects the vasculature. We hypothesize high cardiorespiratory fitness may accompany greater arterial responsiveness post-acute inflammation in older adults.
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Affiliation(s)
- Elizabeth C Lefferts
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, IA
| | - Sushant M Ranadive
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD
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Brellenthin AG, Lee DC, Lefferts EC, Lefferts WK, Dougherty RJ, Kim Y. Physical Activity Intensity and Risk of Dementia. Am J Prev Med 2024:S0749-3797(24)00026-6. [PMID: 38307157 DOI: 10.1016/j.amepre.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/04/2024]
Abstract
INTRODUCTION Regular participation in aerobic physical activity is associated with a reduced risk of dementia. It is currently unclear whether this association is due to the total volume or intensity of physical activity. METHODS This prospective cohort study analyzed 386,486 adults from the UK Biobank who were free of dementia and self-reported >0 minutes of moderate-to-vigorous intensity physical activity (MVPA) at baseline (2007-2010). Participants were categorized as performing 0%, >0%-30%, or >30% of their total MVPA in vigorous activity (VPA). Cox proportional hazards regression models were used to examine the associations between categories of VPA and incident dementia while adjusting for sociodemographic and lifestyle factors including total MVPA. Analyses were performed in 2022. RESULTS Over an average follow-up of 12.0 (1.7) years, there were 5,177 (1.3%) cases of dementia. Compared to the group reporting 0% VPA, the hazard ratios (95% confidence intervals) of dementia for the groups reporting >0%-30% and >30% VPA were 0.73 (0.68-0.78) and 0.81 (0.75-0.87), respectively, in the fully adjusted model. In a joint analysis, reporting some VPA was associated with a reduced risk of dementia regardless of meeting the aerobic physical activity guidelines (HR=0.78 [0.72-0.85]) or not (HR=0.76 [0.60-0.98]), while meeting the aerobic physical activity guidelines alone without VPA was not associated with incident dementia (HR=0.98 [0.90-1.07]), compared to the group that did not meet the guidelines and reported no VPA. CONCLUSIONS These results suggest that engaging in VPA as part of MVPA is associated with a lower risk of dementia.
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Affiliation(s)
| | - Duck-Chul Lee
- Department of Kinesiology, Iowa State University, Ames, Iowa
| | | | | | - Ryan J Dougherty
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Youngwon Kim
- University of Hong Kong, Li Ka Shing Faculty of Medicine, School of Public Health, Pokfulam, Hong Kong; University of Cambridge, MRC Epidemiology Unit, Cambridge, United Kingdom.
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Marôco JL, Rosenberg AJ, Grigoriadis G, Lefferts EC, Fernhall B, Baynard T. Older females but not males exhibit increases in cerebral blood velocity, despite similar pulsatility increases after high-intensity resistance exercise. Am J Physiol Heart Circ Physiol 2023; 325:H909-H916. [PMID: 37594485 DOI: 10.1152/ajpheart.00349.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/07/2023] [Accepted: 08/17/2023] [Indexed: 08/19/2023]
Abstract
Sex differences in resting cerebral hemodynamics decline with aging. Given that acute resistance exercise (RE) is a hypertensive challenge, it may reveal sex-dependent abnormalities in cerebral hemodynamics. Thus, we hypothesized that cerebral blood velocity and pulsatility responses to RE would be sex-dependent in older adults. Fourteen older females and 11 males (50-68 yr) completed a high-intensity unilateral isokinetic knee flexion/extension exercise. Measurements were collected at baseline, immediately, 5- and 30-min post-RE. Blood pressure was measured via finger photoplethysmography. Mean middle cerebral artery blood velocity (MCAv) and pulsatility were assessed via transcranial Doppler ultrasound. Carotid pulsatility was obtained via duplex ultrasound. MCAv increased immediately after RE in older females [mean difference (d) = 6.02, 95% CI: 1.66 to 10.39 cm/s, P < 0.001] but not in males (d = -0.72, 95% CI: -3.83 to 5.27 cm/s, P = 0.99), followed by similar reductions 5-min post-RE in older females (d = -4.40, 95% CI: -8.81 to -0.10 cm/s, P = 0.045) and males (d = -6.41, 95% CI: -11.19 to -1.62 cm/s, P = 0.003). MCAv pulsatility increased similarly in older females (d = 0.24, 95% CI: 0.11 to 0.40, P < 0.001) and males (d = 0.38, 95% CI: 0.20 to 0.53, P < 0.001), persisting 5-min post-RE. Older females showed smaller increases in carotid pulsatility immediately after RE (d = 0.18, 95% CI: 0.03 to 0.38, P = 0.01) than males (d = 0.48, 95% CI: 0.26 to 0.68, P < 0.001). An exercise-mediated hypertensive stimulus revealed differential sex responses in MCAv and carotid pulsatility but not in cerebral pulsatility. Cerebral pulsatility findings suggest a similar sex susceptibility to cerebrovascular abnormalities following exercise-mediated hypertensive stimulus in older adults.NEW & NOTEWORTHY Sex differences in resting cerebral hemodynamics decline with advancing age as females experience larger reductions in cerebral blood velocity and steeper pulsatility increases than males. However, an exercise-mediated hypertensive stimulus might reveal sex differences in cerebral hemodynamics not apparent at rest. Following high-intensity resistance exercise, older females but not males exhibit increases in cerebral blood velocity, despite similar increases in cerebral pulsatility. The susceptibility to cerebrovascular abnormalities following exercise-mediated hypertensive stimulus appears similar between sexes.
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Affiliation(s)
- João L Marôco
- Integrative Human Physiology Laboratory, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, United States
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Alexander J Rosenberg
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
- Department of Physiology, Midwestern University, Downers Grove, Illinois, United States
| | - Georgios Grigoriadis
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Elizabeth C Lefferts
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
- Clinical Vascular Research Laboratory, College of Human Sciences, Iowa State University, Ames, Iowa, United States
| | - Bo Fernhall
- Integrative Human Physiology Laboratory, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, United States
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Tracy Baynard
- Integrative Human Physiology Laboratory, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, United States
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
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Lefferts EC, Saavedra JM, Song BK, Brellenthin AG, Pescatello LS, Lee DC. Increasing Lifestyle Walking by 3000 Steps per Day Reduces Blood Pressure in Sedentary Older Adults with Hypertension: Results from an e-Health Pilot Study. J Cardiovasc Dev Dis 2023; 10:317. [PMID: 37623330 PMCID: PMC10455876 DOI: 10.3390/jcdd10080317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023] Open
Abstract
Increasing daily steps by an additional 3000 steps/day on 5 days/week equates to ~150 min/week of aerobic physical activity to meet the physical activity guidelines; however, its effectiveness for blood pressure control in older adults with hypertension is unknown. A 20-week, single-arm, pilot e-health lifestyle walking intervention was conducted in 21 sedentary older adults (73 ± 5 years old) with hypertension (13 female, 8 male) to investigate the effectiveness of increasing daily steps by an additional 3000 steps/day for blood pressure control. The intervention consisted of two phases, with behavior change assistance provided during the first active phase (weeks 1-10) to help reach step goals and minimal assistance provided during the second self-maintenance phase (weeks 11-20). Nineteen participants (91%) completed both the 10- and 20-week assessments. The participants wore the pedometer for ≥10 h on 97% of the days over 20 weeks. They significantly increased average steps/day from 3899 ± 2198 at baseline to 6512 ± 2633 at 10 weeks and 5567 ± 2587 at 20 weeks. After 20 weeks, both systolic (137 ± 10 to 130 ± 11 mm Hg, p < 0.001) and diastolic (81 ± 6 to 77 ± 6 mm Hg, p = 0.01) blood pressure improved. The response was consistent in participants with (n = 8) and without (n = 13) anti-hypertensive medication. The results of our lifestyle walking intervention are encouraging for reducing blood pressure in older adults with hypertension; however, larger randomized, controlled trials need to be performed to confirm these findings.
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Affiliation(s)
- Elizabeth C. Lefferts
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA; (E.C.L.); (J.M.S.); (A.G.B.)
| | - Joseph M. Saavedra
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA; (E.C.L.); (J.M.S.); (A.G.B.)
| | - Bong Kil Song
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA; (E.C.L.); (J.M.S.); (A.G.B.)
| | - Angelique G. Brellenthin
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA; (E.C.L.); (J.M.S.); (A.G.B.)
| | | | - Duck-chul Lee
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA; (E.C.L.); (J.M.S.); (A.G.B.)
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Beck VDY, Wee SO, Lefferts EC, Hibner BA, Burton LC, Baynard T, Fernhall B, Hilgenkamp TIM. Comprehensive cardiopulmonary profile of individuals with Down syndrome. J Intellect Disabil Res 2022; 66:978-987. [PMID: 35734935 DOI: 10.1111/jir.12954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 04/15/2022] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Individuals with Down syndrome (DS) have low levels of cardiorespiratory fitness and previous studies have shown that these low levels of fitness have a physiological cause. During exercise, the cardiovascular, ventilatory and muscular systems are simultaneously active. While individual parameters of these systems have been investigated in DS before, the interaction between these parameters and systems have not been discussed in detail. Doing so may provide important insight regarding the aetiology of low cardiorespiratory fitness and which parameters of the cardiovascular, pulmonary and muscular systems are altered in individuals with DS compared with their peers without DS. METHODS Cardiopulmonary exercise tests were performed in healthy adults with and without DS. Parameters related to the cardiovascular, ventilatory and muscular systems were collected until VO2peak . In total, 51 participants were included in analysis, of which 21 had DS. RESULTS Individuals with DS showed lower peak values for all collected outcomes (P ≤ 0.001) compared with those without DS, except for ventilatory threshold as a percentage of maximal oxygen uptake and VE /VCO2 slope, which were similar. CONCLUSIONS Our results show that individuals with DS present impairments across the cardiovascular, ventilatory and muscular aspects of the cardiopulmonary system.
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Affiliation(s)
- V D Y Beck
- Department of Physical Therapy, University of Nevada - Las Vegas, Las Vegas, NV, USA
| | - S O Wee
- Department of Kinesiology, California State University San Bernardino, San Bernardino, CA, USA
| | - E C Lefferts
- Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - B A Hibner
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - L C Burton
- Department of Health and Kinesiology, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
| | - T Baynard
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - B Fernhall
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - T I M Hilgenkamp
- Department of Physical Therapy, University of Nevada - Las Vegas, Las Vegas, NV, USA
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Song BK, Saavedra JM, Lefferts EC, Brellenthin AG, Lee DC. Associations between cardiorespiratory fitness and diverticulitis in older adults. PLoS One 2022; 17:e0275433. [PMID: 36174031 PMCID: PMC9522298 DOI: 10.1371/journal.pone.0275433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 08/31/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives
Examine the independent and joint associations of cardiorespiratory fitness (CRF) and body mass index (BMI) with the prevalence of diverticulitis in older adults.
Methods
476 older adults (61% Female; 71 ± 5 years) with no history of myocardial infarction, stroke, cancer, inflammatory bowel disease, or diabetes were included in this cross-sectional study. Diverticulitis cases were identified by self-reported physician diagnosis from the medical history questionnaire. Logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of the prevalence of diverticulitis by tertiles of CRF and BMI category. CRF and BMI were further dichotomized into either “unfit” (the lowest one-third of CRF), “fit” (the upper two-thirds of CRF), “overweight/obese” (BMI ≥25.0 kg/m2), or “normal-weight” (BMI <25.0 kg/m2) to investigate the joint association of CRF and BMI with diverticulitis.
Results
Thirty-five (7.4%) participants were identified as having diverticulitis. Compared with the lowest CRF tertile, the ORs (95% CIs) of diverticulitis were 0.52 (0.22–1.22) and 0.33 (0.12–0.94) in the middle and upper CRF tertiles, respectively, after adjusting for potential confounders. After further adjustment for BMI, the association was no longer significant with ORs (95% CIs) of 0.55 (0.23–1.33) and 0.37 (0.12–1.10) in middle and upper CRF tertiles, respectively. Compared with the normal-weight group, the ORs (95% CIs) of diverticulitis were 2.86 (1.05–7.79) and 2.98 (0.95–9.35) in the overweight and obese groups, respectively, after adjusting for possible confounders and CRF. Compared with the “unfit and overweight/obese” group in the joint analysis, the OR (95% CI) of diverticulitis was 0.16 (0.04–0.61) in the “fit and normal-weight” group.
Conclusions
Older adults who maintain higher CRF and lower BMI may have significantly lower odds of diverticulitis, with the lowest odds found in the normal-weight and fit older adults.
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Affiliation(s)
- Bong Kil Song
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, Iowa, United States of America
- * E-mail:
| | - Joey M. Saavedra
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, Iowa, United States of America
| | - Elizabeth C. Lefferts
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, Iowa, United States of America
| | - Angelique G. Brellenthin
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, Iowa, United States of America
| | - Duck-chul Lee
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, Iowa, United States of America
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Lefferts WK, Weiner CM, Mascone SE, Augustine JA, Heffernan KS, Lefferts EC. Influence of sex and presence of cardiovascular risk factors on relations between cardiorespiratory fitness and cerebrovascular hemodynamics. J Appl Physiol (1985) 2022; 133:1019-1030. [PMID: 36074924 PMCID: PMC9576163 DOI: 10.1152/japplphysiol.00371.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Cerebral hemodynamics and pulsatility are important mechanisms of cerebrovascular and brain health. Cardiorespiratory fitness may improve cerebrovascular pulsatility in healthy females, but not in males. Whether cardiovascular disease (CVD) risk factors modify sex-specific associations of fitness with cerebral hemodynamics and vascular contributors to cerebral hemodynamics is unknown. We assessed V̇o2peak and cerebrovascular hemodynamics in 157 adults without (42 ± 13 yr, BMI 24.5 ± 2.7 kg/m2), and 66 adults with modifiable CVD risk factors (54 ± 8 yr, BMI 29.9 ± 4.0 kg/m2). Intracranial [middle cerebral artery (MCA) pulsatility index (PI), mean velocity, conductance, and pulsatile damping] and extracranial hemodynamics [carotid artery wave transmission/reflection, PI, pulse wave velocity (PWV)-β, and carotid-femoral PWV] were assessed via transcranial Doppler/ultrasound and tonometry. Cardiorespiratory fitness was assessed via V̇o2peak during an incremental exercise test. Multiple regression was used to assess contributions of V̇o2peak to cerebrovascular outcomes after adjustment for relevant covariates. V̇o2peak was inversely associated with MCA PI among females (β = −0.39, P = 0.01) but not males (β = −0.16, P = 0.25) without CVD risk factors. V̇o2peak was positively associated with MCA PI among females (β = 0.44, P = 0.01) and not associated in males with CVD risk factors (β = −0.06, P = 0.079). V̇o2peak was beneficially associated with vascular contributors to cerebral hemodynamics but had sex-specific associations with carotid stiffness and pulse pressure in females without CVD risk factors only. These results suggest that sex-specific associations between fitness and cerebral pulsatility among females without CVD risk factors may relate to the differential effects of fitness on carotid stiffness and pulse pressure. In addition, the presence of modifiable CVD risk factors may influence the protective relations of fitness on cerebrovascular hemodynamics. NEW & NOTEWORTHY We identify beneficial associations between cardiorespiratory fitness and lower carotid stiffness and pulse pressure as potential mechanisms underlying sex-specific associations of fitness and cerebral pulsatility in females without modifiable risk factors. Greater fitness is beneficially associated with conductance, pulsatile damping, and forward wave energy among adults without risk factors; however, associations are attenuated among adults with modifiable risk factors. These data suggest sex and risk factors may alter cerebrovascular sensitivity to cardiorespiratory fitness.
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Affiliation(s)
- Wesley K Lefferts
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Cynthia M Weiner
- Department of Kinesiology, University of Maryland, College Park, MD, United States
| | - Sara E Mascone
- Department of Kinesiology, University of Maryland, College Park, MD, United States
| | | | - Kevin S Heffernan
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States
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Saavedra JM, Lefferts EC, Song BK, Lee DC. Associations Of Body Mass Index And Cardiorespiratory Fitness With Sleep Apnea In Older Adults. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000878700.46991.db] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Grigoriadis G, Sherman SR, Hibner BA, Lefferts EC, Lima NS, Phillips SA, Fernhall B, Baynard T. High-fit Breast Cancer Survivors Have Greater Cardiac And Pulmonary Function Compared To Low-fit. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000875068.15947.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Beck VDY, Wee SO, Lefferts EC, Hibner BA, Burton LC, Baynard T, Fernhall B, Hilgenkamp TIM. Lower Oxygen Uptake Efficiency Slope With Similar VE/VCO2 Slope In Individuals With Down Syndrome. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000880460.41767.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Song BK, Lefferts EC, Saavedra JM, Lee DC. Associations Of Daily Step Count And Sitting Time With Gastroesophageal Reflux Disease In Older Adults. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000880856.62902.ea] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sherman SR, Lefferts WK, Lefferts EC, Grigoriadis G, Lima NS, Fernhall B, Baynard T, Rosenberg AJ. The effect of aging on carotid artery wall mechanics during maximal resistance exercise. Eur J Appl Physiol 2022; 122:2477-2488. [PMID: 36008691 DOI: 10.1007/s00421-022-05016-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/29/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Age-related stiffening of the large elastic arteries (e.g., common carotid artery [CCA]) may impair wall dynamics (i.e., strain) and amplify transmission of pulsatile blood flow into the brain with large increases in pressure that occur during maximal resistance exercise (RE). The purpose of this study was to compare CCA arterial wall dynamics, central hemodynamics, and cerebral blood velocity responses during maximal RE between young and older adults. METHODS Thirty-one young (YA; 26 ± 5 yrs; 23.8 ± 3.3 kg/m2) and 25 older adults (OA; 60 ± 6 yrs; 30.0 ± 5.5 kg/m2) performed a unilateral maximal isokinetic knee flexion/extension exercise protocol (i.e., maximal RE). All measures were recorded at baseline and during the last 10 s of maximal RE. Common carotid artery strain, CCA strain time to peak, and CCA strain rate (i.e., variables of arterial wall dynamics) were analyzed using 2D speckle tracking software from circumferential ultrasound images. Transcranial Doppler was used to measure right middle cerebral artery (MCA) blood velocity. Non-invasive arterial blood pressure measurements were obtained using finger photoplethysmography. RESULTS Older adults had greater reductions in CCA strain time to peak from baseline to maximal RE (345 ± 39 to 242 ± 52 ms) than YA (308 ± 35 to 247 ± 42 ms; interaction effect, p < 0.01). MCA velocity was similar between YA and OA during maximal RE (p = 0.48), despite a greater arterial pressor response in OA (p < 0.01). CONCLUSION These data suggest cerebral blood velocity responds similarly during maximal RE among OA compared to YA, despite subtle age-related differences in the pressor and extracranial vascular response during maximal RE.
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Affiliation(s)
- Sara R Sherman
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Wesley K Lefferts
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.,Clinical Vascular Research Laboratory, Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Elizabeth C Lefferts
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.,Clinical Vascular Research Laboratory, Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Georgios Grigoriadis
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Natalia S Lima
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Bo Fernhall
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Tracy Baynard
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Alexander J Rosenberg
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA. .,Cerebral and Cardiovascular Physiology Laboratory, University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, USA. .,Department of Physiology, Midwestern University, Downers Grove, IL, USA.
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Grigoriadis G, Sherman SR, Lima NS, Lefferts EC, Hibner BA, Ozemek HC, Danciu OC, Kanaloupitis D, Fernhall B, Baynard T. Breast cancer survivors with preserved or rescued cardiorespiratory fitness have similar cardiac, pulmonary and muscle function compared to controls. Eur J Appl Physiol 2022; 122:2189-2200. [PMID: 35796827 DOI: 10.1007/s00421-022-04992-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/16/2022] [Indexed: 11/29/2022]
Abstract
Breast cancer survivors (BCS) have a high prevalence of cardiovascular disease and low cardiorespiratory fitness (CRF). CRF is an important predictor of survival in BCS. However, the physiological factors that contribute to low CRF in BCS have not been completely elucidated. To assess differences in physiological factors (cardiac, pulmonary, muscle function) related to CRF between BCS and controls. Twenty-three BCS and 23 age-body mass index (BMI) matched controls underwent a peak cycling exercise test to determine CRF, with physiological factors measured at resting and at peak exercise. Cardiac hemodynamics (stroke volume [SV], SVindex, heart rate [HR], cardiac output [Formula: see text], and [Formula: see text]index) were evaluated using ultrasonography. Pulmonary function was evaluated using the oxygen uptake efficiency slope (OUES), ventilation to carbon dioxide production slope [Formula: see text] and breathing reserve at peak exercise (BR). Muscle oxygenation variables (oxygenated [HbO2] deoxygenated [HHb] and total hemoglobin [Hb], and tissue oxygenation index [TSI]) were measured with near-infrared spectroscopy (NIRS). Both groups had similar CRF and similarly increased all hemodynamic variables (HR, SV, SVindex, [Formula: see text] and [Formula: see text]index) at peak exercise compared to resting (p < 0.001). BCS had higher overall HR and lower SVindex (group effect, p < 0.05). BCS had similar OUES, [Formula: see text] and BR compared to the controls. Both groups decreased TSI, and increased Hb and HHb similarly at peak exercise compared to resting (p < 0.001). Our data suggest BCS do not exhibit differences in cardiac, pulmonary, or muscle function at peak exercise compared to controls, when both groups have similar CRF and physical activity.
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Affiliation(s)
- Georgios Grigoriadis
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.
| | - Sara R Sherman
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Natalia S Lima
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Elizabeth C Lefferts
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Brooks A Hibner
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Hannah C Ozemek
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Oana C Danciu
- Department of Hematology and Oncology, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Bo Fernhall
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Tracy Baynard
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
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15
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Hibner BA, Lefferts EC, Lima NS, Sherman SR, DeJonge SR, Baynard T, Fernhall B. Aerobic Fitness as a Predictor of Conduit, Resistance and, Microvascular Arterial Function. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r2450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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16
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Lefferts EC, Saavedra JM, Song BK, Lee DC. Effect of the COVID-19 Pandemic on Physical Activity and Sedentary Behavior in Older Adults. J Clin Med 2022; 11:jcm11061568. [PMID: 35329894 PMCID: PMC8952771 DOI: 10.3390/jcm11061568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 12/12/2022] Open
Abstract
Whether the COVID-19 pandemic has long-lasting effects on physical activity (PA) and sedentary behavior in the vulnerable older adult population is uncertain. A total of 387 older adults (75 ± 6 years) completed a retrospective questionnaire on time spent sitting, walking, and performing aerobic and muscle-strengthening PA before, during the first three months, and one year into the COVID-19 pandemic. Whether the participants met the aerobic and muscle-strengthening PA guidelines was then determined. Of the 387 older adults, 376 (97%) were vaccinated. The participants completed 361 ± 426, 293 ± 400, and 454 ± 501 min/week of moderate-to-vigorous aerobic PA before, during the first three months, and one year into the pandemic, respectively. During the same time periods, the participants performed muscle-strengthening PA 87 ± 157, 68 ± 163, and 90 ± 176 min/week, walked 2.4 ± 1.7, 2.3 ± 1.7, and 2.6 ± 1.9 h/day, and sat 6.2 ± 2.9, 7.4 ± 3.1, and 6.1 ± 2.9 h/day, respectively. Aerobic PA, muscle-strengthening PA, and walking time decreased, whereas sitting time increased, during the first three months of the pandemic (p < 0.05), and then returned to pre-pandemic levels after one year (p < 0.05). The percentage of participants meeting both aerobic and muscle-strengthening PA guidelines decreased during the first three months of the pandemic (48.9% to 33.5%, p < 0.001), but returned to pre-pandemic levels one year later (p < 0.001). In conclusion, the COVID-19 pandemic significantly decreased PA and increased sitting time in older adults; however, both PA and sitting time returned to pre-pandemic levels after one year.
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17
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Lima NS, Lefferts EC, Clifford PS. Reactive hyperemia augments local heat-induced skin hyperemia. Exp Physiol 2022; 107:383-389. [PMID: 35218593 DOI: 10.1113/ep090071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 02/11/2022] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? It is valuable to be able to monitor disease or treatment related changes in the microcirculation. Laser doppler flowmetry with local heating allows noninvasive monitoring of the skin microcirculation and its ability to vasodilate. Does reactive hyperemia augment the increase in skin blood flow elicited by local heating? What is the main finding and its importance? The results of this study show that the addition of reactive hyperemia to local heating results in greater vasodilation than heating alone. Thus, reactive hyperemia can augment local heat-induced hyperemia in the skin. ABSTRACT The skin circulation has been proposed as a model of generalized microvascular function which could be monitored noninvasively using laser doppler flowmetry (LDF). The response to heat hyperemia (HH) is commonly used to monitor disease or treatment related changes in microvascular function. We hypothesized that reactive hyperemia would augment the increase in skin blood flow elicited by local heating. Fourteen healthy young adults were subjected to 3 different conditions: reactive hyperemia (RH; skin temperature controlled at 33°C), heat hyperemia (HH; 42°C held for 40 minutes), and HH+RH. Two Peltier-controlled thermomodules with laser LDF probes were placed on the right forearm to continuously monitor skin blood flow. A cuff was placed on the right upper arm to elicit RH by inflation to 220 mmHg for 5 minutes. This procedure was performed with skin temperature at 33°C and again after 40 min of local heating to 42°C. Beat-by-beat mean arterial pressure (MAP) obtained by a photoplethysmographic sensor on the middle finger of the left hand allowed calculation of cutaneous vascular conductance (CVC) as LDF / MAP. Both HH and RH increased LDF (p<0.0001 and p <0.0001, respectively) and CVC (p = 0.0001 and p<0.0001) above baseline values. LDF and CVC values were significantly higher during HH+RH when compared to RH or HH alone (p<0.0001). In summary, HH+RH resulted in greater vasodilation when compared to HH or RH alone. These results indicate that RH can augment local heat-induced hyperemia in the skin. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Natalia S Lima
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Elizabeth C Lefferts
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois, United States.,Department of Kinesiology, Iowa State University, Ames, Iowa, United States
| | - Philip S Clifford
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois, United States
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18
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Hibner BA, Lefferts EC, Yan H, Horn GP, Smith DL, Rowland T, Fernhall B. Effect of live-fire training on ventricular-vascular coupling. Eur J Appl Physiol 2021; 122:591-597. [PMID: 34853895 DOI: 10.1007/s00421-021-04859-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 11/25/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Cardiovascular events are a leading cause of firefighter duty-related death, with the greatest risk occurring during or shortly after fire suppression activity. Increased cardiovascular risk potentially manifests from detrimental changes in ventricular function, vascular load, and their interaction, described as ventricular-vascular coupling. PURPOSE To determine the effect of live-fire training on ventricular-vascular coupling. METHODS Sixty-eight male (28 [Formula: see text] 7 years, 26.9 [Formula: see text] 3.9 kg/m2) and fifteen female (36 [Formula: see text] 8 years, 24.3 [Formula: see text] 3.9 kg/m2) firefighters completed hemodynamic and cardiac measures before and after 3 h of intermittent live-fire training. Left ventricular function was assessed as ejection fraction (EF) and ventricular elastance (ELV: end systolic pressure [ESP]/end systolic volume) via echocardiography and applanation tonometry-estimated ESP. Vascular load was assessed as arterial elastance (EA: ESP/stroke volume [SV]). Ventricular-vascular coupling (VVC) was quantified as the ratio of EA to ELV and indexed to body surface area (EAI, ELVI). RESULTS Following firefighting EF decreased (p < 0.01) with no change in ELVI (p = 0.34). SV decreased (p < 0.01) with no change in ESP (p = 0.09), driving a significant increase in EAI (p < 0.01). These changes resulted in a significant increase in the VVC ratio (p < 0.01). CONCLUSION The findings suggest that firefighting does not alter ventricular elastance but increases arterial elastance in healthy firefighters, resulting in a mismatch between ventricular and vascular systems. This increase in ventricular-vascular coupling ratio and concomitant reduction in ventricular systolic function may contribute to increased cardiovascular risk following live firefighting.
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Affiliation(s)
- Brooks A Hibner
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, IL, USA.
| | - Elizabeth C Lefferts
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, IL, USA
| | - Huimin Yan
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Gavin P Horn
- Illinois Fire Service Institute, University of Illinois-Urbana/Champaign, Champaign, IL, USA.,UL Firefighter Safety Research Institute, Underwriters Laboratories, Inc, Columbia, MD, USA
| | - Denise L Smith
- Illinois Fire Service Institute, University of Illinois-Urbana/Champaign, Champaign, IL, USA.,Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, USA
| | - Thomas Rowland
- Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, USA
| | - Bo Fernhall
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, IL, USA
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19
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Lefferts EC, Hibner BA, Lefferts WK, Lima NS, Baynard T, Haus JM, Lane‐Cordova AD, Phillips SA, Fernhall B. Oral vitamin C restores endothelial function during acute inflammation in young and older adults. Physiol Rep 2021; 9:e15104. [PMID: 34762777 PMCID: PMC8582295 DOI: 10.14814/phy2.15104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/14/2021] [Indexed: 11/24/2022] Open
Abstract
Oxidative stress has been linked to reductions in vascular function during acute inflammation in young adults; however, the effect of acute inflammation on vascular function with aging is inconclusive. The aim of this study was to determine if oral antioxidant administration eliminates vascular dysfunction during acute inflammation in young and older adults. Brachial flow-mediated dilation (FMD) and carotid-femoral pulse wave velocity (PWV) were measured in nine young (3 male, 24 ± 4 yrs, 26.2 ± 4.9 kg/m2 ) and 16 older (13 male, 64 ± 5 yrs, 25.8 ± 3.2 kg/m2 ) adults before and 2-h after oral consumption of 2 g of vitamin C. The vitamin C protocol was completed at rest and 24 h after acute inflammation was induced via the typhoid vaccine. Venous blood samples were taken to measure markers of inflammation and vitamin C. Both interleukin-6 (Δ+0.7 ± 1.8 pg/ml) and C-reactive protein (Δ+1.9 ± 3.1 mg/L) were increased at 24 h following the vaccine (p < 0.01). There was no change in FMD or PWV following vitamin C administration at rest (p > 0.05). FMD was lower in all groups during acute inflammation (Δ-1.4 ± 1.9%, p < 0.01), with no changes in PWV (Δ-0.0 ± 0.9 m/s, p > 0.05). Vitamin C restored FMD back to initial values in young and older adults during acute inflammation (Δ+1.0 ± 1.8%, p < 0.01) with no change in inflammatory markers or PWV (p > 0.05). In conclusion, oral vitamin C restored endothelial function during acute inflammation in young and older adults, with no effect on aortic stiffness. The effect of vitamin C on endothelial function did not appear to be due to reductions in inflammatory markers. The exact mechanisms should be further investigated.
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Affiliation(s)
- Elizabeth C. Lefferts
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Department of KinesiologyIowa State UniversityAmesIowaUSA
| | - Brooks A. Hibner
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Wesley K. Lefferts
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinoisUSA
- Department of KinesiologyIowa State UniversityAmesIowaUSA
| | - Natalia S. Lima
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Tracy Baynard
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Jacob M. Haus
- School of KinesiologyUniversity of MichiganAnn ArborMichiganUSA
| | - Abbi D. Lane‐Cordova
- Department of Exercise ScienceArnold School of Public HealthUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Shane A. Phillips
- Department of Physical TherapyUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Bo Fernhall
- Department of Kinesiology and NutritionUniversity of Illinois at ChicagoChicagoIllinoisUSA
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20
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Song BK, Kim GH, Kim JW, Lefferts EC, Brellenthin AG, Lee DC, Kim YM, Kim MK, Choi BY, Kim YS. Association Between Relative Quadriceps Strength and Type 2 Diabetes Mellitus in Older Adults: The Yangpyeong Cohort of the Korean Genome and Epidemiology Study. J Phys Act Health 2021; 18:1539-1546. [PMID: 34697251 DOI: 10.1123/jpah.2021-0361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/06/2021] [Accepted: 08/25/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND To examine the independent and combined association between relative quadriceps strength and the prevalence of type 2 diabetes mellitus (T2DM) in older adults. METHODS Among 1441 Korean older adults aged ≥65 years (71 [4.7] y) recruited between 2007 and 2016, 1055 older adults with no history of myocardial infarction, stroke, or cancer were included in the analysis. Cases of T2DM were identified by self-reported physician diagnosis, use antihyperglycemic medication or insulin, or fasting blood glucose ≥126 mg/dL. Logistic regression was used to calculate the odds ratios and 95% confidence intervals of T2DM by quartiles of relative quadriceps strength. RESULTS There were 162 T2DM cases (15%). Compared with the lowest quartile (weakest), the odds ratios (95% confidence intervals) of T2DM were 0.56 (0.34-0.90), 0.60 (0.37-0.96), and 0.47 (0.28-0.80) in the second, third, and fourth quartiles, respectively, after adjusting for possible confounders, including body mass index. In the joint analysis, compared with the "weak and overweight/obese" group, the odds (odds ratios [95% confidence intervals]) of T2DM was only lower in the "strong and normal weight" group (0.36 [0.22-0.60]) after adjusting for possible confounders. CONCLUSIONS Greater relative quadriceps strength is associated with reduced odds of T2DM in older adults after adjusting for potential confounders including body mass index.
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21
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Kim GH, Song BK, Kim JW, Lefferts EC, Brellenthin AG, Lee DC, Kim YM, Kim MK, Choi BY, Kim YS. Associations between relative grip strength and type 2 diabetes mellitus: The Yangpyeong cohort of the Korean genome and epidemiology study. PLoS One 2021; 16:e0256550. [PMID: 34437604 PMCID: PMC8389482 DOI: 10.1371/journal.pone.0256550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/09/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate the association between relative grip strength and the prevalence of type 2 diabetes mellitus (T2DM) independently and in combination with body mass index (BMI) in Korean adults. Methods The cross-sectional study includes 2,811 men and women (age 40 to 92 years old) with no history of heart disease, stroke, or cancer. Relative grip strength was measured by a handheld dynamometer and calculated by dividing absolute grip strength by body weight. Logistic regression analysis was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of T2DM by sex-specific quintiles of relative grip strength. In a joint analysis, participants were classified into 4 groups: “weak (lowest 20% quintile one) and normal weight (BMI <25.0 kg/m2)”, “weak and overweight/obese (BMI ≥25.0 kg/m2)”, “strong (upper 80% four quintiles) and normal weight” or “strong and overweight/obese”. Results Among the 2,811 participants, 371 were identified as having T2DM. Compared with the lowest quintile of relative grip strength (weakest), the ORs (95% CIs) of T2DM were 0.73 (0.53–1.02), 0.68 (0.48–0.97), 0.72 (0.50–1.03), and 0.48 (0.32–0.74) in upper quintiles two, three, four, and five, respectively, after adjusting for BMI and other potential confounders. In the joint analysis, compared with the “weak and overweight/obese” reference group, the odds of T2DM [ORs (95% CIs)] was lower in the “strong and overweight/obese” group [0.65 (0.46–0.92)] and the “strong and normal weight” group [0.49 (0.35–0.67)], after adjusting for potential confounders. Conclusion In this cross-sectional study, greater relative grip strength was associated with a lower prevalence of T2DM independent of BMI in Korean adults. Additional prospective studies are needed to determine whether a causal association exists between relative grip strength and T2DM prevalence considering BMI.
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Affiliation(s)
- Geon Hui Kim
- Department of Physical Education, College of Education, Seoul National University, Seoul, Republic of Korea
| | - Bong Kil Song
- Department of Physical Education, College of Education, Seoul National University, Seoul, Republic of Korea
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, Iowa, United States of America
- * E-mail:
| | - Jung Woon Kim
- Department of Physical Education, College of Education, Seoul National University, Seoul, Republic of Korea
| | - Elizabeth C. Lefferts
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, Iowa, United States of America
| | - Angelique G. Brellenthin
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, Iowa, United States of America
| | - Duck-chul Lee
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, Iowa, United States of America
| | - Yu-Mi Kim
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
- Institute for Health and Society, Hanyang University, Seoul, Republic of Korea
| | - Mi Kyung Kim
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
- Institute for Health and Society, Hanyang University, Seoul, Republic of Korea
| | - Bo Youl Choi
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
- Institute for Health and Society, Hanyang University, Seoul, Republic of Korea
| | - Yeon Soo Kim
- Department of Physical Education, College of Education, Seoul National University, Seoul, Republic of Korea
- Institute of Sports Science, Seoul National University, Seoul, Republic of Korea
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22
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Kim YS, Song BK, Kim GH, Kim JW, Lefferts EC, Lee DC. Association Between Quadriceps Strength And Type 2 Diabetes In Korean Older Adults. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000761268.04887.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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23
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Kim GH, Song BK, Kim JW, Lefferts EC, Brellenthin AG, Lee DC, Kim YS. Associations Between Relative Grip Strength And Type 2 Diabetes Mellitus: The Yangpyeong Cohort Of The KoGES. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000761232.21460.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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24
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Song BK, Saavedra JM, Lefferts EC, Brellenthin AG, Lee DC. Associations Between Cardiorespiratory Fitness And Diverticulitis In Older Adults. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000761212.73947.4e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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25
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Gutierrez-Martinez L, Brellenthin AG, Lefferts EC, Lee DC, Sui X, Lavie CJ, Blair SN. Resting Heart Rate and Risk of Cancer Mortality. Cancer Epidemiol Biomarkers Prev 2021; 30:1072-1078. [PMID: 33827985 PMCID: PMC8172441 DOI: 10.1158/1055-9965.epi-20-1731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/16/2021] [Accepted: 03/26/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Increased resting heart rate (RHR) is a predictor of mortality. RHR is influenced by cardiorespiratory fitness (CRF). Little is known about the combined associations of RHR and CRF on cancer mortality. METHODS 50,108 men and women (mean age 43.8 years) were examined between 1974 and 2002 at the Cooper Clinic in Dallas, Texas. RHR was measured by electrocardiogram and categorized as <60, 60-69, 70-79, or ≥80 beats/minute. CRF was quantified by maximal treadmill test and dichotomized as unfit and fit corresponding to the lower 20% and the upper 80%, respectively, of the age- and sex-specific distribution of treadmill exercise duration. The National Death Index was used to ascertain vital status. Cox regression was used to compute HRs and 95% confidence intervals (CI) for cancer mortality across RHR categories. RESULTS During a mean follow-up of 15.0 ± 8.6 years, 1,090 cancer deaths occurred. Compared with RHR <60 beats/minute, individuals with RHR ≥80 beats/minute had a 35% increased risk of overall cancer mortality (HR, 1.35; 95% CI, 1.06-1.71) after adjusting for confounders, including CRF. Compared with "fit and RHR <80 beats/minute", HRs (95% CI) for cancer mortality were 1.41 (1.20-1.66), 1.51 (1.11-2.04), and 1.78 (1.30-2.43) in "unfit and RHR <80," "fit and RHR ≥80," and "unfit and RHR ≥80 beats/minute," respectively. CONCLUSIONS RHR ≥80 beats/minute is associated with an increased risk of overall cancer mortality. High CRF may help lower the risk of cancer mortality among those with high RHR. IMPACT RHR along with CRF may provide informative data about an individual's cancer mortality risk.
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Affiliation(s)
| | | | | | - Duck-Chul Lee
- Department of Kinesiology, Iowa State University, Ames, Iowa
| | - Xuemei Sui
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, Louisiana
| | - Steven N Blair
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
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Lefferts EC, Rosenberg AJ, Grigoriadis G, Wee SO, Kerber S, Fent KW, Horn GP, Smith DL, Fernhall B. Firefighter hemodynamic responses to different fire training environments. Vasc Med 2021; 26:240-246. [PMID: 33606968 PMCID: PMC8170364 DOI: 10.1177/1358863x20987608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Firefighting is associated with an increased risk for a cardiovascular (CV) event, likely due to increased CV strain. The increase in CV strain during firefighting can be attributed to the interaction of several factors such as the strenuous physical demand, sympathetic nervous system activation, increased thermal burden, and the environmental exposure to smoke pollutants. Characterizing the impact of varying thermal burden and pollutant exposure on hemodynamics may help understand the CV burden experienced during firefighting. The purpose of this study was to examine the hemodynamic response of firefighters to training environments created by pallets and straw; oriented strand board (OSB); or simulated fire/smoke (fog). Twenty-three firefighters had brachial blood pressure measured and central blood pressure and hemodynamics estimated from the pressure waveform at baseline, and immediately and 30 minutes after each scenario. The training environment did not influence the hemodynamic response over time (interaction, p > 0.05); however, OSB scenarios resulted in higher pulse wave velocity and blood pressure (environment, p < 0.05). In conclusion, conducting OSB training scenarios appears to create the largest arterial burden in firefighters compared to other scenarios in this study. Environmental thermal burden in combination with the strenuous exercise, and psychological and environmental stress placed on firefighters should be considered when designing fire training scenarios and evaluating CV risk.
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Affiliation(s)
- Elizabeth C Lefferts
- Department of Kinesiology &
Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Alexander J Rosenberg
- Department of Kinesiology &
Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Georgios Grigoriadis
- Department of Kinesiology &
Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Sang Ouk Wee
- Department of Kinesiology, California
State University San Bernardino, San Bernardino, CA, USA
| | - Stephen Kerber
- UL Firefighter Safety Research
Institute, Columbia, MD, USA
| | - Kenneth W Fent
- National Institute for Occupational
Safety & Health, Cincinnati, OH, USA
| | - Gavin P Horn
- UL Firefighter Safety Research
Institute, Columbia, MD, USA
- Fire Service Institute, University of
Illinois, Urbana-Champaign, IL, USA
| | - Denise L Smith
- Fire Service Institute, University of
Illinois, Urbana-Champaign, IL, USA
- Department of Health and Human
Physiological Sciences, Skidmore College, Saratoga Springs, NY, USA
| | - Bo Fernhall
- Department of Kinesiology &
Nutrition, University of Illinois at Chicago, Chicago, IL, USA
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27
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Lefferts WK, Lefferts EC, Hibner BA, Smith KJ, Fernhall B. Impact of acute changes in blood pressure and arterial stiffness on cerebral pulsatile haemodynamics in young and middle-aged adults. Exp Physiol 2021; 106:1643-1653. [PMID: 33938052 DOI: 10.1113/ep089319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/28/2021] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Does cerebrovascular pulsatility respond differently to acute increases in arterial stiffness in middle-aged compared with young adults? What is the main finding and its importance? Compared with young adults, middle-aged adults exhibited similar changes in cerebral pulsatile damping despite attenuated changes in carotid diameter and cerebrovascular pulsatility during blood pressure-dependent, but not blood pressure-independent, increases in large artery stiffness. ABSTRACT Acute manipulation of arterial stiffness through interventions that increase sympathetic activity might provoke cerebral pulsatility and damping and reveal whether cerebrovascular haemodynamics respond differently to transient elevations in arterial stiffness in middle-aged compared with young adults. We compared cerebral pulsatility and damping in middle-aged versus young adults during two different sympathetic interventions [cold pressor test (CP) and lower-body negative pressure (LBNP)] that increase arterial stiffness acutely. Cerebrovascular haemodynamics were assessed in 15 middle-aged (54 ± 7 years old; 11 female) and 15 sex-matched young adults (25 ± 4 years old) at rest and during the CP test (4 min, 6.4 ± 0.8°C) and LBNP (6 min, -20 mmHg). Mean blood pressure was measured continuously via finger photoplethysmography. Carotid-femoral pulse wave velocity (cfPWV) and carotid stiffness were measured via tonometry and ultrasound. Blood velocity pulsatility index (PI) was measured at the middle cerebral (MCA) and common carotid artery (CCA) using Doppler, with pulsatile damping calculated as CCA PI divided by MCA PI. Increases in cfPWV were driven by changes in mean pressure during CP but not during LBNP in both groups (P < 0.05). Pulsatile damping decreased in both groups (P < 0.05) despite reductions in MCA PI and greater carotid dilatation during CP in young compared with middle-aged adults (P < 0.05). Pressure-independent increases in cfPWV during LBNP did not alter pulsatile damping but decreased MCA PI in both young and middle-aged adults (P < 0.05). These data suggest that changes in carotid diameter and cerebrovascular pulsatility differ between young and middle-aged adults despite similar changes in cerebral pulsatile damping during blood pressure-dependent, but not blood pressure-independent, increases in large artery stiffness.
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Affiliation(s)
- Wesley K Lefferts
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA.,Department of Kinesiology, Iowa State University, Ames, Iowa, USA
| | - Elizabeth C Lefferts
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Brooks A Hibner
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kurt J Smith
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Bo Fernhall
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
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28
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Bunsawat K, Lefferts EC, Grigoriadis G, Wee SO, Kilianek MM, Fadel PJ, Clifford PS, Fernhall BO, Baynard T. Central and Peripheral Postexercise Blood Pressure and Vascular Responses in Young Adults with Obesity. Med Sci Sports Exerc 2021; 53:994-1002. [PMID: 33060547 DOI: 10.1249/mss.0000000000002540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Adults with obesity are at an increased risk of incident hypertension. Regular aerobic exercise is recommended for the prevention and treatment of hypertension, but whether young adults with obesity exhibit impaired postexercise blood pressure (BP) and vascular responses remains unclear. PURPOSE We tested the hypothesis that young adults with obesity exhibit attenuated postexercise hypotension (PEH) and postexercise peripheral vasodilation compared with young adults without obesity. METHODS Thirty-six normotensive adults without and with obesity (11 men and 7 women per group) underwent measurements of brachial and central BP, and leg blood flow (Doppler ultrasound) at baseline and at 30, 60, and 90 min after acute 1-h moderate-intensity cycling. Leg vascular conductance (LVC) was calculated as flow/mean arterial pressure. RESULTS Both groups exhibited similar brachial and central PEH (peak change from baseline, -2 and -4 mm Hg for brachial and central systolic BPs, respectively, for both groups; time effect, P < 0.05). Both groups also exhibited postexercise peripheral vasodilation, assessed via LVC (time effect, P < 0.05), but its overall magnitude was smaller in young adults with obesity (LVC change from baseline, +47% ± 37%, +29% ± 36%, and +20% ± 29%) compared with young adults without obesity (LVC change from baseline, +88% ± 58%, +59% ± 54%, and +42% ± 51%; group effect, P < 0.05). CONCLUSIONS Although obesity did not impair PEH after acute moderate-intensity exercise, young adults with obesity exhibited smaller postexercise peripheral vasodilation compared with young adults without obesity. Collectively, these findings have identified evidence for obesity-induced alterations in the peripheral vasculature after exercise.
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Affiliation(s)
| | - Elizabeth C Lefferts
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
| | - Georgios Grigoriadis
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
| | | | - Melissa M Kilianek
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
| | - Paul J Fadel
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX
| | - Philip S Clifford
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
| | - B O Fernhall
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
| | - Tracy Baynard
- Integrative Physiology Laboratory, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
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29
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Hilgenkamp TIM, Lefferts EC, White DW, Baynard T, Fernhall B. Blunted autonomic response to standing up and head-up tilt in individuals with intellectual disabilities. J Appl Physiol (1985) 2021; 130:1778-1785. [PMID: 33914659 DOI: 10.1152/japplphysiol.00328.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Previous research suggests individuals with intellectual disabilities (ID) may experience autonomic dysfunction, however, this has not been thoroughly investigated. The aim of this study was to compare the autonomic response to standing up (active orthostasis) and head-up tilt (passive orthostasis) in individuals with ID to a control group without ID. Eighteen individuals with and 18 individuals without ID were instrumented with an ECG-lead and finger-photoplethysmography for continuous heart rate and blood pressure recordings. The active and passive orthostasis protocol consisted of 10-min supine rest, 10-min standing, 10-min supine recovery, 5-min head-up tilt at 70°, followed by 10-min supine recovery. The last 5 min of each position was used to calculate hemodynamic and autonomic function (time- and frequency-domain heart rate and blood pressure variability measures and baroreflex sensitivity). Individuals with ID had higher heart rate during baseline and recovery (P < 0.05), and an attenuated hemodynamic (stroke volume, heart rate) and heart rate variability response to active and passive orthostasis (interaction effect P < 0.05) compared with individuals without ID. Mean arterial pressure (MAP) was higher in individuals with ID at all timepoints. Individuals with ID demonstrated altered hemodynamic and autonomic regulation compared with a sex- and age-matched control group, evidenced by a higher mean arterial pressure and a reduced response in parasympathetic modulation to active and passive orthostasis.NEW & NOTEWORTHY Individuals with ID demonstrated altered hemodynamic and autonomic regulation to the clinical autonomic function tasks standing up and head-up tilt (active and passive orthostasis). Higher resting heart rate and higher MAP throughout the protocol suggest a higher arousal level, and individuals with ID showed a blunted response in parasympathetic modulation. Further research should investigate the relationship of these findings with clinical outcomes.
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Affiliation(s)
- Thessa I M Hilgenkamp
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois.,Chair of Intellectual Disability Medicine, Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Elizabeth C Lefferts
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois
| | - Daniel W White
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois
| | - Tracy Baynard
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois
| | - Bo Fernhall
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, Illinois
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30
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Beck VDY, Baynard T, Lefferts EC, Hibner BA, Fernhall B, Hilgenkamp TIM. Anthropometry does not fully explain low fitness among adults with Down syndrome. J Intellect Disabil Res 2021; 65:373-379. [PMID: 33458913 DOI: 10.1111/jir.12815] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/02/2020] [Accepted: 12/18/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Cardiorespiratory fitness, expressed as peak oxygen uptake during exercise (VO2 peak), is an important predictor of cardiovascular health and is related to anthropometry in the general population. Individuals with Down syndrome (DS) have reduced cardiorespiratory fitness and often exhibit different anthropometrics compared with the general population. Interestingly, the relation between anthropometry and cardiorespiratory fitness found in the general population is not apparent in individuals with DS. However, accurate measures with dual energy X-ray absorptiometry (DEXA) scan have not been used to investigate this relationship in this population. The purpose of this paper was to investigate the relationship between accurate measures of anthropometry and cardiorespiratory fitness in adults with DS compared with an age-matched and sex-matched control group. METHODS Anthropometrics (height, weight, waist and hip circumference, body composition via DEXA) and cardiorespiratory fitness (VO2 peak, measured during a graded maximal exercise test) were assessed in adults with (n = 9; 25 ± 3 years; 6 male patients) and without DS (n = 10, 24 ± 4 years; 5 male patients). RESULTS Participants with DS were shorter (P < 0.01) than without DS and had a higher body mass index (P < 0.01), waist circumference (WC) (P = 0.026) and waist/height ratio (WHtR) (P < 0.01), but similar weight, body surface area (BSA), waist/hip ratio and body composition (P > 0.05). Participants with DS had significantly lower relative VO2 peak and VO2 peak corrected for total lean mass (TLM), but similar absolute VO2 peak, compared with without DS. In participants with DS, only WC and WHtR were associated with VO2 peak, whereas in participants without DS, height, weight, BSA, TLM, leg lean mass and body fat percentage were associated with VO2 peak. CONCLUSIONS These results suggest that the relation between anthropometry and cardiorespiratory fitness found in the general population is not the same in adults with DS and that anthropometrics do not fully explain cardiorespiratory fitness in adults with DS. Further research into potential alternative explanations is required.
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Affiliation(s)
- V D Y Beck
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, IL, USA
- Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - T Baynard
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, IL, USA
| | - E C Lefferts
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, IL, USA
| | - B A Hibner
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, IL, USA
| | - B Fernhall
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, IL, USA
| | - T I M Hilgenkamp
- Integrative Physiology Laboratory, University of Illinois at Chicago, Chicago, IL, USA
- Department of Physical Therapy, University of Nevada, Las Vegas, NV, USA
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31
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Lefferts EC, Bakker EA, Carbone S, Lavie CJ, Lee DC. Associations of total and aerobic steps with the prevalence and incidence of frailty in older adults with hypertension. Prog Cardiovasc Dis 2021; 67:18-25. [PMID: 33640357 DOI: 10.1016/j.pcad.2021.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 02/16/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To examine the associations of total steps/day and faster aerobic steps/day (≥60 steps/min) with the development of frailty in older adults with hypertension (HTN) using a two-phased cross-sectional and prospective approach. METHODS The sample consisted of 427 older adults with HTN from the Physical Activity and Aging Study (PAAS), aged ≥65 years, with valid step data from an accelerometer-based pedometer. Participants were classified into tertiles of total steps/day (low, mid, high) and three categories of aerobic steps/day (none, low, high). Frailty was defined using a modified Fried score with 5 subdomains including shrinking, weakness, slowness, low physical activity (PA), and exhaustion. RESULTS We observed a negative dose-response relationship across categories of total steps/day and aerobic steps/day for the prevalence of frailty and the subdomains of slowness, low PA, and exhaustion (all p for trends <0.05). Greater aerobic steps/day, but not total steps/day, was associated with lower incidence of developing frailty in the 241 participants with a follow-up examination who had no frailty at baseline. CONCLUSION Higher aerobic steps/day were more strongly associated with the lower prevalence and incidence of frailty compared to total steps/day, suggesting that faster aerobic walking may potentially provide greater benefits regarding frailty in older adults with HTN.
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Affiliation(s)
- Elizabeth C Lefferts
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, IA, United States
| | - Esmée A Bakker
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands; Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Salvatore Carbone
- Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, United States; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA, United States
| | - Carl J Lavie
- Pauley Heart Center, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Duck-Chul Lee
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, IA, United States.
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