1
|
Sjúrðarson T, Bejder J, Breenfeldt Andersen A, Bonne T, Kyhl K, Róin T, Patursson P, Oddmarsdóttir Gregersen N, Skoradal M, Schliemann M, Lindegaard M, Weihe P, Mohr M, Nordsborg NB. Effect of angiotensin-converting enzyme inhibition on cardiovascular adaptation to exercise training. Physiol Rep 2022; 10:e15382. [PMID: 35822425 PMCID: PMC9277514 DOI: 10.14814/phy2.15382] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/11/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023] Open
Abstract
Angiotensin-converting enzyme (ACE) activity may be one determinant of adaptability to exercise training, but well-controlled studies in humans without confounding conditions are lacking. Thus, the purpose of the present study was to investigate whether ACE inhibition affects cardiovascular adaptations to exercise training in healthy humans. Healthy participants of both genders (40 ± 7 years) completed a randomized, double-blind, placebo-controlled trial. Eight weeks of exercise training combined with placebo (PLA, n = 25) or ACE inhibitor (ACEi, n = 23) treatment was carried out. Before and after the intervention, cardiovascular characteristics were investigated. Mean arterial blood pressure was reduced (p < 0.001) by -5.5 [-8.4; -2.6] mmHg in ACEi , whereas the 0.7 [-2.0; 3.5] mmHg fluctuation in PLA was non-significant. Maximal oxygen uptake increased (p < 0.001) irrespective of ACE inhibitor treatment by 13 [8; 17] % in ACEi and 13 [9; 17] % in PLA. In addition, skeletal muscle endurance increased (p < 0.001) to a similar extent in both groups, with magnitudes of 82 [55; 113] % in ACEi and 74 [48; 105] % in PLA. In contrast, left atrial volume decreased (p < 0.05) by -9 [-16; -2] % in ACEi , but increased (p < 0.01) by 14 [5; 23] % in PLA. Total hemoglobin mass was reduced (p < 0.01) by -3 [-6; -1] % in ACEi , while a non-significant numeric increase of 2 [-0.4; 4] % existed in PLA. The lean mass remained constant in ACEi but increased (p < 0.001) by 3 [2; 4] % in PLA. In healthy middle-aged adults, 8 weeks of high-intensity exercise training increases maximal oxygen uptake and skeletal muscle endurance irrespective of ACE inhibitor treatment. However, ACE inhibitor treatment counteracts exercise training-induced increases in lean mass and left atrial volume. ACE inhibitor treatment compromises total hemoglobin mass.
Collapse
Affiliation(s)
- Tórur Sjúrðarson
- Center of Health Science, Faculty of Health ScienceUniversity of the Faroe IslandsTórshavnFaroe Islands
- Department of Nutrition, Exercise, and Sports (NEXS)University of CopenhagenCopenhagenDenmark
| | - Jacob Bejder
- Department of Nutrition, Exercise, and Sports (NEXS)University of CopenhagenCopenhagenDenmark
| | | | - Thomas Bonne
- Department of Nutrition, Exercise, and Sports (NEXS)University of CopenhagenCopenhagenDenmark
| | - Kasper Kyhl
- Department of Cardiology at Copenhagen University Hospital RigshospitaletCopenhagenDenmark
| | - Tóra Róin
- Center of Health Science, Faculty of Health ScienceUniversity of the Faroe IslandsTórshavnFaroe Islands
| | - Poula Patursson
- Department of Surgery, The Faroese Hospital SystemTórshavnFaroe Islands
| | | | - May‐Britt Skoradal
- Center of Health Science, Faculty of Health ScienceUniversity of the Faroe IslandsTórshavnFaroe Islands
| | - Michael Schliemann
- Department of Nutrition, Exercise, and Sports (NEXS)University of CopenhagenCopenhagenDenmark
| | - Malte Lindegaard
- Department of Nutrition, Exercise, and Sports (NEXS)University of CopenhagenCopenhagenDenmark
| | - Pál Weihe
- Center of Health Science, Faculty of Health ScienceUniversity of the Faroe IslandsTórshavnFaroe Islands
- Department of Occupational Medicine and Public HealthThe Faroese Hospital SystemTórshavnFaroe Islands
| | - Magni Mohr
- Center of Health Science, Faculty of Health ScienceUniversity of the Faroe IslandsTórshavnFaroe Islands
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC)Faculty of Health Sciences, University of Southern DenmarkOdenseDenmark
| | - Nikolai B. Nordsborg
- Department of Nutrition, Exercise, and Sports (NEXS)University of CopenhagenCopenhagenDenmark
| |
Collapse
|
2
|
Patursson P, Møller G, Thomsen BB, Olsen E, Mortensen J, Andorsdóttir G, Mohr M, Andersen JR. Effects of Postdischarge High-Protein Oral Nutritional Supplements and Resistance Training in Malnourished Surgical Patients: A Pilot Randomized Controlled Trial. Nutrients 2022; 14:nu14132599. [PMID: 35807780 PMCID: PMC9268632 DOI: 10.3390/nu14132599] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/17/2022] [Accepted: 06/19/2022] [Indexed: 02/04/2023] Open
Abstract
The presence of malnutrition is increasingly becoming a postdischarge problem in surgical patients. We aimed to investigate whether oral nutritional supplements combined with resistance training could minimize skeletal muscle atrophy in surgical patients after discharge. This randomized controlled study was conducted at the Department of Surgery, National Hospital of Faroe Islands from 2018 to 2020. A total of 45 patients aged 37−74 years participated and were allocated to one of three groups: diet (DI; n = 13), exercise and diet (EX + DI; n = 16), or control (CON; n = 16). The intervention period lasted 8 weeks. The intervention groups received individual dietary counselling and a protein-rich oral nutritional supplement twice a day containing 22 g of protein/day. Patients in the EX + DI group were assigned to resistance training sessions. Patients in the CON group received standard care. The primary outcome was change in lean body mass (LBM). Secondary outcomes were change in body weight, handgrip strength, quality of life, surgery-related side effects, energy and protein intake, length of stay and one-year mortality. To estimate within-group changes, linear mixed models including group−time interactions as fixed effects and patients as random effects were fitted. Within-group change in LBM was 233, 813 and 78 g in the DI, EX + DI and CON groups, respectively, with no significant between-group difference (p > 0.05). Pain score declined more (p = 0.04) in the EX + DI group compared with the CON group. Body weight, handgrip strength, quality of life and surgery-related side effects did not differ between groups. At the end of study, mean cumulative weight change in the DI and EX + DI groups was 0.4% and 1.6%, respectively, whereas the CON group experienced a weight loss of −0.6%. No significant difference in primary outcome between groups was noted. However, our results indicate some benefits from exercise and nutrition for malnourished surgical patients.
Collapse
Affiliation(s)
- Poula Patursson
- Department of Surgery, National Hospital of the Faroe Islands, J.C. Svabosgøta 41–49, 100 Torshavn, Faroe Islands;
- Correspondence:
| | - Grith Møller
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark; (G.M.); (J.R.A.)
| | - Bjartur Bernhardson Thomsen
- Department of Occupational and Physiotherapy, National Hospital of the Faroe Islands, J.C. Svabosgøta 41–49, 100 Torshavn, Faroe Islands;
| | - Eyðfinnur Olsen
- Department of Surgery, National Hospital of the Faroe Islands, J.C. Svabosgøta 41–49, 100 Torshavn, Faroe Islands;
| | - Jann Mortensen
- Department of Clinical Physiology, Nuclear Medicine & PET, Centre of Diagnostic Investigation, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark;
| | - Guðrið Andorsdóttir
- The Genetic Biobank of the Faroes, J.C. Svabosgøta 43, 100 Torshavn, Faroe Islands;
| | - Magni Mohr
- Centre of Health Sciences, Faculty of Health, University of the Faroe Islands, Vestara Bryggja 15, 100 Torshavn, Faroe Islands;
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
| | - Jens Rikardt Andersen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark; (G.M.); (J.R.A.)
| |
Collapse
|
3
|
Berbisá MÁF, Nielsen KR, Ingham AC, Midjord J, Hammer T, Patursson P, Vest NMO, Gregersen NO, Burisch J, Vang A. Similar Gut Bacterial Composition Between Patients With Ulcerative Colitis and Healthy Controls in a High Incidence Population: A Cross-sectional Study of the Faroe Islands IBD Cohort. Inflamm Bowel Dis 2022; 28:1081-1089. [PMID: 35138361 PMCID: PMC9247847 DOI: 10.1093/ibd/izab355] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The Faroe Islands has the world's highest incidence of inflammatory bowel disease (IBD). Epidemiological studies have characterized this unique cohort and a decreased risk of developing IBD with emigration. Therefore, this well-characterized Faroese IBD cohort gives the opportunity to better understand this complex disease. This study represents the first investigation of the gut microbiota for the cohort. METHODS This cross-sectional study consisted of 41 patients with established ulcerative colitis and 144 age- and sex-matched healthy controls recruited through the Faroe Genome project. Participants donated a 1-time fecal sample and completed questionnaires on food frequency, background health, and lifestyle. 16S rRNA amplicon sequencing of the V3-V4 region was performed followed by bioinformatic analysis of taxonomy and diversity metrics. RESULTS The overall bacterial composition in both groups was dominated by Firmicutes and Bacteroidetes. No significant differences were found based on metrics of alpha or beta diversity. However, discriminatory analysis identified differential abundance of several indicator taxa in healthy controls and ulcerative colitis participants, whereas Akkermansia was completely absent from 27% of all study participants. Food frequency questionnaires revealed similar dietary patterns between the 2 groups. CONCLUSION The similarity in bacterial community composition and absence of the beneficial Akkermansia genus in both groups raise further questions concerning the underlying susceptibility toward inflammatory disorders within this high-risk population. Results vary widely by study design and geographic location, which speaks to the need for regionally tuned reference groups and disease-based studies on the Faroe Islands.
Collapse
Affiliation(s)
- Marjun á Fríðirksmørk Berbisá
- Department of Science and Technology, Aarhus University, Aarhus, Denmark,Department of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Kári Rubek Nielsen
- Department of Medicine, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | - Anna Cäcilia Ingham
- Department of Bacteria, Parasites, and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Jóngerð Midjord
- Department of Medicine, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | - Turið Hammer
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands
| | - Poula Patursson
- Department of Medicine, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | - Nicolina M O Vest
- Department of Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Noomi O Gregersen
- FarGen Project, Genetic Biobank of the Faroe Islands, Tórshavn, Faroe Islands
| | | | - Amanda Vang
- Address correspondence to: Amanda Vang, PhD, Hoyvíksvegur 51, 100 Tórshavn, Faroe Islands ()
| |
Collapse
|
4
|
Patursson P, Møller G, Muhic A, Andersen JR. N-3 fatty acid EPA supplementation in cancer patients receiving abdominal radiotherapy - A randomised controlled trial. Clin Nutr ESPEN 2021; 43:130-136. [PMID: 34024504 DOI: 10.1016/j.clnesp.2021.03.001] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND & AIMS Malnutrition occurs frequently in patients with cancer during and after radiotherapy to the gastrointestinal (GI) and pelvic area and can lead to negative outcomes. N-3 fatty acids from fish, especially eicosapentaenoic acid (EPA) may possess anticachectic properties. The aim of this study was to investigate the effect of two nutritional interventions; dietary counselling and a daily oral nutritional supplement (ONS) containing 33.8 g of protein and 2.2 g EPA and 1.1 g docosahexaenoic acid (DHA) or standard care, including dietary counselling and protein supplementation when needed. METHODS Outpatients commencing radiotherapy to the GI area were randomized to receive dietary counselling and daily supplementation over a 5-7-week period or standard care. Outcome parameters were measured at baseline (onset of radiotherapy), week 5, and 12 weeks after commencing radiotherapy, with one additional measurement of body weight at week 2. Quality of life (QoL) was measured using the EORTC QLQ-C30 questionnaire. Radiotherapy-related side effects were assessed using a questionnaire developed specifically for this study. Data from a historical control group collected in a previous observational study were included in this study to compare incidence of weight loss. RESULTS In total, 30 patients were recruited to this study and 26 patients were enrolled and randomised. The rate of withdrawals was 7.7% at week 2, 15.4% at week 5, and 19.2% at week 12. In total, 22 patients completed the intervention. All the patients in the ONS-group and 85% in the control group experienced weight-loss. Using the intention to treat principle, there were no significant differences between groups in any of the outcomes. All patients experienced side effects. Five out of 11 patients consumed more than 75% of prescribed dose of the fish oil enriched oral nutritional supplement. Post hoc analysis showed that at week 2 the weight changed in high-compliant patients was +1.7% (1.0-2.6) compared with -0.7% (-2.8 to -0.1) in low compliant patients (p < 0,01). The results indicated a dose-response relationship, as correlation analysis recovered a significant positive correlation between weight change and compliance to the fish oil enriched nutritional supplement at both week 2 and 5 (p < 0.05 and p < 0.01, respectively), but not at week 12, indicating a dose-response relationship during radiotherapy but not after. The proportion of patients experiencing weight loss throughout the study period was higher in this study (84.2%) than in the historical control group (73%) (p<0.05%). CONCLUSION This study showed no effect from dietary counselling and intended protein/fish-oil supplementation on weight loss, quality of life, and nutritional intake, micronutrient status in plasma or radiotherapy-related side effects compared to the control group. However, the compliance to the fish oil enriched oral nutritional supplement was low. Post hoc analysis of dose-response relations indicate a positive correlation between the compliance and the ability to reduce weight loss in cancer patients during radiotherapy treatment. TRIAL REGISTRATION CLINICALTRIALS. GOV IDENTIFIER NCT04687124.
Collapse
Affiliation(s)
- Poula Patursson
- Department of Surgery, The National Hospital of the Faroe Islands, J.C. Svabosgøta 41-49, 100, Tórshavn, Faroe Islands.
| | - Grith Møller
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark.
| | - Aida Muhic
- Department of Oncology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
| | - Jens Rikardt Andersen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark.
| |
Collapse
|
5
|
Skoradal MB, Weihe P, Patursson P, Mortensen J, Connolly L, Krustrup P, Mohr M. Football training improves metabolic and cardiovascular health status in 55- to 70-year-old women and men with prediabetes. Scand J Med Sci Sports 2018; 28 Suppl 1:42-51. [PMID: 29718556 DOI: 10.1111/sms.13081] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 01/04/2023]
Abstract
We examined the effects of 16 weeks of football training and dietary advice on blood glucose control and health status in 55- to 70-year-old women and men with prediabetes. Fifty participants with prediabetes (age; 61 ± 6 years, BMI; 29.6 ± 4.7; VO2max 22.3 ± 5.7 mL·min-1 ·kg-1 ) were randomized into a football and dietary advice group (F+D; n = 27) and a dietary advice group (D; n = 23). F+D performed football training (twice weekly 30- to 60-minutes sessions) and received dietary advice, while D only received dietary advice. An oral glucose tolerance test (OGTT) was completed pre and post the 16-week period. Body composition, blood pressure, and maximal oxygen uptake (VO2max ) were additionally measured. Both groups demonstrated a decrement (P < .05) in fasting blood glucose (-0.4 ± 0.5 mmol·L-1 ) and lowered blood glucose throughout OGTT. F+D displayed lower values than D (P < .05) after 60 minutes (9.0 ± 2.7 vs 10.6 ± 2.9 mmol·L-1 ) and 120 minutes (5.7 ± 1.6 vs 7.5 ± 2.4 mmol·L-1 ). VO2max increased by 14% in F+D, with a higher (P < .05) change score than in D (2%). Mean arterial pressure declined more (P < .05) in F+D than in D (-8 ± 9 vs -4 ± 11 mm Hg). Fat loss was greater (P < .05) in F+D than in D (-3.4 ± 2.8 vs -1.2 ± 2.0 kg), and the increase in lean body mass was also greater (P < .05) in F+D than in D (0.7 ± 1.5 vs -0.3 ± 1.6 kg). In conclusion, football training combined with dietary advice has broad-spectrum effects on metabolic and cardiovascular health profile with greater overall effects than professional dietary advice per se for 55- to 70-year-old women and men with prediabetes.
Collapse
Affiliation(s)
- M-B Skoradal
- Faculty of Health Sciences, Centre of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - P Weihe
- Faculty of Health Sciences, Centre of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands.,Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands
| | - P Patursson
- Faculty of Health Sciences, Centre of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands.,Department of Medicine, The Faroese National Hospital, Tórshavn, Faroe Islands
| | - J Mortensen
- Department of Medicine, The Faroese National Hospital, Tórshavn, Faroe Islands.,Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - L Connolly
- Sport and Health Sciences, University of Exeter, Exeter, UK
| | - P Krustrup
- Sport and Health Sciences, University of Exeter, Exeter, UK.,Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - M Mohr
- Faculty of Health Sciences, Centre of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands.,Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Department of Food and Nutrition, and Sport Science, Center for Health and Human Performance, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
6
|
Patursson P, Andorsdottir G, Gaardbo I, A Rogvi Joensen G, Nielsen S, Rubek Nielsen K, Gaini S. PP270-MON: Self Reported Food Intake and Patient Satisfaction with Food: A Cross-Sectional Study in Faroe Islands. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50604-8] [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: 10/24/2022]
|
7
|
Haugaard LK, Lund AM, Patursson P, Christensen E. [Fish odour--could be a sign of trimethylaminuria]. Ugeskr Laeger 2010; 172:3268-3269. [PMID: 21092725] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We present a case with a ten-year-old girl with trimethylaminuria (TMAU). Primary TMAU is caused by a deficiency of flavin monooxygenase 3 (FMO3) due to mutations in the FMO3-gene. Patients suffering from TMAU show an impaired enzymatic oxidation of fish-smelling trimethylamine, and their excretion of this amine in body fluids produces an unpleasant body odour. TMAU is also seen secondary to e.g. liver diseases. It remains unknown if TMAU causes other problems than malodour, and today social and psychological problems are considered the most important consequence. Treatment includes a low-choline diet and antibiotics.
Collapse
|