Physical activity and weight loss following bariatric surgery

Physical activity is a cornerstone in the medical management of obesity and could be important for weight loss following bariatric surgery. This review aims to describe the evolution of physical activity following massive weight loss induced by bariatric surgery, and to identify the relationship between physical activity and amount of weight loss. A literature search identified 20 publications (19 studies) reporting physical activity data in relation to bariatric surgery. All studies were observational. Self‐assessment of physical activity was used in all the studies. Objective measures (pedometry) were used in two studies. The time frame for physical activity assessment varied: before surgery in two publications, after surgery in nine, and longitudinal pre‐ to post‐operative evolution in nine. The latter nine publications found an increase in physical activity after bariatric surgery. In 10/13 studies where it was described, there was a positive relationship between physical activity level and amount of weight loss. In conclusion, observational evidence of self‐reported physical activity suggests that physical activity increases after bariatric surgery and that physical activity is associated with surgically induced weight loss. However, these findings warrant further evaluation using objective measures of physical activity and testing in controlled trials.     

Effects of whey protein nutritional supplement on muscle function among community-dwelling frail older people: A multicenter study in China

BackgroundFrailty, featured by the presence of fatigue, weight loss, decrease in grip strength, decline gait speed and reduced activities substantially increase the risk of falls, disability, hospitalizations, and mortality of older people. Nutritional supplementation and resistance exercise may improve muscle function and reverse frailty status.ObjectiveTo evaluate whether whey protein supplements can improve muscle function of frail older people in addition to resistance exercise.Methods115 community-dwelling older adults who met the Fried's criteria for frailty from four hospitals’ out-patients clinic in Beijing, China completed the study. It's a case–control study which whey protein was used as daily supplementation for 12 weeks for active group and regular resistance exercise for active group and control group. Handgrip strength, gait speed, chair-stand test, balance score, and SPPB score were compared in both groups during the 12-week follow-up.ResultsOverall, 115 subjects were enrolled for study with 66 in active group and 49 in control group. Handgrip strength, gait speed, and chair-stand time were all significantly improved in both groups with significant between-group differences. The active group improved significantly in handgrip strength compared with the control group, which between-group effect (95% confidence interval) for female was 0.107 kg (0.066–0.149), p = 0.008 and for male was 0.89 kg (0.579–1.201), p = 0.007. For chair-stand time, between-group effect (95% confidence interval) was −2.875 s (−3.62 to −2.124), p = 0.004 and for gait speed, between-group effect (95% confidence interval) was 0.109 m/s (0.090 to 0.130), p = 0.003.ConclusionsThe 12-week intervention of whey protein oral nutritional supplement revealed significant improvements in muscle function among the frailty elderly besides aiding with resistance exercise. These results warrant further investigations into the role of a multi-modal supplementation approach which could prevent adverse outcomes among frailty elderly at risk for various disabilities.     

Added Value of Physical Performance Measures in Predicting Adverse Health-Related Events: Results from the Health, Aging and Body Composition Study

OBJECTIVES: To determine how three different physical performance measures (PPMs) combine for added utility in predicting adverse health events in elders.
DESIGN: Prospective cohort study.
SETTING: Health, Aging and Body Composition Study.
PARTICIPANTS: Three thousand twenty-four well-functioning older persons (mean age 73.6).
MEASUREMENTS: Timed gait, repeated chair stands, and balance (semi- and full-tandem, and single leg stands each held for 30 seconds) tests were administered at baseline. Usual gait speed was categorized to distinguish high- and low-risk participants using the previously established 1-m/s cutpoint. The same population-percentile (21.3%) was used to identify cutpoints for the repeated chair stands (17.1 seconds) and balance (53.0 seconds) tests. Cox proportional hazard analyses were performed to evaluate the added value of PPMs in predicting mortality, hospitalization, and (severe) mobility limitation events over 6.9 years of follow-up.
RESULTS: Risk estimates for developing adverse health-related events were similarly large for each of the three high-risk groups considered separately. Having more PPM scores at the high-risk level was associated with a greater risk of developing adverse health-related events. When all three PPMs were considered, having only one poor performance was sufficient to indicate a highly significantly higher risk of (severe) lower extremity and mortality events.
CONCLUSION: Although gait speed is considered to be the most important predictor of adverse health events, these findings demonstrate that poor performance on other tests of lower extremity function are equally prognostic. This suggests that chair stand and standing balance performance may be adequate substitutes when gait speed is unavailable.     

Effect of short-term isometric handgrip training on blood pressure in middle-aged females

Objective

To determine the effect of isometric handgrip training on blood pressure (BP) in middle-aged women (47.88 ± 1.8 years).

Methods

Isometric handgrip training was performed over five consecutive days. In each session, the treatment group (n = 9) performed four isometric contractions of 45 seconds each at 30% of their maximal grip strength. The control group (n = 9) sat for 15 minutes without exercising, for five consecutive days. Resting systolic (SBP) and diastolic blood pressure (DBP) were measured pre- and post-intervention. Data were analysed using a two-factor ANOVA (p ≤ 0.05).

Results

Blood pressure readings were reduced in both groups (SBP: p = 0.036; DBP: p = 0.0079), however there was no interaction effect for SBP or DBP.

Conclusions

The findings suggest that 15 minutes of sitting per day for five consecutive days is just as effective as isometric handgrip training for reducing BP levels. Future research is required to investigate the optimal isometric handgrip training stimulus required to reduce resting BP levels.     

Physical activity intervention improved the number and functionality of endothelial progenitor cells in low birth weight children

Background and aimsThe purpose of this study was to investigate whether an intervention with physical activity (PA) would promote positive effects on the angiogenic factors, mobilization, and functionality of circulating endothelial progenitor cells (EPCs) in children with low birth weight (LBW).Methods and resultsThirty-five children participated in a 10-week PA program (intensity: 75–85% of heart rate reserve, frequency: four times/week, and duration: 45 min). Before and after the PA program, we evaluated anthropometric parameters, blood pressure levels, biochemical profile, number of EPCs, number of EPC colony forming units, and plasma levels of vascular endothelial growth factor-A (VEGF-A), nitric oxide (NO), and matrix metalloproteinases (MMPs) 2 and 9. We found a significant main effect of the PA program on waist circumference (η_p² = 0.489), cardiorespiratory fitness (η_p² = 0.463), and MMP-9 (η_p² = 0.582). Birth weight or the PA program produced significant independent effects on systolic blood pressure (birth weight: η_p² = 0.431; PA program: η_p² = 0.615) and EPC colony forming units (birth weight: η_p² = 0.541; PA program: η_p² = 0.698) with no significant interactions. The combination of birth weight and the PA program produced a significant interaction effect on the number of circulating EPCs (η_p² = 0.123), NO (η_p² = 0.258), and VEGF-A (η_p² = 0.175). The variation in the number of EPCs from baseline to 10 weeks of the PA program correlated positively with the change in NO (P = 0.002) and VEGF-A (P = 0.004).ConclusionsA 10-week PA program attenuates the adverse effect of LBW on the number and functionality of EPCs; this effect occurs through an improvement in circulating levels of NO and VEGF-A.Clinical trialshttps://www.clinicaltrials.gov. Unique Identifier: NCT02982967. Date: December/2016.     

Dual-task training in older adults: The effect of additional motor tasks on mobility performance

ObjectivesDual-task (DT) performance is common to most activities of daily living and difficulties in DT activities may reduce quality of life in older adults. This study investigated the effect of DT training in a sample of older adults.MethodsSixty older adults (mean = 74.4 ± 3.1 years) participated in the study. Twenty-two older adults were included in the control (CG), 19 in the single-task (ST) training and 19 in DT training group. ST group received balance and walking training twice a week for16 weeks, while DT training group performed the same training with additional motor tasks. Data were gathered on 6 m timed walk (6MTW), timed up and go test (TUG) and four square step test (FSST). DT conditions required participants to complete 6MTW, TUG and FSST, either (i) while carrying a glass of water or (ii) while carrying a ball on a round tray.ResultsA significant Group x Time interaction was found in TUG (F [2,57] = 29.5; p < 0.01; partial η² = 0.51) and in FSST (F [2,57] = 23.2; p < 0.01; partial η² = 0.44). After intervention DT showed better scores in overall TUG (mean difference = 1.21 s [95% CI, 0.82–1.60]; p < 0.05) and FSST (mean difference = 2.51 s [95% CI, 1.67–3.35]; p < 0.01), whereas CG and ST did not exhibit significant changes.ConclusionOur results suggested that 16 weeks of motor DT training, using motor additional tasks as manipulation of common objects of everyday life, could improve mobility in older age.     

The influence of physical exercise and leisure activity on neuropsychological functioning in older adults

It has been suggested that leisure activity and physical exercise can be a protective factor for neuropsychological functions and are associated with a reduced risk of dementia. Thus, the purpose of this study was to investigate the influence of physical exercise and leisure on the neuropsychological functions of healthy older adults. The sample was composed of 51 sedentary female volunteers who were 60–70 years old and were distributed into three groups: A—control, B—leisure, and C—training. Volunteers were submitted to a physical and neuropsychological assessment at baseline and after 6 months. Groups A and B were monitored longitudinally three times a week. Group C improved their neuropsychological functioning and oxygen consumption compared to groups A and B (p = <0.05). The neuropsychological functions of groups A and B were significantly worse after 6 months of monitoring (p = <0.05). The data suggest that physical exercise improves neuropsychological functioning, although leisure activities may also improve this functioning. Thus, an aerobic physical fitness program can partially serve as a non-medication alternative for maintaining and improving these functions in older adults; however, leisure activities should also be considered.     

Effects of physical exercise on cognitive function of older adults with mild cognitive impairment: A systematic review and meta-analysis

Background and PurposeMild Cognitive Impairment (MCI) is associated with a greater risk of dementia for older adults. However, systematic reviews have shown that some physical exercise (PE) seems to improve MCI symptoms and signs. Those reviews and meta-analysis could not explain what possible moderator influenced their results. This meta-analysis aims to identify the effect of PE over older people’s cognition with MCI and explore sources of heterogeneity.MethodsDatabases were searched from inception January 2020 for randomized clinical trials that evaluated the effects of PE over cognition of older persons with MCI. Random effect meta-analyses were performed for each cognitive outcome. Subgroup analyses and meta-regressions models explored the potential sources of heterogeneity.ResultsA total of 2077 participants (mean age = 71.8 years) from 27 studies were included. PE improves global cognitive function (SMD = 0.348 [95 % CI 0.166 to 0.529]; p = 0.0001), executive function (SMD = 0.213 [95 % CI 0.026 to 0.400]; p = 0.026) and delayed recall (SMD = 0.180 [95 % CI 0.002 to 0.358]; p = 0.047). A trend towards beneficial effects of PE on verbal fluency (SMD = 0.270 [95 %, CI -0.021 to 0.561]; p = 0.069) and attention (SMD = 0.170 [CI -0.016 to 0.357]; p = 0.073) were also observed. Subgroup analyses showed a relationship between modality and intensity of physical exercise and changes observed in global cognitive function, executive function, delayed recall, verbal fluency and working memory.Discussion and ConclusionPE can ameliorate cognitive deficts of older adults with MCI. The most pronounced effects appear to arise from other types of exercise that included mind-body exercises and moderate intensity.     

Relationships of muscle strength and power with leisure-time physical activity and adolescent exercise in middle-aged and elderly Japanese women

Aim:   The purpose of the present study is to assess the relationships of muscle strength and power with recent leisure-time physical activity and exercise during adolescence in middle-aged and elderly Japanese women.
Methods:   The subjects consisted of 1128 community-dwelling women aged 40–79 years. They were interviewed about their physical activity habits during leisure time in the past 12 months and exercise they engaged in during adolescence. Muscle function was measured as grip strength, knee extension strength and leg extension power. Subjects were grouped into three intensity levels for leisure-time physical activity and as to whether or not they engaged in adolescent exercise. The relationships of muscle strength and power with leisure-time physical activity and adolescent exercise were assessed using analysis of covariance controlled for age, smoking status, annual income and education level.
Results:   The proportion of subjects that participated in leisure-time physical activity was 67.1% (light, 33.7%; moderate or heavy, 33.4%). The subjects that engaged in adolescent exercise represented 41.9% of the total. There was a significant relationship between leisure-time physical activity and adolescent exercise. In the analysis of covariance controlled for age, smoking status, annual income and education level, leisure-time physical activity and adolescent exercise had significant main effects on all muscle strength and power measurements. However, there was no interaction effect between leisure-time physical activity and adolescent exercise.
Conclusion:   The results suggest that current leisure-time physical activity and adolescent exercise benefit muscle function in middle-aged and elderly women.     

Performance Measures Predict Onset of Activity of Daily Living Difficulty in Community‐Dwelling Older Adults

OBJECTIVES: To assess the predictive value of five performance‐based measures for the onset of difficulty in activities of daily living (ADLs). DESIGN: A prospective cohort study; home visits every 6 months for 18 months. SETTING: Community‐based. PARTICIPANTS: Community‐dwelling older adults, n=110, (mean age 80.3±7.0; range 67–98) who reported no difficulty in basic ADLs. MEASUREMENTS: The Short Physical Performance Battery (SPPB), gait speed, Berg Balance Scale (BBS), grip strength, and Timed Up and Go Test (TUG) were evaluated at baseline. Seven ADL items were assessed at baseline and 6, 12, and 18 months. The onset of ADL disability was self‐report of difficulty in any of the seven ADL items. Logistic regression models were fitted for each of the physical performance measures to predict onset of ADL difficulty at 6, 12, and 18 months. RESULTS: After controlling for age, comorbid conditions, and sex, the BBS was the most consistent and best predictor for the onset of ADL difficulty over an 18‐month period (6 months, c‐statistic=0.725, (95% confidence interval (CI)=0.60–0.85; 12 months, c‐statistic=0.840 95% CI=0.75, 0.93; 18 months, c‐statistic=0.821, 95% CI=0.71, 0.93). The SPPB showed excellent predictive value for the onset of difficulty at 12 months. Ninety‐five, 89, and 75 older adults completed the 6, 12, and 18‐month follow‐up visits, respectively. CONCLUSION: BBS, followed by SPPB, TUG, gait speed, and grip strength, were predictive of the onset of ADL difficulty over an 18‐month period in community‐dwelling older adults. Screening nondisabled older adults with simple performance tests could allow clinicians to identify those at risk for ADL difficulty and may help to detect early functional decline.     

The effect of mind-body exercise on blood pressure in middle-aged and elderly patients with hypertension: A protocol for a systematic review and meta-analysis

Background:Depending on the person, cervical spondylosis may have no clinical symptoms, but cervical spondylosis will definitely cause changes in people''s blood pressure, which will further affect physical and mental health.Objectives:This study aims to explore the effect and safety of mind-body exercise intervention on the blood pressure in middle-aged and elderly patients with hypertension through meta-analysis.Methods:This meta-analysis searched studies from 4 research databases: the China National Knowledge Infrastructure (from 1979), Web of Science (from 1950), PubMed (from 1965), and Cochrane (from 1991), Date of retrieval: January 22, 2021, Two authors will independently search literature records, scan titles, abstracts, and full texts, collect data, and assess materials for risk of bias. The data will be analyzed by Stata 14.0 software.Results:The present study is a systematic review and meta-analysis program with no results. Data analysis will be completed after the program has been completed.Discussion:This meta-analysis may provide clinical practice with more reliable evidence-based medical evidence that mind-body exercise can benefit the blood pressure of middle-aged and elderly hypertensive patients.INPLASY Registration Number:INPLASY202130072.     

A cross-sectional follow-up study of physical activity in adults with moderate and severe haemophilia

Aim

To conduct a cross-sectional follow-up assessment of physical activity (PA) in people with moderate and severe haemophilia (PwMSH) from the Irish Personalised Approach to the Treatment of Haemophilia (iPATH) study.

Methods

Between June–December 2021, participants’ PA was measured over one week using accelerometery, and was compared with their previously measured data from the original iPATH assessment. Self-awareness of PA and the impact of the Covid-19 pandemic on PA, pain, mobility and function were retrospectively examined using a survey.

Results

Of 30 participants who returned surveys [n = 19, severe (FVIII, <.01 IU/mL); n = 4, moderate (FVIII, .01–.05 IU/mL); n = 7, severe (FIX, <.01 IU/mL); age: 47 (36, 55) years], 28 completed accelerometery (follow-up time: 3 years). There were no significant differences in accelerometer PA (all p > .05), but achievement of World Health Organisation guidelines increased (67.9%–75.0%; p = .646). Increased self-awareness of PA was reported by 76.7%, and 66.7% reported desires to become more physically active. Compared to normal, most reported either no differences or lower levels of PA during lockdown restrictions. Self-reported PA increased for most when restrictions eased from April 2021 onwards. Beyond the pandemic, concerns included pain and access to exercise resources.

Conclusion

Self-reported PA throughout the pandemic was variable, whilst there were no significant differences in objectively measured PA between assessment periods, despite reports of increased self-awareness and desires to be physically active at follow-up. Further qualitative research is needed to design personalised PA and health interventions, capturing perspectives of patients, their families, and multi-disciplinary haemophilia healthcare providers.     

Effects of smoking and physical activity on body weight: developments in Sweden between 1980 and 1989

Abstract. Objectives . To study the effects of changes in smoking and exercise habits on body weight in Sweden. Design . Analysis of factors affecting relative body weight by construction of regression equations using two models: one adjusted for age, education, socioeconomic group, geographical region and nationality, the other further adjusted for cigarette smoking and leisure-time physical activity. Setting . Cross-sectional interview data derived from the ‘Undersökning om LevnadsFörhållanden’ (Living Conditions) survey 1980–81 and 1989–89. Subjects . Nationally representative samples of Swedish men and women aged 16–84. Main outcome measures . Changes in body-mass index (BMI) in Sweden during the 1980s. Results . Using the first model, an increase in the BMI of 0.23 kg/m² in men and 0.17 kg/m² in women, from 1980 to 1989, was found. When controlling for smoking and physical activity, these values were 0.20 and 0.18 kg/m², respectively, (P at least < 0.003). Conclusions . These findings indicate that the reported decrease in smoking and changes in physical activity during the 1980s only marginally explain the BMI increase in the adult Swedish population. The health programmes launched during the 1980s seem to have little beneficial effects on body-weight development, in particular in younger generations of both sexes.     

Physical activity as a determinant of change in mobility performance: the Longitudinal Aging Study Amsterdam

OBJECTIVES: This study examined the association of (change in) physical activity and decline in mobility performance in older men and women. DESIGN: A 3-year prospective study using data of the Longitudinal Aging Study. SETTING: Netherlands. PARTICIPANTS: Two thousand one hundred nine men and women aged 55 to 85. MEASUREMENTS: Total physical activity (expressed as hours per day and kilocalories per day) and sports participation were measured using a validated, interviewer-administered questionnaire. Mobility performance was assessed using two timed tests: 6-meter walk and repeated chair stands. RESULTS: Mobility performance declined for 45.6% of the sample. At baseline, the mean time +/- standard deviation spent on total physical activity was 3.0 +/- 2.1 h/d or 719 +/- 543 kcal/d, and 56.6% of the sample participated in sports. Sports participation and a higher level of total physical activity, walking, or household activity were associated with a smaller mobility decline. After 3 years, total physical activity declined, and only 53.4% of those reporting sports at baseline continued doing so. Continuation of physical activity over time was associated with the smallest decline in mobility. The observed associations were similar for those with and without chronic disease (P> 0.3). The conclusions did not change after adjustment for potential confounders, including demographic and lifestyle variables, depression, and cognitive status. CONCLUSIONS: Physical activity, and especially a regularly active lifestyle, may slow the decline in mobility performance. A beneficial effect was observed for sports and nonsports activities, independent of the presence of chronic disease.     

Pharmacological inhibition of TRalpha1 receptor potentiates the thyroxine effect on body weight reduction in rats: potential therapeutic implications in controlling body weight

It has been previously reported that thyroid hormone receptor alpha1 (TRalpha1) is involved in the regulation of food intake and heart rhythm. Herein, we show that pharmacological inhibition of TRalpha1 by dronedarone, an amiodarone like compound (shown to antagonize thyroid hormone binding to TRalpha1), prevented the thyroid hormone induced increase in food intake and heart rate acceleration in rats. This resulted in a marked reduction in body weight. It is likely that thyroid analogs may prove potential therapeutic agents for controlling body weight.     

Associations between the rate,amount, and composition of weight loss as predictors of spontaneous weight regain in adults achieving clinically significant weight loss: A systematic review and meta‐regression

Weight regain following weight loss is common although little is known regarding the associations between amount, rate, and composition of weight loss and weight regain. Forty‐three studies (52 groups; n = 2379) with longitudinal body composition measurements were identified in which weight loss (≥5%) and subsequent weight regain (≥2%) occurred. Data were synthesized for changes in weight and body composition. Meta‐regression models were used to investigate associations between amount, rate, and composition of weight loss and weight regain. Individuals lost 10.9% of their body weight over 13 weeks composed of 19.6% fat‐free mass, followed by a regain of 5.4% body weight over 44 weeks composed of 21.6% fat‐free mass. Associations between the amount (P < 0.001) and rate (P = 0.049) of weight loss and their interaction (P = 0.042) with weight regain were observed. Fat‐free mass (P = 0.017) and fat mass (P < 0.001) loss both predicted weight regain although the effect of fat‐free mass was attenuated following adjustment. The amount (P < 0.001), but not the rate of weight loss (P = 0.150), was associated with fat‐free mass loss. The amount and rate of weight loss were significant and interacting factors associated with weight regain. Loss of fat‐free mass and fat mass explained greater variance in weight regain than weight loss alone.     

Effect of physical activity on functional status among older middle‐age adults with arthritis

Objective

To determine the effect of leisure time and work‐related physical activity on changes in physical functioning among 3,554 nationally representative survey respondents, ages 53–63 years in 1994, with arthritis and joint symptoms, interviewed in the Health and Retirement Study (HRS).

Methods

In 1992–1994, light and vigorous exercise items were empirically categorized into recommended, insufficient, and inactive leisure time physical activity levels using data from the HRS. Leisure and work‐related physical activity levels in 1994 were used to predict 1996 functional decline or improvement, controlling for baseline functional difficulties, health status, sociodemographic characteristics, and behavioral risk factors.

Results

Whereas 29.7% of respondents reported functional declines in 1996, 38.6% of those with baseline difficulties in 1994 reported improvement. Compared with inactive respondents, recommended and insufficient leisure time physical activity were equally protective against functional decline (odds ratio [OR] 0.59 and 0.62, respectively; P < 0.0001). Higher levels of physical activity were also modestly associated with functional improvement among respondents with baseline functional difficulties (OR 1.47, P = 0.05 and OR 1.45, P = 0.01, respectively). Work‐related physical activity was not a significant predictor of decline or improvement.

Conclusion

Given the high prevalence of arthritis, even modest increases in rates of lifestyle physical activity among older adults could make a substantial contribution to disability‐free life expectancy.