Increase In Skeletal Muscle Mass Research Articles

Gender-Related Effectiveness of Personalized Post-COVID-19 Rehabilitation.

Background: Post-COVID-19 syndrome (PCS) may affect a substantial proportion of patients who have had COVID-19. The rehabilitation program might improve the physical capacity, functioning of the cardiopulmonary system, and mental conditions of these patients. This study aimed to investigate the effectiveness of personalized rehabilitation in patients with PCS according to gender. Methods: Adults who underwent a 6-week personalized PCS rehabilitation program were enrolled in a prospective post-COVID-19 Rehabilitation (PCR-SIRIO 8) study. The initial visit and the final visit included the hand-grip strength test, the bioimpedance analysis of body composition, and the following scales: modified Borg's scale, Modified Fatigue Impact Scale (MFIS), Functioning in Chronic Illness Scale (FCIS), modified Medical Research Council (mMRC) dyspnea scale, and tests: 30 s chair stand test (30 CST), Six-Minute Walk Test (6MWT), Short Physical Performance Battery test (SPPB)e. Results: A total of 90 patients (54% female) underwent the rehabilitation program. Rehabilitation was associated with an increase in skeletal muscle mass (24.11 kg vs. 24.37 kg, p = 0.001) and phase angle (4.89° vs. 5.01°, p = 0.001) and with a reduction in abdominal fat tissue volume (3.03 L vs. 2.85 L, p = 0.01), waist circumference (0.96 m vs. 0.95 m, p = 0.001), and hydration level (83.54% vs. 82.72%, p = 0.001). A decrease in fat tissue volume and an increase in skeletal muscle mass were observed only in females, while an increase in grip strength was noticed selectively in males. Patients' fatigue (modified Borg's scale, MFIS), physical capacity (30 CST, 6MWT), balance (SPPB), dyspnea (mMRC), and functioning (FICS) were significantly improved after the rehabilitation regardless of gender. Conclusions: Personalized rehabilitation improved the body composition, muscle strength, and functioning of patients diagnosed with PCS. The beneficial effect of rehabilitation on body composition, hydration, and phase angle was observed regardless of gender.

Association of Elevated Serum Branched-chain Amino Acid Levels With Longitudinal Skeletal Muscle Loss.

Branched-chain amino acids (BCAA) are substrates for protein synthesis. Although their intake may contribute to an increase in skeletal muscle mass, elevated serum BCAA levels have been reported to be associated with insulin resistance, potentially resulting in decreased skeletal muscle mass. This study aimed to explore the association between elevated serum BCAA levels and longitudinal skeletal muscle loss. A cohort analysis was conducted, in which serum amino acids were analyzed in healthy individuals who underwent a medical health checkup at Kameoka Municipal Hospital (HOZUGAWA study), Japan. Seventy-one participants (37 men and 34 women) underwent follow-up checkups after the baseline visit. The follow-up duration was 1.2 ± .4 years. The relationship between fasting baseline serum BCAA levels and lifestyle factors, body composition, blood test results, dietary history, and changes in skeletal muscle mass was evaluated. In both men and women, serum BCAA levels were positively correlated with body weight, body mass index, skeletal muscle mass index (SMI), and serum triglycerides but inversely correlated with serum high-density lipoprotein cholesterol. In men, fasting serum BCAA levels were inversely associated with the rate of change in SMI (adjusted β = -.529, P = .006), and elevated BCAA levels were independently associated with a longitudinal decrease in skeletal muscle mass (odds ratio: 1.740; 95% confidence interval: 1.023-2.960 per 50 nmol/mL serum BCAAs increase). Increased circulating BCAAs could be an indicator of skeletal muscle loss in men.

Once-weekly semaglutide administered after laparoscopic sleeve gastrectomy: Effects on body weight, glycemic control, and measured nutritional metrics in Japanese patients having both obesity and type 2 diabetes

BackgroundGlucagon-like peptide (GLP)-1 analogue may be useful for controlling weight recurrence and diabetes relapse after bariatric surgery, but may also adversely affect the measured nutritional metrics. This study aimed to investigate the effect of treatment with once-weekly semaglutide after laparoscopic sleeve gastrectomy (LSG) in patients with type 2 diabetes (T2D). We also examined the effects of combined use with a low-energy, high-protein formula diet (FD). MethodsThis study was a single-center retrospective database analysis. We enrolled 29 Japanese patients with T2D who underwent LSG, and more than 12 months later received semaglutide. The patients were divided retrospectively into a FD group (=6) and a conventional diet (CD) group (n = 23). ResultsBMI and HbA1c decreased significantly by 10.7 kg/m2 and 1.1 %, respectively, 12 months after LSG, and decreased by an additional 1.6 kg/m2 and 0.6 % after 12-months of treatment with semaglutide. Decreases in serum albumin, vitamin B12 and zinc were observed only after semaglutide administration. A ratio of energy from protein, fat and carbohydrates changed from 13:31:56 before to 19:30:50 after LSG, and from 17:32:51 before to 15:29:56 after semaglutide. Skeletal muscle ratio, which is the ratio of skeletal muscle mass to body weight, increased after LSG, but did not change after semaglutide. FD group showed a significant increase in skeletal muscle mass per 1 % body weight compared to CD group during semaglutide treatment. ConclusionSemaglutide after LSG in patients with obesity and T2D resulted in additional weight reduction and improved glycemic control, but worsened measured nutritional metrics. Administration of a low-energy, high protein formula diet may ameliorate adverse nutritional effects of semaglutide in patients with T2D after LSG. (Ethics Committee of Toho University Sakura Medical Center approval number S18061)

The Impact of Combination of Aerobic and Resistive Exercise on Activities of Daily Living and Risk of Fall in Osteosarcopenic Patients.

It is aimed to explain the impact of the combination of aerobic and resistive exercise on activities of daily living and the risk of falls in osteosarcopenic patients. Female and male patients over 70 years of age followed up from the osteoporosis outpatient clinic were screened. Appropriate patients were evaluated for sarcopenia gait speed, grip strength and skeletal muscle mass. Patients with sarcopenia who did not have the exclusion criteria were included in the 3-month aerobic and resistive exercise program. Changes in skeletal muscle mass measurements, physical performance and balance tests were evaluated at 1 month and 3 months. Sarcopenia was screened in 91 patients with osteoporosis and osteopenia. Sarcopenia was detected in 27 patients and 23 completed the 3-month study. The mean age of the patients was 78.4±5.7 years and the number of female patients was 16 (69.6%). There was no significant change in skeletal muscle mass measurements and Katz Activities of Daily Living Scale performed at 1 and 3 months (p>0.05). Short Physical Performance Battery (SPPB), Timed Up and Go Test (TUGT) and Berg Balance Test (BBT) were found to improve significantly in the first month, and it continued to develop in the third month (p<0.05). Although the combination of aerobic and resistive exercise in osteosarcopenic patients did not lead to a significant increase in skeletal muscle mass, It has a significant effect on physical performance and balance. It can be foreseen that this will increase the independence of the person while reducing the risk of falling.

Effects of Low-Load, High-Repetition Resistance Training on Maximum Muscle Strength and Muscle Damage in Elite Weightlifters: A Preliminary Study

This study aimed to assess the impact of different resistance training (RT) loads and repetition on muscle damage, intramuscular anabolic signaling, and maximal muscle strength (MMS) in weightlifters. Eighteen male weightlifters were randomly assigned to 8 weeks of supervised RT regimes: high-load, low-repetition (HL), low-load, high-repetition (LH), and combination of HL and LH (COMBI). All groups exhibited a significant increase in skeletal muscle mass (SMM) and growth hormone levels, which ultimately contributed to improvement in MMS as indicated by 1-repetition maximum in the back squat and back muscle strength. Notably, while there were no significant changes in the mTOR protein, the phosphorylation of phosphorylation of p70 ribosomal protein S6 kinase 1 (p70S6K1), eukaryotic initiation factor 4E-binding protein 1 (4E-BP1), and eukaryotic elongation factor 2 (eEF2), which are involved in muscle cell growth, was significantly affected by the different training regimens. More importantly, LH-RT led to a significant reduction in muscle damage markers, creatine kinase (CK) and lactate dehydrogenase (LDH), suggesting reduced recovery time and fatigue. Our results demonstrated that the LH-RT paradigm could be a viable alternative for weightlifters to enhance MMS and muscle hypertrophy similar to HL-RT, while reducing RT-induced muscle damage, ultimately contributing to the enhancement of exercise performance.

FRI622 Impact Of Personalized Diet Using Digital Twin On Body Composition Parameters: 180 Day Analysis Of 209 Participants

Abstract Disclosure: P. Shamanna: None. J. Mohammed: None. M. Mohamed: None. T. Poon: None. M. Dharmalingam: None. B. Saboo: None. S. Damodharan: None. A. Vadavi: None. M. Thajudeen: None. A. Keshavamurthy: None. S. Bhonsley: None. B. R: None. S. Joshi: None. Background and Aims: The aim was to study the effect of a personalized diet using the Digital Twin (DT) on the various parameters of body composition. The personalized food recommendations were provided through the mobile app. Materials and Methods: Data from 209 participants (176 males and 33females) who had been on DT for 6 months or more were analyzed. DT uses a machine learning algorithm to integrate clinical and sensor data. USFDA approved Powermax BCA-130 Bluetooth Smart Scale, was used for bioimpedance analysis. Results: We analyzed 209 participants (176 males, 33 females) to study bioimpedance changes over 180 days. Weight significantly decreased in both males and females, with mean decreases of 10.6 kg (80 to 69.4kg) and 11.5kg (75.8 to 64.3kg), respectively, (p&amp;lt;0.001). BMI (kg/m2) also significantly decreased in both genders, with mean decreases of 3.8 (27.2 to 23.4) and 4.3(29.6 to 25.3), respectively, (p&amp;lt;0.001). Body fat percentage decreased in both genders, with mean decreases of 7.7% (28.4 to 20.7%) and 8.3% (41 to 32.7), respectively, (p&amp;lt;0.001). BMR decreased significantly in males 1585.4 to1544.0 kcal/day (p&amp;lt;.001), decreased by 2.6%, but not in females, (1297.7 to1273.2 kcal/day), p=0.095. Total Body Water % significantly increased in both males (51.7% to 57.2%, p&amp;lt;.001) and females (40.5% to 46.2%, p&amp;lt;0.001). Bone mass and lean body weight decreased significantly in both males (2.8 kg to2.7 kg, p&amp;lt;0.001) and females (2.6 kg to 2.5 kg, p=.171). Metabolic age decreased significantly in both genders, with a mean decrease from 44.1 to 41.0years for males (p&amp;lt;0.001) and from 48.9 to 46.2 years for females(p&amp;lt;0.001). Muscle mass decreased significantly in both genders, males 53.5to 51.7 kg, females 40.4 to 39.3 kg, p=0.095 but skeletal mass % increased significantly, 40.8% to 45.2% for males (p&amp;lt;0.001) and 34.4% to 39.2% for females (p&amp;lt;0.001). Protein levels increased significantly in both genders,16.3 g/dL to 18.1 g/dL for males (p&amp;lt;0.001) and from 13.0 g/dL to 15.5 g/dL for females (p&amp;lt;0.001). Subcutaneous fat decreased significantly in both genders, 25.2% to 18.6% for males (p&amp;lt;0.001) and 36.6% to 29.8% for females(p&amp;lt;0.001). Visceral fat decreased significantly from a mean of 9.9 to 6.1for males (p&amp;lt;.001) and from 12.2 to 7.7 for females (p&amp;lt;0.001). Conclusions: Digital Twin (DT) technology through personalized diet interventions is a successful approach for weight and body fat reduction, while maintaining BMR at a stable level. There is a positive impact on metabolic age, and an increase in skeletal muscle mass. DT algorithms and personalized nutrition recommendations are beneficial for improving body composition parameters. Presentation: Friday, June 16, 2023

The Prevalence of Responders and Non-Responders for Body Composition, Resting Blood Pressure, Musculoskeletal, and Cardiorespiratory Fitness after Ten Weeks of School-Based High-Intensity Interval Training in Adolescents

Many observations have demonstrated great heterogeneity in the magnitude of the response to the physical exercise stimulus. Only a few studies have investigated the effects of high-intensity interval training (HIIT) on the prevalence of non-responders (NRs) in adolescents while considering health-related fitness measurements and other co-variables. Therefore, the aim of the current work was twofold: (1) to assess the effects of ten weeks of school-based HIIT on the prevalence of responders (Rs) and NRs for body composition, resting blood pressure (BP), cardiorespiratory and musculoskeletal fitness, and (2) to assess the relationship of this prevalence with sex, body mass category, and biological maturation status, while estimating the likelihood of a response. Adolescents aged 16 years (n = 73) were included in the study. Waist-to-hip ratio, body fat percentage (BFP), skeletal muscle mass (SMM), BP, cardiorespiratory fitness (CRF), and musculoskeletal fitness were the primary outcomes. Co-variables included sex, body mass index (BMI), and maturity offset. The percentages of the Rs and NRs were analyzed based on changes (Δ) between post-intervention and pre-intervention values. The typical error (TE) method was used to identify Rs and NRs. Results showed a variation in the relative size of changes (% of changes) depending on the variable and sex. The greatest changes were observed in females’ abdomen muscle strength (Δ% = 23.89%), and the difference from that of males (Δ% = 5.98%) was statistically significant (p &lt; 0.001) with very large effect size of (Cohen’s d = 0.941). Similar significant differences in relative changes were observed in body composition, but in the reverse direction. Males gained more from HIIT in the decrease in the body fat percentage (Δ% = −8.24%) and increase in skeletal muscle mass (Δ% = 3.38%) comparing to females (Δ% = 0.46, p = 0.040 and Δ% = 1.06%, p = 0.007, respectively). Effect size for body fat was small (Cohen’s d = 0.469), and for skeletal muscle mass it was moderate (Cohen’s d = −0.659). The results also showed positive significant differences in the prevalence of Rs compared to NRs in BFP, SMM, systolic BP (SBP), diastolic BP (DBP), CRF, and abdominal muscular strength (ABS) (p = 0.047, p = 0.047, p &lt; 0.001, p = 0.003, p = 0.014, and p = 0.014, respectively). The effect was greatest and largest for SBP (Cohen’s ω = 0.67). Sex was related to the prevalence of Rs for ABS and close to significance for SMM. More males than females benefited from HIIT in SMM (p = 0.058), but more females than males had ABS benefits (p = 0.050). Males were more likely (2.5-fold) to be Rs than females in SMM. BMI was not related to the prevalence of Rs and NRs. Biological maturation was related to the prevalence of Rs and NRs in SMM (p = 0.036) and SBP (p = 0.016). In SBP, 100% of the early matured derived benefit from HIIT, but the effect size was small (Cramer’s V = 0.27). Those who maturated later were more likely (almost 70%) to be Rs. Thus, the HIIT program introduced to a typical physical education (PE) lesson can be considered partially effective. Therefore, there is a need to continue the search for an optimal and effective program for all health-related parameters. The close relationship between analyzed values and sex and biological maturation, but not BMI, indicates that the intervention programs should be tailored specifically for males and females.

The effect of confounding variables on the relationship between anthropometric and physiological features in 2000-m rowing ergometer performance.

Background: Anthropometric and physiological characteristics are often considered as potential variables that are significantly related with motor performance. Aim: The aim of this study was to identify and weigh the key anthropometric and physiological characteristics that are associated with 2000-m rowing ergometer performance in male and female athletes. Methods: The study involved 70 best female and 130 best male rowers from the seven largest Hungarian rowing clubs, classified into one of the following age categories: juniors (36 women and 55 men, age range: 15-16years), older juniors (26 women and 52 men, age range: 17-18years), and seniors (8 women and 23 men, age range: over 18years). Anthropometric and body composition measurements were determined by the bioelectrical impedance method proposed by Weiner and Lourie (1969), and skin fold measurements were conducted to estimate relative body fat content. The countermovement jump test and the 2000-m maximal rowing ergometer test were used for physiological measurements. Results: An increase in skeletal muscle mass was correlated (r = -.39, p <.001) with a significant decrease in rowing time over a distance of 2000m, whereas a significant increase in rowing time was noted with an increase in sitting height (only in men, r = .33, p <.001), body mass (in women and men: r = .24, p = .013 and r = .31, p = .009), and body fat percentage (r = .26, p < .030). Rowing time was also bound by a significant correlation with maximal force (r = -.79 and -.90, p <.001) and relative maximal power (r = -.54 and -.78, p <.001) in both sexes, with relative peak power in males (r = -.51, p < .001), and with estimated relative maximal aerobic capacity in females (r = -.43, p <.001). Conclusion: Rowing performance over a distance of 2000m is significantly negatively correlated with the skeletal muscle mass, maximal force, relative maximal power, relative peak power, and estimated relative maximal aerobic capacity.

Effect of Milk or Milk Derived Food Supplementation on Body Composition of Young Indian Women

Background: Lysine intake in India is low mainly due to consumption of cereals as staple diet and processing loss of lysine. The present study was aimed to assess the impact of supplementation either in the form of dietary supplements of lysine, calcium and vitamin D in order to identify an appropriate approach for the improvement of body composition. Methods: One hundred and twenty volunteer subjects in the age group of 20-30 years residing in Punjab Agricultural University hostels were selected for supplementary trial. Supplementation of milk and its products in amounts to fill the gap of dietary intake and adequacy of protein as well as limiting amino acid lysine in their diets for a period of 12 weeks was done to determine its effect on body composition. Result: The diets were also poor in protein quality as the limiting amino acid lysine was only 55% of the recommended level. Supplementation of milk and its products resulted in a significant reduction in body fat (6.62%) and visceral fat rating (9.47%) and a significant increase in skeletal muscle mass (3.98%) and bone mass (2.72%). The study recommends that improving the quality of diets through dietary supplementation of lysine, calcium and vitamin D is an effective approach to achieve optimum body composition.

The Positive Effect of Four-Week Combined Aerobic–Resistance Training on Body Composition and Adipokine Levels in Obese Females

Obesity is a metabolic disease that is caused by a lack of physical activity and is associated with an increased risk of chronic inflammation. A total of 40 obese adolescent females with an average age of 21.93 ± 1.35 years and average body mass index (BMI) of 30.81 ± 3.54 kg/m2 were enrolled in this study, randomized, and divided into four groups, i.e., control (CTL; n = 10), moderate intensity aerobic training (MAT; n = 10), moderate intensity resistance training (MRT; n = 10), and moderate intensity combined aerobic-resistance training (MCT; n = 10). The enzyme-linked immunosorbent assay (ELISA) kits method was used to analyze the adiponectin and leptin levels between pre-intervention and post-intervention. Statistical analysis was conducted using a paired sample t-test, while correlation analysis between variables used the Pearson product-moment correlation test. Research data showed that MAT, MRT, and MCT significantly increased adiponectin levels and decreased leptin levels compared to the CTL (p ≤ 0.05). The results of the correlation analysis of delta (∆) data showed that an increase in adiponectin levels was significantly negatively correlated with a decrease in body weight (BW) (r = -0.671, p ≤ 0.001), BMI (r = -0.665, p ≤ 0.001), and fat mass (FM) (r = -0.694, p ≤ 0.001) and positively correlated with an increase in skeletal muscle mass (SMM) (r = 0.693, p ≤ 0.001). Whereas, a decrease in leptin levels was significantly positively correlated with a decrease in BW (r = 0.744, p ≤ 0.001), BMI (r = 0.744, p ≤ 0.001), and FM (r = 0.718, p ≤ 0.001) and negatively correlated with an increase in SMM (r = -0.743, p ≤ 0.001). In summary, it can be concluded that our data show that adiponectin levels increased and leptin levels decreased after the intervention of aerobic, resistance, and combined aerobic-resistance training.

Stable fitness during COVID-19: Results of serial testing in a cohort of youth with heart disease.

Little is known about how sport and school restrictions early during the novel coronavirus 2019 (COVID-19) pandemic impacted exercise performance and body composition in youth with heart disease (HD). A retrospective chart review was performed on all patients with HD who had serial exercise testing and body composition via bioimpedance analysis performed within 12 months before and during the COVID-19 pandemic. Formal activity restriction was noted as present or absent. Analysis was performed with a paired t-test. There were 33 patients (mean age 15.3 ± 3.4 years; 46% male) with serial testing completed (18 electrophysiologic diagnosis, 15 congenital HD). There was an increase in skeletal muscle mass (SMM) (24.1 ± 9.2-25.9 ± 9.1 kg, p < 0.0001), weight (58.7 ± 21.5-63.9 ± 22 kg, p < 0.0001), and body fat percentage (22.7 ± 9.4-24.7 ± 10.4%, p = 0.04). The results were similar when stratified by age <18 years old (n = 27) or by sex (male 16, female 17), consistent with typical pubertal changes in this predominantly adolescent population. Absolute peak VO2 increased, but this was due to somatic growth and aging as evidenced by no change in % of predicted peak VO2. There remained no difference in predicted peak VO2 when excluding patients with pre-existing activity restrictions (n = 12). Review of similar serial testing in 65 patients in the 3 years before the pandemic demonstrated equivalent findings. The COVID-19 pandemic and related lifestyle changes do not appear to have had substantial negative impacts on aerobic fitness or body composition in children and young adults with HD.

Effects of Multidisciplinary Rehabilitation Program in Patients with Long COVID-19: Post-COVID-19 Rehabilitation (PCR SIRIO 8) Study.

Up to 80% of COVID-19 survivors experience prolonged symptoms known as long COVID-19. The aim of this study was to evaluate the effects of a multidisciplinary rehabilitation program in patients with long COVID-19. The rehabilitation program was composed of physical training (aerobic, resistance, and breathing exercises), education, and group psychotherapy. After 6 weeks of rehabilitation in 97 patients with long COVID-19, body composition analysis revealed a significant decrease of abdominal fatty tissue (from 2.75 kg to 2.5 kg; p = 0.0086) with concomitant increase in skeletal muscle mass (from 23.2 kg to 24.2 kg; p = 0.0104). Almost 80% of participants reported dyspnea improvement assessed with the modified Medical Research Council scale. Patients' physical capacity assessed with the 6 Minute Walking Test increased from 320 to 382.5 m (p &lt; 0.0001), the number of repetitions in the 30 s Chair Stand Test improved from 13 to 16 (p &lt; 0.0001), as well as physical fitness in the Short Physical Performance Battery Test from 14 to 16 (p &lt; 0.0001). The impact of fatigue on everyday functioning was reduced in the Modified Fatigue Impact Scale from 37 to 27 (p &lt; 0.0001). Cardiopulmonary exercise test did not show any change. The multidisciplinary rehabilitation program has improved body composition, dyspnea, fatigue and physical capacity in long COVID-19 patients.

ВЛИЯНИЕ РОСТА СКЕЛЕТНО-МЫШЕЧНОЙ МАССЫ НА ПОКАЗАТЕЛИ ОБМЕНА ЖЕЛЕЗА У ВОЕННОСЛУЖАЩИХ ПО ПРИЗЫВУ В ПЕРИОД АДАПТАЦИИ К УСЛОВИЯМ ВОЕННОЙ СЛУЖБЫ

Thousands of young men are conscripted for military service with various nutritional status and physical fitness condition every year. The adaptation of conscripted soldiers to the factors of military service occurs at three levels: physiological, psychological and social. The purpose of the study was to assess the dynamic changes of body structure parameters in conscripted soldiers during 6 months of service by conscription and to determine the effect of skeletal muscle mass growth on iron metabolism during adaptation to military service conditions. A prospective observational study involved 145 conscripted soldiers from one of the military units after informed consent. The study was performed from the moment of conscription for military service in 3 stages with an interval of 3 months using a four-component model of body structure and a four-component model of iron metabolism. The skeletal muscle mass and adipose tissue mass and were determined caliperometrically. Hematological and biochemical parameters of iron metabolism were assessed. Dynamic changes and types of growth of the skeletal muscle mass, as well as changes in the parameters of iron metabolism have been obtained. The body weight of conscripted soldiers changes slightly within 6 months from the moment of conscription. At the same time internal changes occurred in the structure of the body of conscripted soldiers due to an increase in skeletal muscle mass and a decrease in the mass of adipose tissues. The types of skeletal muscle mass growth were determined among conscripted soldiers. There were an increase in skeletal muscle mass and hemoglobin fund to provide them oxygen by the influence of increased physical loading. It led to a decrease in iron stores, estimated by serum ferritin, and signs became more pronounced of iron deficiency erythropoiesis, which were determined in erythrocyte indexes. These combined changes can be assessed as functional iron deficiency or iron deficiency without anemia.

JS-CME-2: REDUCTION IN CARDIOVASCULAR MORBIDITY AND MORTALITY BY CARDIAC REHABILITATION: WHAT'S THE EVIDENCE?

The Japanese Society of Cardiac Rehabilitation defines cardiac rehabilitation (CR) as follows. Cardiac rehabilitation refers to a long-term, multifaceted, comprehensive program designed to optimize a cardiac patients physical, psychological, social, and vocational status, in addition to stabilizing, slowing, or even reversing the progression of the underlying atherosclerotic or heart failure processes, thereby reducing recurrence, rehospitalization and mortality and enabling patients to live comfortably and actively. CR programs include medical assessment, prescribed exercise training, coronary risk factor modification, patient education, counseling and optimal medical therapy for individual patients, which are provided by a multi-disciplinary team in a coordinated manner. Comprehensive CR consists of continuous multidisciplinary team medical care centered on exercise therapy and disease management. Comprehensive CR improves exercise tolerance and physical function in most heart diseases. Improvements in subjective symptoms and QOL are also observed in many heart diseases. Concerning long-term prognostic improvement effect, it is observed in coronary artery disease and heart failure. Reduced readmissions are also observed in heart failure patients. Mechanisms for improving the long-term prognosis of patients with coronary artery disease and heart failure include: 1) improvement of coronary risk factors, 2) improvement of vascular endothelial function and systemic anti-arteriosclerosis/anti-inflammatory effects via suppression of oxidative stress, 3) improvement of autonomic nerve function, 4) increase in skeletal muscle mass and associated various myokine actions. Based on the above-mentioned evidence, all clinical guidelines of the Japanese Circulation Society, AHA, and ESC strongly recommend participation in CR as class I (evidence and/or general agreement that a given procedure or treatment is effective and useful) for patients after acute myocardial infarction. In post-CABG patients, American and European guidelines recommend CR as Class I. As for chronic heart failure, exercise therapy is strongly recommended as class I in all heart failure clinical guidelines in Japan, Europe, and the United States. However, a clinical problem is the low rate of CR participation in patients with heart disease. This tendency is particularly conspicuous in Japan. Furthermore, an increase in the number of elderly heart failure patients with frailty is also a major issue. There is a need to create a system that supports patients through a community network throughout the acute, recovery, and maintenance phases.

Effects of resistance training on body recomposition, muscular strength, and phase angle in older women with different fat mass levels.

The concomitant increase in skeletal muscle mass (SMM) and decrease in fat mass has been termed body recomposition. This study aimed to analyze the influence of pre-training levels of fat mass on body recomposition, muscular strength, and (phase angle) PhA after 24weeks of resistance training (RT) in older women. Data from 99 older women (68.6 ± 5.7years, 65.7 ± 8.6kg, 155.1 ± 5.8cm, 27.2 ± 3.1kg/m2) was retrospectively analyzed. Participants were separated into tertiles according to the amount of fat mass at baseline as follows: low fat mass (L-FM, n = 33), moderate fat mass (M-FM, n = 33), and high fat mass (H-FM, n = 33). The participants underwent a RT program consisting of eight exercises, three sets per exercise, with a load between 8 and 15 RM, performed three times per week for 24weeks. The SMM and fat mass were evaluated by dual-energy X-ray absorptiometry (DXA). Body recomposition was determined by the composite Z-score of changes in SMM and fat mass. One repetition maximum (1RM) tests in chest press, knee extension, and preacher curl were assessed to verify muscular strength. Bioimpedance was used to determine phase angle. Results indicated that after the RT period, a greater positive body recomposition was observed in the L-FM group than in M-FM and H-FM groups. Moreover, all groups increased muscular strength and phase angle with no significant difference among groups (P > 0.05). The present study results suggest that the initial amount of fat mass influences the body recomposition induced by RT in older women, with those with lower pre-training fat mass levels presenting higher levels of body recomposition. However, improvements in muscular strength and phase angle are not dependent on the amount of initial fat mass in older women.

Hypoglycemic drug liraglutide alleviates low muscle mass by inhibiting the expression of MuRF1 and MAFbx in diabetic muscle atrophy.

Low muscle mass, that is, muscular atrophy, is an independent risk factor for type 2 diabetes mellitus (T2DM). Few studies investigated whether hypoglycemic drugs can alleviate low muscle mass and related mechanisms. This study recruited 51 type 2 diabetes mellitus (T2DM) patients, who were divided into two groups based on skeletal muscle index (SMI) evaluated by Dual-energy X-ray absorptiometry (DXA): the experiment group (n = 25, SMI < 7 kg/m 2 ) and the control group (n = 26, SMI≥7 kg/m 2 ). GLP-1 levels were measured by ELISA. In vitro, 10 KK-A y mice (11- to 12-week-old) were assigned into two groups: liraglutide group (n = 5) and saline group (n = 5). Real-time PCR and Western blot were used to determine the expression levels of muscle specific ubiquitin protease E3, MuRF1, and MAFbx. T2DM patients with a higher SMI had significantly higher GLP-1 levels (t = 3.77, p < 0.001). SMI were positively associated with GLP-1 levels (β = 0.435, p = 0.001) and inversely associated with age (β = 0.299, p = 0.015). The incidence of low muscle mass at below the second quartiles was 10.55 times that of above the second quartiles (odds ratio = 10.556, p < 0.001). Liraglutide-treatment mice showed significant decrease in food intake, final body weight, fasting blood glucose, and significant increase in skeletal muscle mass, which coincided with the significant decrease in the expression levels of ubiquitin protease E3 MuRF1 and MAFbx. In vitro studies showed that liraglutide promoted myogenic differentiation and attenuated dexamethasone (DEX)-induced myotube atrophy. Ectopic expression of MuRF1 and MAFbx antagonized the beneficial effects of liraglutide on DEX-induced myotube atrophy. T2DM patients have muscular atrophy, and liraglutide alleviates muscular atrophy at least in part by inhibiting the expression of MuRF1 and MAFbx.

Effects Of High- And Low-load Resistance Training On Body Composition In Recreationally Trained Males

Resistance training has been shown to improve body composition. PURPOSE: Determine the effects of resistance training at 30% or 85% of predicted 1-repetition maximum (1-RM) with regards to body mass, body fat percentage, and skeletal muscle mass. METHODS: 16 recreationally trained males (Mage = 20.4 ± 2.7 yrs) were recruited for this study. Participants were randomly assigned to one of two training groups: 30% or 85% of predicted 1-RM. Participants completed three sessions per week of a whole-body workout (back squat, deadlift, bench press, T-row, bicep curls, skullcrushers) over six weeks. Sessions consisted of two warmup sets and three working sets to failure at 30% or 85% of predicted 1-RM. Body composition data including body mass (BM), body fat percentage (%BF), and skeletal muscle mass (SMM) was collected at baseline and the end of the training program. A paired T-Test was used to assess differences in body composition from pre- to post-training. Significance was set a-priori at P < 0.05. RESULTS: There was a significant decrease in %BF over the course of the training program (P = 0.01), however no statistically significant changes were seen in SMM or BM (P > 0.56). CONCLUSIONS: Consistent with previous research, resistance training had a significant effect on body composition through a reduction in %BF. Both high- and low-load training contributed to these findings, but it should be noted that there were decreases in %BF in the 30% and increases in the 85% group (-0.75 vs +0.24%) indicating that low-load resistance may result in a more favorable body composition. Additionally, the observed increases in SMM in the 85% group indicate that high-load training may be more influential on improved muscle hypertrophy.

Impact of beta‐Hydroxy‐beta‐methylbutyrate plus Vitamin D3 Supplementation on Skeletal Muscle Size, Function and Quality in Sedentary and Resistance Exercise Trained Women

The age‐related loss of skeletal muscle mass, quality, and strength can lead to the loss of independence later in life. Beta‐hydroxy‐beta‐methylbutyrate (HMB), a leucine metabolite, can increase skeletal muscle size and function. However, emerging evidence suggests HMB may be less effective at improving muscle function in people with insufficient Vitamin D3 levels (25‐hydroxy‐Vitamin D (25‐OH‐D) &lt;30 ng/mL,) common in middle‐aged and older adults. Therefore, our current study tested the hypothesis that combining HMB (Calcium salt) with Vitamin D3 (HMB+D) would increase skeletal muscle size, quality and function in middle aged women (53±1 yrs, 26±1 kg/m2, n=43) randomized to sedentary control (SED) or progressive resistance exercise training (RT). In a placebo‐controlled, double‐blinded fashion, women were further randomized to placebo or HMB+D (3g of HMB + 2000IU of Vitamin D3). Study enrollment and recruitment occurred before and after COVID‐19 stay at home measures. In both RT and SED, HMB+D raised circulating levels of 25‐OH‐D after 8 (33±2 ng/mL) and 12 (35±2 ng/mL) weeks to reach sufficient Vitamin D3 levels. In SED, HMB+D prevented the loss of lean arm mass observed in the placebo group (0.07±0.06 vs ‐0.19±0.06 kg; P&lt;0.05). HMB+D also increased thigh skeletal muscle (26±13 vs ‐5±8 cm3; P&lt;0.05) and decreased intermuscular adipose tissue (IMAT) volume (‐20±11 vs 5±6 cm3; P&lt;0.05) compared to placebo. However, 12‐weeks of HMB+D did not change skeletal muscle function. In the RT, 12‐weeks of HMB+D decreased IMAT compared to placebo (‐22±13 vs 6±4 cm3; P&lt;0.05) but did not influence the increase in skeletal muscle mass or function. These data show that 12‐weeks of HMB+D supplementation consistently decreased thigh IMAT volume in both SED and RT. HMB+D in sedentary middle‐aged women was beneficial for skeletal muscle size but did not lead to improved muscle function or quality. Further, HMB+D did not influence the hypertrophic or functional improvements after resistance exercise training in middle‐aged women. HMB+D may be able to help combat the age‐related loss of skeletal muscle mass in sedentary women. These results lend support to conducting a larger study for a longer duration to validate these findings as well as explore additional populations who may also benefit from HMB+D.

Moderate and Higher Protein Intakes Promote Superior Body Recomposition in Older Women Performing Resistance Training.

Resistance training (RT) combined with appropriate dietary intake can promote a concomitant increase in skeletal muscle mass (SMM) and reduction in fat mass, a condition termed body recomposition. This study's primary purpose was to explore the effects of protein ingestion on body recomposition after 24 wk of RT in older women. Data from 130 untrained older women (68.7 ± 5.6 yr, 66.5 ± 11.5 kg, 155.5 ± 6.0 cm, and 27.4 ± 4.0 kg·m-2) across six studies were retrospectively analyzed. The participants were divided into tertiles according to their customary protein intake (g·kg-1·d-1): lower (LP; n = 45), moderate (MP; n = 42), and higher (HP; n = 43) protein intake. Participants performed a whole-body RT program carried out over 24 wk (eight exercises, three sets, 8-15 repetitions, three sessions a week). SMM and fat mass were determined by dual-energy x-ray absorptiometry. All groups increased SMM from baseline (P < 0.05), with the HP and MP groups showing greater increases than the LP group (LP, 2.3%; MP, 5.4%; and HP, 5.1%; P < 0.05). Reductions in fat mass were similar for all three groups (LP, 1.7%; MP, 3.7%; and HP, 3.1%; P > 0.05). The composite z-score of the percentage changes from pretraining to posttraining indicated greater positive body recomposition values for HP and MP compared with LP (P < 0.05). Results suggest that protein intake is a moderating variable for body recomposition in older women undergoing RT, with a low protein intake having a less favorable effect on body recomposition.

Essential Amino Acid and Tea Catechin Supplementation after Resistance Exercise Improves Skeletal Muscle Mass in Older Adults with Sarcopenia: An Open-Label, Pilot, Randomized Controlled Trial

Objective: Tea catechins (TCCs) have gained significant attention owing to their health effects. However, evidence is limited regarding the benefit of TCC and essential amino acids (EAAs) ingestion plus that of TCC ingestion after resistance exercise (RE) among older individuals with sarcopenia. We aimed to evaluate whether a 24-week nutritional program involving EAA and TCC supplementation after RE improved skeletal muscle mass (SMM) among older adults with sarcopenia. Methods: We conducted an open-label, pilot, randomized controlled trial among older adults with sarcopenia at the Harima Care Center or community in Hyogo, Japan. Participants were allocated to RE (n = 18), RE with EAA supplementation (RE + EAA, n = 18), or RE with EAA and TCC supplementation (RE + EAA + TCC, n = 18) groups. Sarcopenia was defined using the Asian Working Group for Sarcopenia 2019 criteria. A 24-week resistance exercise program was carried out twice weekly, with an intake of 3,000 mg and 540 mg of EAA and TCC supplements, respectively. SMM was the primary outcome parameter. Results: The mean adherence rate to exercise and supplementation intake over the 24-week intervention period was 86.8% in the RE + EAA + TCC group, 86.4% in the RE + EAA group, and 85.4% in the RE group. A significant group-by-time interaction was identified for SMM (p = 0.010). The pre- to post-intervention increase in SMM was significantly higher in the RE + EAA + TCC group than in the RE group (p = 0.010). Conclusions: These results suggest that supplementation with EAA and TCC after RE, compared to RE only, improves SMM in older people with sarcopenia. To the best of our knowledge, our study is the first pilot randomized controlled trial to evaluate the effect of TCC supplementation on SMM in older people with sarcopenia. Supplemental data for this article is available online at http://dx.doi.org/10.1080/07315724.2022.2025546