The effect of an 8 week prescribed exercise and low-carbohydrate diet on cardiorespiratory fitness, body composition and cardiometabolic risk factors in obese individuals: A randomised controlled trial
Description:
Low-carbohydrate (LC) diets are an effective method for treating obesity and reducing cardiometabolic risk. However, exposure to LC diets is associated with reductions in muscle mass and increased osteoporosis risk in obese individuals. The combination of exercise with a LC diet appears to attenuate muscle mass loss induced by LC diets alone, and to further improve cardiometabolic profile. However, evidence to date in obese individuals is limited. We assessed the effect of LC diet in combination with supervised exercise on cardiorespiratory fitness, body composition and cardiometabolic risk factors in obese individuals. Male and female participants in the experimental (EX-LC structured supervised exercise program + low-carbohydrate meals n = 33 35.3 years) and control (EX-CO structured supervised exercise program + standard dietary advice n = 31 34.2 years) conditions underwent measurements of cardiorespiratory fitness ( O peak), body fat, lean muscle mass (LMM), and cardiometabolic biomarkers before and after an 8 week intervention. : Participants in the EX-LC condition demonstrated greater improvements in O peak ( = 0.002) and fat mass index (FMI, = 0.001) compared to the EX-CO condition. Achieving a ketogenic state (β-hydroxybutyrate, βHB ≥0.3 mmol/L) was associated with greater reductions in total body fat ( = 0.011), visceral adipose tissue ( = 0.025), FMI ( = 0.002) and C-reactive protein (CRP, = 0.041) but also with greater reductions in LMM ( = 0.042). : Short-term LC diet combined with prescribed exercise enhanced cardiorespiratory fitness and the cardiometabolic profile of obese individuals but was also associated with greater muscle mass loss compared to similar exercise training and standard dietary advice. The long-term effects of the LC diet should be further explored in future studies.
Description:
Low-carbohydrate (LC) diets are an effective method for treating obesity and reducing cardiometabolic risk. However, exposure to LC diets is associated with reductions in muscle mass and increased osteoporosis risk in obese individuals. The combination of exercise with a LC diet appears to attenuate muscle mass loss induced by LC diets alone, and to further improve cardiometabolic profile. However, evidence to date in obese individuals is limited. We assessed the effect of LC diet in combination with supervised exercise on cardiorespiratory fitness, body composition and cardiometabolic risk factors in obese individuals. Male and female participants in the experimental (EX-LC structured supervised exercise program + low-carbohydrate meals n = 33 35.3 years) and control (EX-CO structured supervised exercise program + standard dietary advice n = 31 34.2 years) conditions underwent measurements of cardiorespiratory fitness ( O peak), body fat, lean muscle mass (LMM), and cardiometabolic biomarkers before and after an 8 week intervention. : Participants in the EX-LC condition demonstrated greater improvements in O peak ( = 0.002) and fat mass index (FMI, = 0.001) compared to the EX-CO condition. Achieving a ketogenic state (β-hydroxybutyrate, βHB ≥0.3 mmol/L) was associated with greater reductions in total body fat ( = 0.011), visceral adipose tissue ( = 0.025), FMI ( = 0.002) and C-reactive protein (CRP, = 0.041) but also with greater reductions in LMM ( = 0.042). : Short-term LC diet combined with prescribed exercise enhanced cardiorespiratory fitness and the cardiometabolic profile of obese individuals but was also associated with greater muscle mass loss compared to similar exercise training and standard dietary advice. The long-term effects of the LC diet should be further explored in future studies.
Description:
Hamstring injuries remain a significant burden in sports that involve high-speed running. In elite male football, hamstring injury has repeatedly been identified as the most common non-contact injury, representing 12% of all injuries. As the incidence remains high, investigations are aimed at better understanding how to improve prevention efforts. Intrinsic risk factors such as strength have been investigated extensively in a cohort of professional football players; however, other intrinsic measures of neuromuscular function have not been studied in this cohort. This study aims to investigate the association between timing of hamstring muscle activity onset and the rate of torque development during the early phase of isokinetic strength testing with risk of hamstring injury in professional football players in a prospective cohort study. All teams (n = 18) eligible to compete in the premier football league in Qatar underwent a comprehensive strength assessment during their annual periodic health evaluation at Aspetar Orthopaedic and Sports Medicine Hospital in Doha, Qatar. Variables included rate of torque development and timing of muscle activity onset. A total of 367 unique players (60.6% of all QSL players) competed for 514 player seasons (103 players competed both seasons) and sustained 65 hamstring injuries. There was no difference in the onset of muscle activity between the biceps femoris and medial hamstrings comparing the injured to uninjured players. For both onset of muscle activity and rate of torque development, there were no significant differences between any of the variables (P >.05), with small effect sizes detected across all the different variables (d < 0.3). Rate of torque development and onset of muscle activity were not associated with a risk of future hamstring injury. The use of these measures as part of a periodic health evaluation to identify risk of hamstring injury is unsupported.
Description:
Objective For effective sports injury prevention, information is needed about the implementation context for interventions. This study describes coaches' feedback on the implementation of an evidence-informed injury prevention programme in community junior netball using coaches' perceptions and the RE–AIM framework. Methods A lower-limb injury prevention programme (Down to Earth; D2E), for teaching safe-landing techniques, was delivered to 31 coaches from 31 junior community netball teams in a 1-h workshop. Coaches then delivered a 6-week programme at team training sessions starting in the week before the competition season commenced. 65% of coaches completed a feedback survey 17 weeks after they had delivered the programme. Results Most (88%) coaches believed that D2E improved their players' ability to perform correct landing techniques in games and that players had retained these improvements over the season. The majority (83%) indicated that an improvement in player athletic attributes was the greatest advantage of D2E, followed by a reduction in injury risk. Identified barriers to implementing D2E were running out of time and very young players finding the drills too difficult. Coaches reported that they needed more ideas for training drills that could be incorporated into their programmes and believed that their own coaching training did not adequately prepare them to implement an injury prevention programme. Conclusions Although coaches believed that D2E was effective in developing correct landing techniques, some modifications are needed to make it more suitable for younger players and coach education by accreditation courses could be improved to support the implementation of injury prevention programmes.
Description:
Objective For effective sports injury prevention, information is needed about the implementation context for interventions. This study describes coaches' feedback on the implementation of an evidence-informed injury prevention programme in community junior netball using coaches' perceptions and the RE–AIM framework. Methods A lower-limb injury prevention programme (Down to Earth; D2E), for teaching safe-landing techniques, was delivered to 31 coaches from 31 junior community netball teams in a 1-h workshop. Coaches then delivered a 6-week programme at team training sessions starting in the week before the competition season commenced. 65% of coaches completed a feedback survey 17 weeks after they had delivered the programme. Results Most (88%) coaches believed that D2E improved their players' ability to perform correct landing techniques in games and that players had retained these improvements over the season. The majority (83%) indicated that an improvement in player athletic attributes was the greatest advantage of D2E, followed by a reduction in injury risk. Identified barriers to implementing D2E were running out of time and very young players finding the drills too difficult. Coaches reported that they needed more ideas for training drills that could be incorporated into their programmes and believed that their own coaching training did not adequately prepare them to implement an injury prevention programme. Conclusions Although coaches believed that D2E was effective in developing correct landing techniques, some modifications are needed to make it more suitable for younger players and coach education by accreditation courses could be improved to support the implementation of injury prevention programmes.
Description:
Objective: To explore the relationship between child injury morbidity and socioeconomic status. Design: A cross-sectional analysis of routinely collected hospital separation data for unintentional injury for the period 1999/2000-2004/2005. Setting: All statistical local areas of New South Wales (NSW), Australia Subjects: 110 549 unintentional injury-related hospital separations for NSW children aged 0-14 years. Main outcome measure: Adjusted incidence rate ratios (IRRs) for hospital separations for unintentional injury (for all injury and by individual injury mechanisms) by quintile of socioeconomic disadvantage for children aged 0-14 years. Results: There was no clear relationship between socioeconomic status and injury when all injury mechanisms were combined. However, children in the more disadvantaged quintiles were more likely to be hospitalized than children in the least disadvantaged quintile for the following injury mechanisms: motor cycle ( point estimates for IRRs across the socioeconomic status quintiles ranged from 2.95 to 4.02 relative to the least disadvantaged quintile), motor-vehicle occupant (IRR range 1.33-2.27), pedestrian (IRR range 1.43-2.54 for ages 0-4 years), pedal cyclist ( IRR range 1.30-1.50), fire and burns ( IRR range 1.37-2.00), and poisoning (IRR range 1.32-1.91). Similarly, hospital separation rates for foreign body, other transport, and pedestrian (aged 5-9 years) injuries were also greater, but the differences were not statistically significant across all quintiles. These injury mechanisms accounted for about 25% of the hospital separations. Conclusions: The relationship between relative socioeconomic disadvantage and injury risk in NSW children is strongest for transport-related injuries, fires and burns, and poisoning. Interventions that address these specific injury mechanisms may help to reduce the disparity between high and lower socioeconomic groups.
Description:
OBJECTIVE: The male-specific region of the Y chromosome (MSY) remains one of the most unexplored regions of the genome. We sought to examine how the genetic variants of the MSY influence male susceptibility to coronary artery disease (CAD) and atherosclerosis. Approach and Results: Analysis of 129 133 men from UK Biobank revealed that only one of 7 common MSY haplogroups (haplogroup I1) was associated with CAD-carriers of haplogroup I1 had ≈11% increase in risk of CAD when compared with all other haplogroups combined (odds ratio, 1.11; 95% CI, 1.04-1.18; P=6.8×10-4). Targeted MSY sequencing uncovered 235 variants exclusive to this haplogroup. The haplogroup I1-specific variants showed 2.45- and 1.56-fold respective enrichment for promoter and enhancer chromatin states, in cells/tissues relevant to atherosclerosis, when compared with other MSY variants. Gene set enrichment analysis in CAD-relevant tissues showed that haplogroup I1 was associated with changes in pathways responsible for early and late stages of atherosclerosis development including defence against pathogens, immunity, oxidative phosphorylation, mitochondrial respiration, lipids, coagulation, and extracellular matrix remodeling. UTY was the only Y chromosome gene whose blood expression was associated with haplogroup I1. Experimental reduction of UTY expression in macrophages led to changes in expression of 59 pathways (28 of which overlapped with those associated with haplogroup I1) and a significant reduction in the immune costimulatory signal. CONCLUSIONS: Haplogroup I1 is enriched for regulatory chromatin variants in numerous cells of relevance to CAD and increases cardiovascular risk through proatherosclerotic reprogramming of the transcriptome, partly through UTY.
Description:
OBJECTIVE: The male-specific region of the Y chromosome (MSY) remains one of the most unexplored regions of the genome. We sought to examine how the genetic variants of the MSY influence male susceptibility to coronary artery disease (CAD) and atherosclerosis. Approach and Results: Analysis of 129 133 men from UK Biobank revealed that only one of 7 common MSY haplogroups (haplogroup I1) was associated with CAD-carriers of haplogroup I1 had ≈11% increase in risk of CAD when compared with all other haplogroups combined (odds ratio, 1.11; 95% CI, 1.04-1.18; P=6.8×10-4). Targeted MSY sequencing uncovered 235 variants exclusive to this haplogroup. The haplogroup I1-specific variants showed 2.45- and 1.56-fold respective enrichment for promoter and enhancer chromatin states, in cells/tissues relevant to atherosclerosis, when compared with other MSY variants. Gene set enrichment analysis in CAD-relevant tissues showed that haplogroup I1 was associated with changes in pathways responsible for early and late stages of atherosclerosis development including defence against pathogens, immunity, oxidative phosphorylation, mitochondrial respiration, lipids, coagulation, and extracellular matrix remodeling. UTY was the only Y chromosome gene whose blood expression was associated with haplogroup I1. Experimental reduction of UTY expression in macrophages led to changes in expression of 59 pathways (28 of which overlapped with those associated with haplogroup I1) and a significant reduction in the immune costimulatory signal. CONCLUSIONS: Haplogroup I1 is enriched for regulatory chromatin variants in numerous cells of relevance to CAD and increases cardiovascular risk through proatherosclerotic reprogramming of the transcriptome, partly through UTY.
Description:
Objective: To determine the rate of injury in junior Australian football, and to describe the patterns and severity of these injuries across nine levels of play (U9 to U18). Design: Prospective cohort study. Setting: Junior Australian football games and training sessions were observed for 54 teams from New South Wales and Victoria over the 2004 playing season. Participants: Six teams from each level of play were invited to participate in the study. Overall, data were collected for 51 teams over 40 208 hours of player exposure. Independent variables: Participation and injury data were collected prospectively. Main outcome measures: Injury was defined as "any trauma that causes some disability or pain''. Injury severity was identified by the action of players immediately after the injury event. Results: The overall injury rate was 18.0 (95% CI 16.6 to 19.3) injuries per 1000 player hours. The main cause of injury was body contact (67.3%). There was an increased frequency of sprains and strains, and injury severity with increasing level of play. The rates of injury for players who stayed off the field (6.4 injuries per 1000 hours, 95% CI 5.6 to 7.2) or were advised to seek off-field medical advice (5.0 injuries per 1000 hours, 95% CI 4.3 to 5.7) were low. Conclusion: Compared with the adult game, junior Australian football is relatively safe. However, injury rates increase as children progress across age-determined levels of play towards the more adult form of the game.
Description:
In the absence of an established literature, identifying and quantifying surf bather drowning risk factors requires a clearly defined problem-focused research strategy. To initiate this strategy, nominal group technique (NGT) was used to identify and rank risk and water exposure-related factors based on consensus of an expert panel. The results identified, in order, level of experience (encompassing swimming ability in surf conditions), lack of local knowledge (encompassing awareness of surf hazards, including rip currents), and surf conditions (encompassing prevailing wave height and rip currents) as the three most influential surf bather drowning risk factors. Factors most influential on exposure to water were identi fied and ranked as prevailing weather geographic location (encompassing bather accessibility to the beach), and infrastructure (encompassing the presence of artificial beach amenities). This study provides direction for future analytic epidemiological research and complementary studies on drowning at surf beaches and other locations. ABSTRACT FROM AUTHOR
Description:
In sports injury prevention field trials, data collectors are often club volunteers with considerable knowledge of the game but with limited detailed medical backgrounds or knowledge of formal scientific processes. The aim of this paper is to determine the agreement among trained primary data collectors (PDCs) with a sport science background and no prior involvement in data collection in a large randomised controlled trial. During the 'Preventing Australian Football Injury through eXercise' (PAFIX) project, player participation and injury data were collected by trained PDCs at training and games over the 2007 and 2008 playing seasons in 40 community level Australian football teams. PDC-collected data relating to player exposure and whether or not a player sustained an injury and subsequently left the field of play was compared to the same information from independent observers (IOs) who attended one randomly selected game for each of the 40 teams. There was 98% agreement between the PDC and the IO on game details (i.e., date, time, grade and score), 79% (ICC 0.9, 95% CI 0.85-0.95) agreement on the number of players per game and 76% (ICC 0.8, 95% CI 0.69-0.91) agreement on the number of injuries sustained in the games. There was 100% agreement on whether the player left the field for all injuries. This study found that exercise and sport science students are reliable data collectors in sports injury fieldwork studies. (C) 2010 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Description:
In sports injury prevention field trials, data collectors are often club volunteers with considerable knowledge of the game but with limited detailed medical backgrounds or knowledge of formal scientific processes. The aim of this paper is to determine the agreement among trained primary data collectors (PDCs) with a sport science background and no prior involvement in data collection in a large randomised controlled trial. During the 'Preventing Australian Football Injury through eXercise' (PAFIX) project, player participation and injury data were collected by trained PDCs at training and games over the 2007 and 2008 playing seasons in 40 community level Australian football teams. PDC-collected data relating to player exposure and whether or not a player sustained an injury and subsequently left the field of play was compared to the same information from independent observers (IOs) who attended one randomly selected game for each of the 40 teams. There was 98% agreement between the PDC and the IO on game details (i.e., date, time, grade and score), 79% (ICC 0.9, 95% CI 0.85-0.95) agreement on the number of players per game and 76% (ICC 0.8, 95% CI 0.69-0.91) agreement on the number of injuries sustained in the games. There was 100% agreement on whether the player left the field for all injuries. This study found that exercise and sport science students are reliable data collectors in sports injury fieldwork studies. (C) 2010 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Description:
Youth rugby is a popular sport in South Africa (SA) with a high injury incidence. The annual SA Rugby Youth Week tournaments attract the top age-group players in the country providing a sample of players for reliable injury surveillance. The aim of the study was to analyze the changes in time-loss injury rates at the SA Rugby Youth Week tournaments between 2011 and 2016, differences between age-groups, and to investigate associated injury risk factors. All confirmed time-loss injuries at the 4 age-group tournaments (under-13, under-16, and 2 under-18) from 2011 to 2016 were recorded. Injury incidence densities (IID) for years, tournaments, and injury risk factors were calculated and Poisson regression analyses were performed to determine differences. Time-loss injuries (n = 494) were reported over 24 240 exposure hours, with an overall IID of 20.4 (18.6-22.2) injuries per 1000 player hours. The year 2013 had a significantly lower IID compared to 2011. Injury risk decreased with increasing age; under-13 and under-16 had significantly higher IID compared to under-18 Craven Week. Tackling was the phase of play at highest risk, with an IID of 7.4 (6.3-8.5) injuries per 1000 player hours. Central/peripheral nervous system (CNS/PNS) and, therefore, the head/neck were the most commonly occurring injuries/location injured. In conclusion, within the SA Rugby tournament structure, the older players had a decreased rate of injury. The tackle event was still the phase of play with the highest injury incidence regardless of age. This increase in incidence is largely due to an increase in CNS/PNS injuries.
Description:
The increasing prevalence of overweight and obesity in children is a major public health concern in Kuwait. Understanding the contributing factors is key to the development of an effective intervention strategy. This study was designed to identify what factors contribute to overweight and obesity in school-aged children. Method: A cross-sectional study, using questionnaires, was conducted with public intermediate school children (girls and boys) and their parents to elicit information related to the children’s daily lifestyle. A total of 635 children aged 11-14 years and their parents (N=635) were surveyed and children’s height and weight were measured by school nurses to identify their Body Mass Index. Results: When classified by BMI, about one quarter of the children (25.5%) were overweight and over one third (36.5%) were classified as obese. Multiple regression model found that the BMI of the male children increased significantly with respect to age if they had overweight siblings, spent time on sedentary activities, and regularly ate food from fast food restaurants. The BMI of the female children also increased significantly with respect to age, having overweight siblings, eating at fast food restaurants and for every time not actively travelling to school. Conclusion: The rate of childhood overweight and obesity in Kuwait is currently still high, and Kuwaiti children have been found to be leading unhealthy lifestyles. Involving parents as a part of the solution is an important step in promoting a healthy lifestyle.
Description:
The increasing prevalence of overweight and obesity in children is a major public health concern in Kuwait. Understanding the contributing factors is key to the development of an effective intervention strategy. This study was designed to identify what factors contribute to overweight and obesity in school-aged children. Method: A cross-sectional study, using questionnaires, was conducted with public intermediate school children (girls and boys) and their parents to elicit information related to the children’s daily lifestyle. A total of 635 children aged 11-14 years and their parents (N=635) were surveyed and children’s height and weight were measured by school nurses to identify their Body Mass Index. Results: When classified by BMI, about one quarter of the children (25.5%) were overweight and over one third (36.5%) were classified as obese. Multiple regression model found that the BMI of the male children increased significantly with respect to age if they had overweight siblings, spent time on sedentary activities, and regularly ate food from fast food restaurants. The BMI of the female children also increased significantly with respect to age, having overweight siblings, eating at fast food restaurants and for every time not actively travelling to school. Conclusion: The rate of childhood overweight and obesity in Kuwait is currently still high, and Kuwaiti children have been found to be leading unhealthy lifestyles. Involving parents as a part of the solution is an important step in promoting a healthy lifestyle.
Description:
Emerging evidence suggests that disordered eating, particularly binge-eating symptomatology, is overrepresented within Polycystic Ovary Syndrome (PCOS) populations. This comorbidity presents a clinical dilemma as current treatment approaches for PCOS emphasize the importance of weight management, diet, exercise, and the potential for harm of such treatment approaches in PCOS patients with comorbid disordered eating. However, limited research has assessed the occurrence of binge eating and disordered eating in PCOS patients. Consequently, little is known about the prevalence of binge eating in PCOS, and the possible etiological processes to explain this comorbidity remain poorly understood. Given the paucity of research on this topic, the aims of this narrative review are fourfold: 1) to outline the main symptoms of PCOS and binge eating; 2) to provide an overview of the prevalence of binge eating in PCOS; 3) to outline possible etiological factors for the comorbidity between PCOS and binge eating; and 4) to provide an overview of management strategies of binge eating in PCOS.
Description:
Emerging evidence suggests that disordered eating, particularly binge-eating symptomatology, is overrepresented within Polycystic Ovary Syndrome (PCOS) populations. This comorbidity presents a clinical dilemma as current treatment approaches for PCOS emphasize the importance of weight management, diet, exercise, and the potential for harm of such treatment approaches in PCOS patients with comorbid disordered eating. However, limited research has assessed the occurrence of binge eating and disordered eating in PCOS patients. Consequently, little is known about the prevalence of binge eating in PCOS, and the possible etiological processes to explain this comorbidity remain poorly understood. Given the paucity of research on this topic, the aims of this narrative review are fourfold: 1) to outline the main symptoms of PCOS and binge eating; 2) to provide an overview of the prevalence of binge eating in PCOS; 3) to outline possible etiological factors for the comorbidity between PCOS and binge eating; and 4) to provide an overview of management strategies of binge eating in PCOS.
Description:
There is increasing concern in Australia about safety in the thoroughbred racing industry, but there has been no reported analysis of injury data. This review analyses injury and workers' compensation data recorded in Victoria. On the basis of the results, it is recommended that the injury and incident data collection systems are improved such that they are not only more complete but also accumulate more detailed information about the location of an incident or injury event, the activity at the time of the incident or injury event, and factors that may have influenced the occurrence.
Description:
There is increasing concern in Australia about safety in the thoroughbred racing industry, but there has been no reported analysis of injury data. This review analyses injury and workers' compensation data recorded in Victoria. On the basis of the results, it is recommended that the injury and incident data collection systems are improved such that they are not only more complete but also accumulate more detailed information about the location of an incident or injury event, the activity at the time of the incident or injury event, and factors that may have influenced the occurrence.