Alterations in physiological and perceptual variables during exhaustive endurance work while wearing a pressure-demand respirator

The purpose of this investigation was to describe the time course of changes in physiological and perceptual variables during exhaustive endurance work with and without an air-supplied, full-facepiece, pressure-demand respirator. Thirty-eight healthy subjects (24 to 51 years of age) volunteered for this study. Treadmill speed was set at 5.5 kph (3.4 mph) and elevation was set at a level calculated to elicit 70% of a previously determined maximal aerobic capacity (VO2max). Subjects continued at this rate to exhaustion. Despite a constant work rate, VO2 and %VO2max increased during exercise and were significantly greater with the respirator (34.4 +/- 1.1 mL/kg.min; 84% VO2max) than without the respirator (31.9 +/- 1.1 mL/kg.min; 76% VO2max) at the "final" measurement point prior to termination of exercise by each subject. The final values for ventilation volume (VE) also were significantly greater with the respirator (89.2 +/- 3.4 L/min) than without (73.4 +/- 3.7 L/min). At the conclusion of the endurance walk, dyspnea index (VE/MMV.25) remained well below maximal values (with = 58.6 +/- 2%; without = 44.6 +/- 2%; p less than 0.001). Also, at the final period, no significant differences occurred in the subjects' perceptual ratings of work of breathing, yet work performance time was significantly reduced (p less than 0.0001) from 69.1 +/- 4.4 min (without) to 55.6 +/- 3.8 min (with). A significantly greater swing in peak pressure (maximum pressure measured within the facepiece of respirator), however, from inspired (PPi) to expired (PPe) occurred with the respirator (13.42 cmH2O) than without the respirator (9.25 cmH2O).(ABSTRACT TRUNCATED AT 250 WORDS)     

Effects of immersion and static lung loading on submerged exercise at depth

The effects of static lung loading in the range +20 cmH2O to -20 cmH2O was investigated in 3 male subjects breathing air during submerged exercise in the prone position at pressures ranging from 1.45 ATA to 6.76 ATA. Both maximal and submaximal exercise was performed and dry controls were done at 1.45 ATA. A low-resistance bag-in-a-box breathing apparatus (less than 1.25 cmH2O/liter/s at 8 g/liter density) was used. Static lung loading had little effect on maximal or submaximal VO2, VCO2, VE, heart rate, or end-tidal PCO2, while increased breathing gas density did affect these parameters to a larger extent. Imersion per se reduced the VE at a given level of VO2 and increased both the VT and VA at a given VE. Increasingly positive static lung load increased VC and ERV both during rest and exercise. Exercise-induced dyspnea was experienced and scored. At submaximal VO2 levels up to 2.5 liter/min this dyspnea did not limit exercise at any depth, but during maximal exertion at 6.76 ATA (VO2 from 3.45--3.77 liter/min), dyspnea became work limiting in several cases. Static load had a marked effect on dyspnea and a load of +10 cmH2O produced the least dyspnea, enabling all subjects to perform maximal exertions for 5 min at 6.76 ATA. The 15-s MVV was performed at all depths and static loads and neither it nor the VE/MVV ratio correlated with the degree of dyspnea.     

Duration of increased pulmonary function sensitivity to an initial ozone exposure

The metabolic and pulmonary function effects were investigated in six non-smoking young adults who were exposed for 2 hours (22 degrees C WBGT) to: filtered air (FA) 0.45 ppm ozone (DAY1); and two days later to a second exposure to 0.45 ppm ozone (DAY2). The subjects alternated 20-minute periods of rest and 20-minute periods of bicycle ergometer exercise at a workload predetermined to elicit a ventilatory minute volume (VE) of 27 L/min (BTPS). Functional residual capacity (FRC) was determined pre- and post-exposure. Forced vital capacity (FVC) was determined before and after exposure, as well as 5 minutes after each exercise period. Heart rate was monitored throughout the exposure, and VE, oxygen uptake (VO2), respiratory rate (fR), and tidal volume (VT) were measured during the last 2 minutes of each exercise period. There were no changes in any variable consequent to FA exposure. Both ozone exposures induced significant (P less than 0.05) decrements in FVC; FEV1.0 (forced expiratory volume in 1 second); FEV3.0 (forced expiratory volume in 3 seconds); FEF25-75% (average flow rate between 25% and 75% of FVC); and total lung capacity (TLC). The decrements following the DAY2 ozone exposure were significantly greater than following DAY1, and averaged 7.2 percentage points greater than those following the DAY1 exposure.     

Acute Rhodiola rosea intake can improve endurance exercise performance

PURPOSE: The purpose of this study was to investigate the effect of acute and 4-week Rhodiola rosea intake on physical capacity, muscle strength, speed of limb movement, reaction time, and attention. METHODS: PHASE I: A double blind placebo-controlled randomized study (n= 24) was performed, consisting of 2 sessions (2 days per session). Day 1: One hour after acute Rhodiola rosea intake (R, 200-mg Rhodiola rosea extract containing 3% rosavin + 1% salidroside plus 500 mg starch) or placebo (P, 700 mg starch) speed of limb movement (plate tapping test), aural and visual reaction time, and the ability to sustain attention (Fepsy Vigilance test) were assessed. Day 2: Following the same intake procedure as on day 1, maximal isometric knee-extension torque and endurance exercise capacity were tested. Following a 5-day washout period, the experimental procedure was repeated, with the treatment regimens being switched between groups (session 2). PHASE II: A double blind placebo-controlled study (n = 12) was performed. Subjects underwent sessions 3 and 4, identical to Phase I, separated by a 4-week R/P intake, during which subjects ingested 200 mg R/P per day. RESULTS: PHASE I: Compared with P, acute R intake in Phase I increased (p <.05) time to exhaustion from 16.8 +/- 0.7 min to 17.2+/- 0.8 min. Accordingly, VO2peak (p <.05) and VCO2peak (p<.05) increased during R compared to P from 50.9 +/- 1.8 ml x min(-1) x kg(- )1 to 52.9 +/- 2.7 ml x min(-10) x kg(-1) (VO2peak) and from 60.0 +/- 2.3 ml x min(-1) x kg(-1) to 63.5+/- 2.7 ml x min(-1) x kg(-1) (VCO2peak). Pulmonary ventilation (p =.07) tended to increase more during R than during P (P: 115.9+/- 7.7 L/min; R: 124.8 +/- 7.7 L/min). All other parameters remained unchanged. PHASE II: Four-week R intake did not alter any of the variables measured. CONCLUSION: Acute Rhodiola rosea intake can improve endurance exercise capacity in young healthy volunteers. This response was not altered by prior daily 4-week Rhodiola intake.     

Comprehensive assessment of ventilatory functions of patients with chronic heart failure

OBJECTIVE: A comprehensive assessment of the ventilatory functions of patients with chronic heart failure (CHF) both at rest and during a cardiopulmonary exercise test (CPET). We studied 42 males, divided into two groups--patients with CHF (n = 21) and age, weight, height and BMI matched healthy controls (n = 21). All subjects underwent a symptom-limited ramp CPET, arterial blood gas analysis, and complex functional examination of the pulmonary system. Subjective rating of dyspnea and exertion were measured by the Borg and ATS dyspnea scales. CHF patients showed a slight, but statistically significant decrease of the spirographic and diffusion parameters, as well as of the indices of respiratory muscle strength. There were no changes in blood gases and in tidal breathing parameters. The exercise capacity was markedly reduced (VO2peak ml.min-1 1352 +/- 335 CHF patients vs 2077 +/- 276 healthy controls; p < 0.001) and the anaerobic threshold occurred earlier (< 40% of predicted VO2peak) during CPET in CHF patients. The increase in VE/VCO2 in CHF patients (35.7 +/- 5.1 CHF; 28.9 +/- 2.5 HC, p < 0.001) indicates a compromised ventilatory efficiency which leads to a higher dyspneic cost of exercise (Borg peak 9.5 +/- 1.03 CHF; 6.0 +/- 1.28 HC; p < 0.001) as compared with healthy controls.     

Effects of pressure-demand respirator wear on physiological and perceptual variables during progressive exercise to maximal levels

Current regulations governing the certification of respiratory protective devices are based on data published in the early 1950s. The limited data base of this early work and documented increases in the average height of the population underscore the need for additional information concerning the parameters of certification. In the present study, a protocol using an inclined treadmill (0.5% grade every 12 sec) was used to test a heterogeneous population (n = 38). Through submaximal up to and including maximal exercise levels with and without respirator wear, maximal oxygen uptake (VO2max) was significantly greater (p less than 0.01) with the respirator (44.11 +/- 1.3 mL/kg.min) than without the respirator (42.18 +/- 1.4 mL/kg.min) while maximal ventilation volumes (VEmax) were not significantly different (with = 118.7 +/- 4 L/min; without 119.6 +/- 5 L/min). While peak inspired flows (PFI) with the respirator (268 +/- 7 L/min) were less than without the respirator (281 +/- 9 L/min), p greater than 0.05, the lower peak expired flow (PFE) with the respirator (289 +/- 12 L/min) than without the respirator (324 +/- 13 L/min), p less than 0.01, indicated a significant blunting effect of the respiratory flows by the expired resistance during exercise to maximal levels. Peak inspired pressures (PPi) with and without the respirator were not significantly different (p greater than 0.05). The negative values obtained within the facepiece of the respirator (-7.65 +/- 0.8 cmH2O), however, indicate that the positive pressure within the facepiece was lost, and respiratory protection may be compromised. Peak expired pressure with the respirator (13.05 +/- 0.7 cmH2O) was significantly greater than without the respirator (10.7 +/- 0.5 cmH2O) indicating that, despite a lower PFE, greater force was required to overcome the resistances of the respirator on expiration. The dyspnea index, an index of physiological effort; suggests that the subjects were working at a higher percentage of their respiratory reserve with the respirator (p less than 0.05) than without. Perceptually, subjects also felt that breathing with the respirator was more difficult (p less than 0.05). The maximum heart rate and the ratings of perceived exertion were not significantly different between the two tests at maximal exercise levels. Maximum oxygen uptake was considered reached when subjects attained a respiratory exchange ratio of at least 1.15, when a heart rate response at or greater than age-predicted maximum was achieved, when ratings of perceived exertion indicated exhaustion, and/or when the measure of VO2 had plateaued during the final minute of exercise.(ABSTRACT TRUNCATED AT 400 WORDS)     

Prevalence of hypoglycemia following pre-exercise carbohydrate ingestion is not accompanied By higher insulin sensitivity

Pre-exercise carbohydrate feeding may result in rebound hypoglycemia in some but not all athletes. The aim of the present study was to examine whether insulin sensitivity in athletes who develop rebound hypoglycemia is higher compared with those who do not show rebound hypoglycemia. Twenty trained athletes (VO(2max) of 61.8 +/- 1.4 ml.kg(-1).min(-1)) performed an exercise trial on a cycle ergometer. Forty-five minutes before the start of exercise, subjects consumed 500 ml of a beverage containing 75 g of glucose. The exercise trial consisted of 20 min of submaximal exercise at 74 +/- 1% VO(2max) immediately followed by a time trial. Based upon the plasma glucose nadir reached during submaximal exercise, subjects were assigned to a Hypo group (<3.5 mmol/L) and a Non-hypo group (> or =3.5 mmol/L). An oral glucose tolerance test was performed to obtain an index of insulin sensitivity (ISI). The plasma glucose nadir during submaximal exercise was significantly lower (p <.01) in the Hypo-group (n = 10) compared with the Non-hypo group (n = 10) (2.7 +/- 0.1 vs. 4.1 +/- 0.2 mmol/L, respectively). No difference was found in ISI between the Hypo and the Non-hypo group (3.7+/-0.4 vs. 3.8 +/- 0.5, respectively). The present results suggest that insulin sensitivity does not play an important role in the occurrence of rebound hypoglycemia.     

Ultrafine particle deposition in subjects with asthma

Ambient air particles in the ultrafine size range (diameter < 100 nm) may contribute to the health effects of particulate matter. However, there are few data on ultrafine particle deposition during spontaneous breathing, and none in people with asthma. Sixteen subjects with mild to moderate asthma were exposed for 2 hr, by mouthpiece, to ultrafine carbon particles with a count median diameter (CMD) of 23 nm and a geometric standard deviation of 1.6. Deposition was measured during spontaneous breathing at rest (minute ventilation, 13.3 +/- 2.0 L/min) and exercise (minute ventilation, 41.9 +/- 9.0 L/min). The mean +/- SD fractional deposition was 0.76 +/- 0.05 by particle number and 0.69 +/- 0.07 by particle mass concentration. The number deposition fraction increased as particle size decreased, reaching 0.84 +/- 0.03 for the smallest particles (midpoint CMD = 8.7 nm). No differences between sexes were observed. The deposition fraction increased during exercise to 0.86 +/- 0.04 and 0.79 +/- 0.05 by particle number and mass concentration, respectively, and reached 0.93 +/- 0.02 for the smallest particles. Experimental deposition data exceeded model predictions during exercise. The deposition at rest was greater in these subjects with asthma than in previously studied healthy subjects (0.76 +/- 0.05 vs. 0.65 +/- 0.10, p < 0.001). The efficient respiratory deposition of ultrafine particles increases further in subjects with asthma. Key words: air pollution, asthma, deposition, dosimetry, inhalation, ultrafine particles.     

Assessment of respiratory compensation phase during graded exercise in patients with chronic heart failure

BACKGROUND: The VE-VO2 relationship during graded exercise has an inflection point beyond the ventilatory anaerobic threshold (VAT) termed the respiratory compensation point (RCP). Metabolic variables analyzed at the level of VAT and RCP may contribute to the better understanding of such limiting symptoms in chronic heart failure (CHF) patients as dyspnea and early fatigue. The AIM of the present study was to analyze the RCP during symptom limited ramp exercise testing in CHF patients. PATIENTS AND METHODS: Forty six CHF patients (II and III NYHA functional class; age = 51 +/- 9 years, LVEF% = 35% +/- 6%; mean +/- SD) and 20 matched controls performed graded cardiopulmonary exercise test on a cycle ergometer. RESULTS: The duration and productivity of RCP (delta(x) = peak(x) - VAT(x)) in patients were significantly (p < 0.001) reduced compared to healthy subjects: delta duration = 3.0 +/- 1.2 vs 4.3 +/- 1.5 min, delta watts = 24.3 +/- 11.5 vs. 39.4 +/- 11.5, delta VO2/kg (ml.kg-1 x min-1) = 3.8 +/- 1.3 vs 8.8 +/- 2.3. An important characteristic of this phase was the higher subjective cost of physical effort assessed by Borg scale and Watts/Borg ratio (Borg peak = 9.9 +/- 0.4 vs. 6.0 +/- 1.2; p < 0.001, Watts/Borg peak = 9.2 +/- 2.3 vs 23.9 +/- 6.4, p < 0.001). The relative hyperventilation of patients on the basis of the watt exercise can be seen in the values of derivative index V (ml x min-1 x watt-1) 478 +/- 59 vs 568 +/- 118; (p < 0.001) in controls and patients, respectively. CONCLUSIONS: The impaired efficiency of oxygen delivery systems in patients with CHF is what causes the appearance of early limiting symptoms. Duration and productivity of respiratory compensation phase in CHF patients are considerably reduced compared to controls.     

Effect of alcohol on postprandial lipemia with and without preprandial exercise

OBJECTIVE: Different factors such as exercise habits and alcohol consumption may modulate postprandial lipid metabolism. What are the effects of alcohol on postprandial metabolism in untrained and trained individuals? METHODS: The postprandial lipid response to an oral fat load (1 g fat per kg body weight (bw)) with and without alcohol (0.5 g/kg bw) was evaluated in physically trained healthy young men (T, n = 12, mean +/- SD age 27 +/- 3 years. BMI 21.6 +/- 1.4 kg/m2) after a premeal running session and in untrained healthy young men (UT, n = 8, age 24 +/- 1 years, BMI 23.2 +/- 1.8 kg/m2) without a premeal exercise session. The T subjects ingested 35.5 +/- 2.7 g alcohol, the UT subjects 38 +/- 0.6 g. Fat was given as butter and the carbohydrates as marmalade and zwieback (rusk). The T subjects received 1.20 +/- 0.05 g fat and 1.02 +/- 0.04 g carbohydrates per kilogram lean body mass. The corresponding numbers for the UT subjects were 1.28 +/- 0.08 g and 1.20 +/- 0.06 g. The postprandial lipemia was observed for an eight-hour period. RESULTS: Alcohol led to an increase to the triacylglycerol area under the curve (AUC) in the T subjects from 7.4 +/- 0.4 mmol/L * h on the control day to 11.3 +/- 0.9 mmol/L * h (p = 0.001). The corresponding numbers in the UT subjects were 13.4 +/- 2.3 mmol/L * h to 19.4 +/- 3.5 mmol/L * h (p = 0.004). Alcohol intake and physical activity training were the major determinants of the triacylglycerol (TG) AUC in these subjects. CONCLUSION: The ingestion of a high fat meal in combination with alcohol leads to an increased in the postprandial lipemia independently from the level of training. It is suggested that this unfavorable effect of alcohol and a high fat diet could be modified by fat restriction or a combination of a premeal exercise session and a higher level of physical activity training.     

Circadian variation in physiological responses to exercise on a stationary bicycle ergometer.

The responses of six healthy male subjects to submaximal and maximal exercise on a stationary bicycle ergometer have been investigated over a 24-hour period. Measurements were made on each subject at approximately three-hourly intervals and they included minute ventilation at a carbon dioxide output of 1-5 1 min-minus 1 (VE 1-5), tidal volume at a fixed VE of 30 1 min-minus 1 (VT 30), oxygen intake (VO2) at a work load (W) of 150 W (VO2 150), tympanic temperature (Tty) and cardiac frequency at a VO2 of 1-5 1 min-minus 1 (fH 1-5). The experiments were conducted in three parts: on the first occasion two subjects were measured during exercise; on the second occasion a further four subjects were observed in a similar way but starting from a baseline of zero load, and the measurements also included an estimate of cardiac output (Q) using a rebreathing technique. Finally the maximum aerobic power output (VO2max) was measured in three of the subjects in early morning and late evening. Diet and habitual physical activity were held constant between the exercise test on all three occasions. The results show that in the first two subjects fH 1-5 and Tty had a rhythmic pattern of variation with time of day whereas VE 1-5, VT30, and VO2 150 remained fairly constant. The variation in fH 1-5 was associated with Tty; the two variables reached a minimum at similar to 0500 hr and a maximum at similar 1200 hr. These results were confirmed on the remaining subjects but the changes in fH 1-5 and Tty were shown to be more variable and reduced in magnitude. Further, if the changes were calculated from a baseline of zero load, it was shown that the absolute changes observed in fH 1-5 and Tty were not due to the exercise per se but to changes in the basal level from which each subject operated. In addition it was shown that VO2 max and Q remained constant and were independent of the time of day. It is concluded that provided the exercise test conditions are rigidly standardized and subjects exercise from a controlled baseline there is no evidence for circadian variation in the change of responses to work at submaximal or maximal effort.     

急性敌百虫中毒与氧化应激及自由基损伤的关系

目的探讨急性敌百虫中毒与氧化应激和自由基损伤的关系。方法采用随机对照设计,用分光光度分析法检测了2002年7月至2003年6月抢救的82例急性敌百虫中毒者和92例健康成人志愿者的血浆维生素C、维生素E、红细胞过氧化脂质(LPO)水平和超氧化物歧化酶(SOD)、乙酰胆碱酯酶(AChE)活性。结果中毒组的维生素C为(3735±998)μmol/L,维生素E为(1657±454)μmol/L,SOD为(1785±154)U/gHb,AChE为(2131±576)U/gHb,志愿组的维生素C为(5534±1598)μmol/L,维生素E为(2566±724)μmol/L,SOD为(2124±185)U/gHb,AChE为(3053±836)U/gHb,中毒组上述指标均显著低于志愿组;中毒组的LPO为(3520±529)nmol/gHb,显著高于志愿组的(2787±466)nmol/gHb。控制年龄的偏相关分析结果表明,中毒组的AChE值与LPO值呈负相关,与维生素C、维生素E和SOD值呈正相关。结论急性敌百虫中毒者体内存在着严重的氧化应激和自由基损伤。     

Carbohydrate-supplement form and exercise performance

Numerous studies have shown that ingesting carbohydrate in the form of a drink can improve exercise performance by maintaining blood glucose levels and sparing endogenous glycogen stores. The effectiveness of carbohydrate gels or jellybeans in improving endurance performance has not been examined. On 4 separate days and 1-2 hr after a standardized meal, 16 male (8; 35.8 +/- 2.5 yr) and female (8; 32.4 +/- 2.4 yr) athletes cycled at 75% VO(2peak) for 80 min followed by a 10-km time trial. Participants consumed isocaloric (0.6 g of carbohydrate per kg per hour) amounts of randomly assigned sports beans, sports drink, gel, or water only, before, during, and after exercise. Blood glucose concentrations were similar at rest between treatments and decreased significantly during exercise with the water trial only. Blood glucose concentrations for all carbohydrate supplements were significantly, p < .05, higher than water during the 80-min exercise bout and during the time trial (5.7 +/- 0.2 mmol/L for sports beans, 5.6 +/- 0.2 mmol/L for sports drink, 5.7 +/- 0.3 mmol/L for gel, and 4.6 +/- 0.3 mmol/L for water). There were no significant differences in blood glucose between carbohydrate treatments. The 10-km time trials using all 3 carbohydrate treatments were significantly faster (17.2 +/- 0.6 min for sports beans, 17.3 +/- 0.6 min for sports drink, and 17.3 +/- 0.6 min for gel) than water (17.8 +/- 0.7 min). All carbohydrate-supplement types were equally effective in maintaining blood glucose levels during exercise and improving exercise performance compared with water only.     

Aerobic exercise alters postprandial lipemia in African American versus White women

PURPOSE: To determine whether ethnicity influences postprandial lipemia after a bout of aerobic exercise. METHODS: Randomized crossover design. Healthy White (W; n=6) and African American (AA; n=6) women (age, W 27.0+/-3.3 yr, AA 21.6+/-1.4 yr; body-mass index, W 25.0+/-0.93 kg/m2, AA 25.8+/-0.79 kg/m2) participated in 2 treatments (control and exercise), each conducted over 2 d. On d 1, participants rested (control) or walked at 60% of maximal oxygen uptake for 90 min (exercise) and then consumed a meal. On d 2, after a 12-hr overnight fast, participants consumed an oral fat-tolerance test (OFTT) meal of 1.7 g fat, 1.65 g carbohydrate, and 0.25 g protein per kg fat-free mass. Blood was collected pre-meal and at 0.5, 1, 2, 3, 4, 5, and 6 hr post-OFTT and analyzed for triacylglycerol (TAG), glucose, and insulin. Areas under the curve (AUCs) were calculated for each blood variable. RESULTS: A significantly lower TAG AUC was observed for AA (0.86+/-0.24 mmol x L(-1) x 6 hr(-1)) after exercise than for W (2.25+/- .50 mmol x L(-1) x 6 hr(-1)). Insulin AUC was significantly higher for AA after exercise (366.2+/-19.9 mmol x L(-1) x 6 hr(-1)) than for the control (248.1+/-29.2 mmol x L(-1) x 6 hr(-1)). CONCLUSIONS: The data indicate that exercise performed approximately 13 hr before an OFTT significantly reduces postprandial lipemia in AA compared with W. It appears that AA women have an increased ability to dispose of TAG after exercise and a high-fat meal.     

Acute effects of aerobic exercise on mood and hunger feelings in male obese adolescents: a crossover study

ABSTRACT: BACKGROUND: The aim of this study was to determine the acute effects of exercise intensity on anxiety, mood states and hunger in obese adolescents. METHODS: Subjects were eight male obese adolescents (age 15.44 +/- 2.06y; BMI 33.06 +/- 4.78 kg/m2). Each subject underwent three experimental trials: 1) Control, seated for 30 min; 2) Low intensity exercise (LIE) - exercise at 10% below ventilatory threshold (VT); 3) High intensity exercise (HIE) - exercise at 10% above VT. Anxiety (STAI Trait/State), mood (POMS) and hunger (VAS) were assessed before and immediately after the experimental sessions. Comparisons between trials and times were assessed using Kruskal-Wallis and Wilcoxon tests, respectively. Associations between variables were described using a Spearman test. RESULTS: The largest increase in hunger was observed after LEI (914.22%). Both exercise sessions increased anxiety, fatigue and decreased vigor (p < 0.05). CONCLUSIONS: Acute exercise bouts are associated with negative changes in anxiety and mood, and with increases in hunger in obese adolescents.     

Effect of sex and obesity on basal VLDL-triacylglycerol kinetics

BACKGROUND: Plasma fatty acid availability is a major regulator of VLDL-triacylglycerol production. Basal whole-body lipolysis is higher in women than in men and is higher in persons with abdominal obesity than in lean individuals. OBJECTIVE: Our goal was to determine whether sex and abdominal obesity affect VLDL-triacylglycerol kinetics. We hypothesized that basal VLDL-triacylglycerol production would be greater in women than in men and greater in obese than in lean subjects. DESIGN: VLDL-triacylglycerol kinetics were measured in 20 lean (10 men, 10 women; body mass index, in kg/m(2): 23 +/- 1) and 20 abdominally obese (10 men, 10 women; body mass index: 35 +/- 1) subjects by using a bolus injection of [(2)H(5)]glycerol and compartmental modeling analysis. RESULTS: The rate of VLDL-triacylglycerol secretion was greater in the lean women than in the lean men (5.1 +/- 0.7 and 2.6 +/- 0.3 micro mol x L plasma(-1) x min(-1), respectively; P < 0.002). Obesity was associated with increased VLDL-triacylglycerol secretion in the men (P < 0.001) but not in the women, which resulted in greater rates of VLDL-triacylglycerol secretion in the obese men than in the obese women (6.8 +/- 0.5 and 5.0 +/- 0.5 micro mol x L plasma(-1) x min(-1), respectively; P < 0.05). The clearance of VLDL-triacylglycerol from plasma was greater (P < 0.05) in the lean women than in the lean men (42 +/- 7 and 27 +/- 4 mL plasma/min, respectively) or in the obese men and obese women (28 +/- 3 and 20 +/- 4 mL plasma/min, respectively). The plasma VLDL-triacylglycerol concentration was directly related to the rate of VLDL-triacylglycerol secretion in the men (R(2) = 0.79, P < 0.001) and inversely related to VLDL-triacylglycerol clearance in the women (R(2) = 0.84, P<0.001). CONCLUSION: Sex and obesity have independent effects on basal VLDL-triacylglycerol kinetics.     

An on-line computer system for monitoring respiratory and cardiac functions of patients

A computer-based noninvasive and continuous patient monitoring system for breath-by-breath assessment of cardiorespiratory functions was developed. Transthoracic impedance changes caused by respiratory and cardiac activities were measured with separate impedance plethysmographs of different frequencies. A mini-computer system calculated on-line eight respiratory parameters (VT, f, VE, PETO2, PETCO2, VO2, VCO2, and R) in cooperation with expired gas analysis data from a mass-spectrometer, and three cardiac parameters (SV, HR and Q). These parameters were displayed simultaneously at the end of each breath. In order to improve the signal-to-noise ratio of the impedance cardiogram to a level allowing computer determination, an ensemble averaging technique was utilized. The computer-derived cardiorespiratory parameters obtained during voluntary hyperventilation and a passive tilt demonstrated reasonable changes.     

Influence of prolonged starvation on glucose kinetics in pregnant patients infected with Plasmodium falciparum

Hypoglycaemia is a recognised complication of malaria in pregnancy, but its pathophysiology is not well understood. We studied the influence of fasting on glucose production and gluconeogenesis by infusion of [6,6-(2)H(2)]glucose and ingestion of (2)H(2)O in 20 female subjects, eight pregnant patients with uncomplicated falciparum malaria, six pregnant controls matched for age and trimester and six non-pregnant controls matched for age.Infection with Plasmodium falciparum induced a significant increase in glucose production (16.7+/-0.3 vs. 12.4+/-0.8 micromol/kg/min; P=0.002) and gluconeogenesis (12.5+/-0.6 vs. 8.2+/-0.7 micromol/kg/min; P=0.001) without a change in the glucoregulatory hormone milieu, compared to the healthy pregnant controls. Extension of the fast from 20.30 to 24.30 h resulted in a rate of decline of glucose production that was similar in patients with malaria and healthy pregnant subjects, a decline that was steeper compared to the non-pregnant subjects (-0.283 and -0.426 vs. -0.065 micromol/kg/min/h; P=0.037). The plasma glucose concentration measured at 20.30 h of fasting in the malaria patients was intermediate between the value found in the pregnant and the non-pregnant controls (4.01+/-0.2 mmol/l) while it was significantly lower in the non-infected pregnant women compared to non-pregnant controls (3.59+/-0.14 vs. 4.70+/-0.29 mmol/l; P=0.009). Plasma glucose concentration declined at a similar rate in patients with malaria and pregnant controls but faster compared to the non-pregnant controls (-0.078 and -0.093 vs. -0.044 mmol/l/h; P < 0.05).We conclude that fasting is a major risk factor for hypoglycaemia in pregnancy. Non-severe Plasmodium falciparum infection in pregnant women results in higher glucose production and higher glucose levels, thereby, compared to healthy pregnant patients, delaying of the occurrence of hypoglycaemia due to fasting. The exact mechanism of hypoglycaemia in fasting pregnant women remains to be elucidated.     

Effects of exercise on emerging and traditional cardiovascular risk factors

BACKGROUND: Common cardiovascular disease risk factors (e.g., insulin and aerobic fitness) are improved with exercise; however, few studies have addressed the potential for training to modify emerging cardiovascular disease risk factors such as homocysteine and high-sensitivity C-reactive protein. METHODS: Sedentary adults (n = 324, 48.9 +/- 8.4 years) were randomized to four groups differing in training intensity (moderate = 45-55% or high = 65-75% of heart rate reserve) and frequency (low = 3-4, 30-min sessions/week or high = 5-7, 30 min-sessions/week). RESULTS: Within-group changes in homocysteine, insulin, and aerobic fitness were significant (all P < 0.0125). Furthermore, homocysteine increased in the high-intensity-low-frequency (0.98 +/- 2.32 micromol/L) and high-intensity-high-frequency (0.93 +/- 2.56 micromol/L) groups, while aerobic fitness increased in the moderate-intensity-high-frequency (0.99 +/- 2.01 mL min(-1) kg(-1)) and high-intensity-high-frequency (1.77 +/- 2.97 mL min(-1) kg(-1)) groups (all P < 0.003). The change in aerobic fitness was greater in the high-intensity-high-frequency compared to the moderate-intensity-low-frequency group (1.77 +/- 2.97 vs. 0.36 +/- 2.10 mL min(-1) kg(-1), P = 0.0014) (effect size estimate = 0.60 mL min(-1) kg(-1)). The main effects for intensity, with respect to the change in insulin (effect size estimate = 0.46 microU/mL), and frequency, with respect to the change in aerobic fitness (effect size estimate = 0.38 mL min(-1) kg(-1)), were significant (P < 0.0125). CONCLUSION: Although frequent bouts of higher intensity exercise were particularly effective in reducing fasting insulin and improving fitness, they resulted in slightly increased homocysteine levels.     

The influence of low versus high carbohydrate diet on a 45-min strenuous cycling exercise

To examine the effects of a 3-day high carbohydrate (H-CHO) and low carbohydrate (L-CHO) diet on 45 min of cycling exercise, 12 endurance-trained cyclists performed a 45-min cycling exercise at 82 +/- 2% VO2peak following an overnight fast, after a 6-day diet and exercise control. The 7-day protocol was repeated under 2 randomly assigned dietary trials H-CHO and L-CHO. On days 1-3, subjects consumed a mixed diet for both trials and for days 4-6 consumed isocaloric diets that contained either 600 g or 100 g of carbohydrates, for the H-CHO and the L-CHO trials, respectively. Muscle biopsy samples, taken from the vastus lateralis prior to the beginning of the 45-min cycling test, indicated that muscle glycogen levels were significantly higher (p < .05) for the H-CHO trial (104.5 +/- 9.4 mmol/kg wet wt) when compared to the L-CHO trial (72.2 +/- 5.6 mmol/kg wet wt). Heart rate, ratings of perceived exertion, oxygen uptake, and respiratory quotient during exercise were not significantly different between the 2 trials. Serum glucose during exercise for the H-CHO trial significantly increased (p < .05) from 4.5 +/- 0.1 mmol x L(-1) (pre) to 6.7 +/- 0.6 mmol x L(-1) (post), while no changes were found for the L-CHO trial. In addition, post-exercise serum glucose was significantly greater (p < .05) for the H-CHO trial when compared to the L-CHO trial (H-CHO, 6.7 +/- 0.6 mmol x L(-1); L-CHO, 5.2 +/- 0.2 mmol x L(-1)). No significant changes were observed in serum free fatty acid, triglycerides, or insulin concentration in either trial. The findings suggest that L-CHO had no major effect on 45-min cycling exercise that was not observed with H-CHO when the total energy intake was adequate.