Immunometabolic Reprogramming in Response to HIV Infection Is Not Fully Normalized by Suppressive Antiretroviral Therapy

Background: HIV infection results in immunometabolic reprogramming. While we are beginning to understand how this metabolic reprogramming regulates the immune response to HIV infection, we do not currently understand the impact of ART on immunometabolism in people with HIV (PWH). Methods: Serum obtained from HIV-infected (n = 278) and geographically matched HIV seronegative control subjects (n = 300) from Rakai Uganda were used in this study. Serum was obtained before and ~2 years following the initiation of ART from HIV-infected individuals. We conducted metabolomics profiling of the serum and focused our analysis on metabolic substrates and pathways assocaited with immunometabolism. Results: HIV infection was associated with metabolic adaptations that implicated hyperactive glycolysis, enhanced formation of lactate, increased activity of the pentose phosphate pathway (PPP), decreased β-oxidation of long-chain fatty acids, increased utilization of medium-chain fatty acids, and enhanced amino acid catabolism. Following ART, serum levels of ketone bodies, carnitine, and amino acid metabolism were normalized, however glycolysis, PPP, lactate production, and β-oxidation of long-chain fatty acids remained abnormal. Conclusion: Our findings suggest that HIV infection is associated with an increased immunometabolic demand that is satisfied through the utilization of alternative energetic substrates, including fatty acids and amino acids. ART alone was insufficient to completely restore this metabolic reprogramming to HIV infection, suggesting that a sustained impairment of immunometabolism may contribute to chronic immune activation and comorbid conditions in virally suppressed PWH.     

Effect of Concussion on Reaction Time and Neurocognitive Factors: Implications for Subsequent Lower Extremity Injury

BackgroundRecent evidence has demonstrated that athletes are at greater risk for a lower extremity injury following a return-to-sport (RTS) after sport-related concussion (SRC). The reason for this is not completely clear, but it has been hypothesized that persistent deficits in neurocognitive factors may be a contributing factor.Hypothesis/PurposeThis study assessed simple reaction time, processing speed, attention, and concentration in a group of athletes, post-concussion upon clearance for RTS for potential deficits that may result in slower reaction time, processing speed, attention, and concentration. The researchers hypothesized that the concussion group would demonstrate worse scores on both assessments compared to a sex-, age-, and sport-matched cohort.Study DesignCase-controlled studyMethodsTwelve participants who had suffered a SRC and eight healthy individuals who were matched to the concussed group by age, sex, and sport were evaluated. Those with a concussion had been cleared for RTS by a licensed healthcare provider. Each participant underwent neurocognitive tests that included a simple reaction time test (SRT) and the King-Devick Test (K-D). Independent t-tests were performed to compare the groups with significance set a priori at p<0.05.ResultsThere was a significant difference (p =0.024) between groups for SRT with the concussed group demonstrating a better SRT than the control group. There were no significant differences (p =0.939) between the groups for the K-D.ConclusionWith no significant differences between groups in the K-D assessment and, surprisingly, the concussed group having a better SRT compared to the healthy group, our hypothesis was not supported.Clinical RelevanceThese specific measures, compounded with extensive post-concussion time lapse until RTS clearance, may have limited capacity in revealing potential persistent deficits in relevant neurocognitive characteristics.Level of EvidenceLevel of Evidence 3     

Targeting Lifestyle Behavior Change in Adults with NAFLD During a 20-min Consultation: Summary of the Dietary and Exercise Literature

Non-alcoholic fatty liver disease (NAFLD) is largely linked to poor diet, lack of physical activity/exercise, and being overweight. In the absence of approved pharmaceutical agents, lifestyle modification, encompassing dietary change and increased physical activity/exercise to initiate weight loss, is the recommended therapy for NAFLD. Despite this, the use of lifestyle therapy within clinical settings is lacking with limited guidance available about what it should involve, how it should be delivered, and whether it can be feasibly delivered as part of standard care. This paper highlights the evidence for the use of lifestyle modification in NAFLD. While there is evidence to support use of behavioral strategies to support lifestyle behavior change in other clinical populations, these are yet to be assessed in people with NAFLD. However, there is sufficient evidence to suggest that behavioral intervention targeting diet and physical activity to promote weight loss in general is effective and a number of practical strategies are presented on how this could be achieved.     

Acute and chronic caffeine administration increases physical activity in sedentary adults

Caffeine is a commonly used stimulant thought to have ergogenic properties. Most studies on the ergogenic effects of caffeine have been conducted in athletes. The purpose of this study was to test the hypothesis that caffeine reduces ratings of perceived exertion and increases liking of physical activity in sedentary adults. Participants completed treadmill walking at 60% to 70% of their maximal heart rate at baseline and for 6 subsequent visits, during which half of the participants were given caffeine (3 mg/kg) and half given placebo in a sports drink vehicle. To investigate the potential synergistic effects of acute and chronic caffeine on self-determined exercise duration, participants were rerandomized to either the same or different condition for the last visit, creating 4 chronic/acute treatment groups (placebo/placebo, placebo/caffeine, caffeine/placebo, caffeine/caffeine). Participants rated how much they liked the activity and perceived exertion at each visit. There was a main effect of time on liking of physical activity, with liking increasing over time and an interaction of sex and caffeine treatment on liking, with liking of activity increasing in female participants treated with caffeine, but not with placebo. There was no effect of caffeine on ratings of perceived exertion. Individuals who received caffeine on the final test day exercised for significantly longer than those who received placebo. These data suggest that repeated exposure to physical activity significantly increases liking of exercise and reduces ratings of perceived exertion and that caffeine does little to further modify these effects.     

Consumer Health Resources for Racial and Ethnic Minority Groups

Culturally appropriate health materials for consumers can be difficult to identify. Many federal resources exist to help support minority health initiatives. In addition, national nonprofit organizations and state agencies provide materials to address the health needs of African Americans, Hispanics/Latinos, Asian Americans, American Indians/Alaska Natives, and Native Hawaiians/Pacific Islanders. This listing offers an initial list of primary resources that librarians can use to address consumer health inquiries from the public.     

Early life predictors of adult leisure-time physical inactivity: prospective findings from the 1958 British Birth Cohort

BackgroundLeisure-time physical inactivity has a high prevalence and associated disease burden. Adult inactivity research ignores earlier life factors from which later life influences can originate. We aimed to establish whether early life factors influence adult inactivity.MethodsThe 1958 British Birth Cohort is a nationwide follow-up study of all births during 1 week in March, 1958. The outcome of the present study was leisure-time inactivity, defined as activity frequency of less than once a week, assessed at ages 33 years, 42 years, and 50 years (n=12 776). Early life factors (birth to 16 years) were categorised into three domains (physical, social, behavioural). We assessed stability of inactivity from 33 years to 50 years and associations with adult inactivity using logistic regression of: factors within domains, the three domains combined (ie, multivariable associations), and allowing for adult factors. Missing values were imputed with multiple imputation chained equations.FindingsAt each adult age, about 32% of participants were inactive (31% at 33 years, 34% at 42 years, and 30% at 50 years). 1189 (9%) were inactive at all three ages. In analysis of the three domains simultaneously, factors related to adult inactivity were: short prepubertal stature, poor hand control or physical coordination, and poor cognition (physical); low class at birth, minimal parental education, poor household amenities, parental divorce, and institutional care (social); and inactivity, average or lower sports aptitude, smoking, and externalising and unsociable behaviours (behavioural). Odds ratios for inactivity at age 33 years ranged from 0·86 per SD increase in cognition (95% CI 0·82–0·91) to 1·41 (1·23–1·61) for average or lower sports aptitude. Associations weakened slightly but were mostly maintained after adjustment for adult covariates. After allowing for adult covariates participants with unskilled manual backgrounds had 23% higher odds of inactivity at 50 years than those from professional or managerial backgrounds.InterpretationOur study, based on self-report, focuses only on leisure-time inactivity. However, to have repeat, prospective data on inactivity spanning several decades in adulthood is rare, and leisure-time inactivity is likely to be amenable to modification. Adult inactivity is only moderately stable, providing opportunities for behaviour change. Factors from early life are associated with adult inactivity, allowing for early identification of groups vulnerable to later inactivity.FundingThis work was supported by the Department of Health Policy Research Programme through the Public Health Research Consortium. The Great Ormond Street and University College London Institute of Child Health was supported in part by the Department of Health's National Institute for Health Biomedical Research Centre.