Leisure-Time Physical Activity and the Metabolic Syndrome in the Finnish Diabetes Prevention Study

OBJECTIVE

To assess the effects of leisure-time physical activity (LTPA) and resistance training on metabolic syndrome (MetS) and its components in a post hoc analysis of the Finnish Diabetes Prevention Study, a randomized controlled lifestyle counseling trial.

RESEARCH DESIGN AND METHODS

A cohort of 486 middle-aged overweight men and women with impaired glucose tolerance were followed for an average of 4.1 years. The intervention and control groups were combined in the analyses. LTPA was assessed by questionnaires, dietary intake by food records, and features of the MetS by anthropometric and biochemical measures annually. Resistance training sessions were documented for 137 participants.

RESULTS

Increased moderate-to-vigorous LTPA, even after adjustments for changes in dietary intakes of total and saturated fat, fiber, and energy, and change in BMI was associated with a greater likelihood for resolution (29.7 vs. 19.1%; P = 0.004 in the upper versus lower third of change) and a lesser likelihood for development (23.5 vs. 44.7%; P = 0.041) of the MetS. Of the components of the MetS, the increase in moderate-to-vigorous LTPA was associated most strongly with improvement of glycemia. Among the 137 participants who participated in resistance training, MetS components were favorable in individuals who were in the upper third of participation rate (median 51 times/year) compared with individuals in the lowest third (median 8.5 times/year).

CONCLUSIONS

Increased moderate-to-vigorous LTPA was associated with a decreased likelihood of developing the MetS and an increased likelihood of its resolution in individuals at high risk for type 2 diabetes.The metabolic syndrome (MetS) is a constellation of interrelated metabolic risk factors, including abdominal obesity, insulin resistance, hyperglycemia, dyslipidemia, and elevated blood pressure, often accompanied by a prothrombotic and proinflammatory state (1,2). The underlying pathophysiology of the MetS is unclear, but both insulin resistance and abdominal obesity are considered main components (1,2). The MetS increases the risk of both type 2 diabetes (3) and cardiovascular disease (4,5).Recent recommendations for the prevention and treatment of the MetS and its components promote increased physical activity (including aerobic and resistance exercise), a healthy diet, and weight loss (2,6–8). In lifestyle interventions trials, the incidence of type 2 diabetes has been reduced by more than half in individuals with impaired glucose tolerance, and the prevalence of the MetS has also been decreased (9,10). In the Finnish Diabetes Prevention Study (DPS), increased moderate-to-vigorous leisure-time physical activity (LTPA) was strongly associated with a lower risk of type 2 diabetes, independently of dietary changes and weight loss (11).Some prospective epidemiological studies and uncontrolled trials have suggested that increased moderate-to-vigorous exercise decreases the incidence or prevalence of the MetS (8,12,13). However, data on the role of changes in LTPA in the prevention and treatment of the MetS in long-term studies are limited. Therefore, we conducted a post hoc analysis of the Finnish DPS. Our hypothesis was that the change in LTPA and participation in resistance training would be associated with the change in the MetS and its components.     

Evolution of the Concept of Altruistic Suicide in Pre-Durkheim Suicidology

Suicide as self-sacrifice was described by early nineteenth century authors before the delineation of altruism by the French Philosopher and Mathematician Auguste Comte. The concept evolved, leading to the categorization of altruistic suicide by Savage in England in 1892 and the elaboration of the term by Durkheim in France in 1897. Pre-Durkheim suicidologists were aware of the subtleties of sacrifice as opposed to revenge in this type of suicide.     

Short-term exposure to stone minerals used in asphalt affect lung function and promote pulmonary inflammation among healthy adults

ObjectiveStone minerals are a partially ignored environmental challenge but a significant contributor to urban air pollution. We examined if short-term exposure to two stone minerals – quartz diorite and rhomb porphyry – commonly used in asphalt pavement would affect lung function, promote pulmonary inflammation, and affect bronchial reactivity differently.MethodsOur randomized crossover study included 24 healthy, non-smoking young adults exposed to the stone minerals quartz diorite, rhomb porphyry, and control dust (lactose). Exposure occurred in an exposure chamber, in three separate 4-hour exposure sessions. Fractional exhaled nitric oxide (FeNO) and lung function were monitored before exposure, then immediately following exposure, and 4 and 24 hours after exposure. In addition, methacholine was administered 4 hours following exposure, and exhaled breath condensate (EBC) was collected before exposure, then immediately and 4 hours after exposure. EBC was analyzed for pH, thiobarbituric acid reactive substances (TBARS), intercellular adhesion molecule 1 (ICAM-1), interleukin-6 (IL-6), IL-10, P-Selectin, surfactant protein D (SP-D), and tumor necrosis factor-α (TNF-α).ResultsOur results showed significantly elevated concentrations of FeNO after exposure to quartz diorite compared to rhomb porphyry, suggesting that quartz diorite is more likely to trigger pulmonary inflammation after short-term exposure. Moreover, short-term exposure to rhomb porphyry was associated with a modest but statistically significant decline in forced vital capacity (FVC) compared to quartz diorite.ConclusionThese results emphasize that using stone material in asphalt road construction should be reconsidered as it may affect lung inflammation and lung function in exposed subjects.     

Dynamic current focusing for loudness encoding in cochlear implants: a take-home trial

Objective: This study aimed to evaluate a more energy-efficient dynamic current focussing (DCF) speech-processing strategy after long-term listening experience. In DCF, tripolar stimulation is used near the threshold and loudness is controlled by the compensation coefficient σ. A recent acute pilot study showed improved spectral-temporally modulated ripple test (SMRT) scores at low loudness levels, but battery life was reduced to 1.5–4?hours.

Design: Within-subject comparisons were made for the clinical versus. DCF strategy after 5?weeks of at-home usage. Speech intelligibility in noise, spectral ripple discrimination, temporal modulation detection, loudness growth, and subjective ratings were assessed.

Study sample: Twenty HiRes90K (Advanced Bionics, Valencia, USA) cochlear implant (CI) users.

Results: Average battery life was 9?hours with the newly implemented DCF compared to 13.4?hours with the clinical strategy. Compared with measurements made at the beginning of the study, SMRT-scores and speech intelligibility in noise were significantly improved with DCF. However, both measures suffered from unexpected learning effects over time. The improvement disappeared and speech intelligibility in noise declined significantly relative to the final control measurement with the clinical strategy.

Conclusion: Most CI users can adapt to the DCF strategy in a take-home setting. Although DCF has the potential to improve performance on the SMRT test, learning effects complicate the interpretation of the current results.     

Schwere ekzematöse Veränderungen durch Lactarius vellereus Fries

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