Chronic kidney disease (CKD) is directly influenced by the deleterious effects of systemic inflammation and oxidative stress. The vascular endothelium may transiently respond to aerobic exercise and improve post-exercise vascular renal function in moderate stages of CKD. Brachial artery flow-mediated dilation (FMD) is a nitric-oxide-dependent measure of endothelial function that is transiently potentiated by exercise. The purpose of the study was to determine the acute influence of a single bout of high-intensity interval exercise (HIIE) or steady-state moderate-intensity exercise (SSE) on endothelial dysfunction in moderate stages of CKD. Twenty participants (n = 6 men; n = 14 women) completed 30 min of SSE (65%) and HIIE (90:20%) of VO_2reserve in a randomized crossover design. FMD measurements and blood samples were obtained before, 1 h, and 24 h post-exercise. FMD responses were augmented 1 h post-exercise in both conditions (p < 0.005). Relative to pre-exercise measures, total antioxidant capacity increased by 4.3% 24 h post-exercise (p = 0.012), while paraoxonase-1 was maintained 1 h and elevated by 6.1% 24 h after SSE, but not HIIE (p = 0.035). In summary, FMD can be augmented by a single episode of either HIIE or SSE in moderate stages of CKD. Modest improvements were observed in antioxidant analytes, and markers of oxidative stress were blunted in response to either SSE or HIIE.

Background: Cardiovascular disease and dementia represent two health problems that may be causally connected. Studies have shown patients with dementia to have reduced cardiovascular health measures, where patients with dementia also have reduced electrophysiological brain activity as measured by event-related potentials (ERP’s). Few studies have attempted to correlate the two: cardiovascular health and ERP brain activity. The objective of this study is to determine if there are ERP differences between patients with lower versus higher measures of cardiovascular risk. Methods: For 180 patients ages 53 (16) years, Audio P300 ERP amplitudes and latencies (speeds) were measured upon initial patient visit alongside other clinical evaluations. Cardiovascular risk was categorized into good versus poor levels for blood pressure resting and stressed, E/A Ratio, atherosclerosis, and carotid intima-media thickness. Results: Groups with good levels had lower latencies (faster P300′s) and higher amplitudes than those with poor levels across all cardiovascular risk measures, significant to p < 0.05 for most parameters. While both cardiovascular health and P300 metrics decline with age, poor blood pressure and plaque was seen to affect P300 performance across all age groups in this study. Conclusion: These data suggest correlation between brain activity, as measured by the P300, and five standard measures of cardiovascular health and this correlation may begin at an early age. While further explorations are warranted, these results could have implications on the management of preventative medicine by bringing preventative cardiology and brain health together.

Fibroblast growth factor 21 (FGF21) is a metabolic regulator that may increase in circulation following exercise. This study was undertaken to determine if changes to FGF21 post-exercise are dependent on biological sex and exercise modality. Secondary analyses were conducted to determine if the post-exercise rise in FGF21 was associated with upstream signaling factors (glucagon, epinephrine, glucose) and excess post-exercise oxygen consumption (EPOC) response. Following a randomized crossover design, male and female participants completed two, thirty minute exercise protocols – during the steady state (SS) protocol, participants cycled at 70% of VO_2peak and during the sprint interval exercise (IE) protocol participants completed six, thirty second “all out” sprints against 7.5% of body weight with four and half minutes of active recovery between sprints. Blood samples were taken at baseline, immediately post-exercise (IPE), and 1-hour post-exercise. Oxygen consumption was monitored continuously throughout the trials. In males, FGF21 levels were increased at 1-hour post-exercise with no difference between conditions; in females, FGF21 levels were unchanged as a result of exercise. Comparison of the post-exercise FGF21 incremental area under the curve revealed that in the SS condition males had a greater FGF21 response than females and that within males the SS condition had a greater response than the IE condition. Exercise significantly increased FGF21 levels in males, but not in females. In males, FGF21 levels were greater in the SS condition than in the IE condition.

The purpose of this descriptive study was to assess the prevalence of metabolic syndrome (MetS), prediabetes and type 2 diabetes (T2DM) in participants who voluntarily participated in a fitness assessment, and to examine associations with routine nutrition intake and overall body composition. One hundred and six participants were recruited. Anthropometric measurements were taken with blood analyses completed for fasting glucose, glycosylated hemoglobin (HbA1c) and lipid panel. A 24-hour diet recall and a dietary screening survey was used to assess nutrient intake, in a sub-set of 36 participants. Statistical analyses utilized partial Spearmans’ rank correlations, risk ratios, and Kendall’s Tau correlations, with significance level at p < 0.05. Twenty five percent of this sample had ≥ three risk factors for MetS, with elevated fasting glucose and blood pressure being the most prevalent. Twenty percent of the participants had HbA1c levels elevated at the prediabetes range, with no previous diagnosis. Four percent of participants had HbA1c levels elevated at the T2DM range. Two nutrients of interest were correlated to BMI status. Percent kcal from carbohydrate (τ -0.207, p<0.05) had a negative correlation with BMI status and percent kcal from fat intake had a positive correlation (τ 0.217, p<0.05). Findings from this small sample of adults indicate the need for routine assessment of: clustering of MetS risk factors, risk of prediabetes and T2DM and treatment of same. Many participants would benefit from increasing their participation in physical activity, weight loss in regard to overall health improvement, and education to improve diet quality.

Context: Tibial stress syndrome (TSS) is an overuse injury of the lower extremities. There is a high incidence rate of TSS among military recruits. Compression therapy is used to treat a wide array of musculoskeletal injuries. The purpose of this study was to investigate the use of compression therapy as a treatment for TSS in military service members. Design: A parallel randomized study design was utilized. Methods: Military members diagnosed with TSS were assigned to either a relative rest group or compression garment group. Both groups started the study with 2 weeks of lower extremity rest followed by a graduated running program during the next 6 weeks. The compression garment group additionally wore a shin splints compression wrap during the waking hours of the first 2 weeks and during activity only for the next 6 weeks. Feelings of pain, TSS symptoms, and the ability to run 2 miles pain free were assessed at baseline, 4 weeks, and 8 weeks into the study. Results: Feelings of pain and TSS symptoms decreased during the 8-week study in both groups (P < .05), but these changes were not significantly different between groups (P > .05). The proportion of participants who were able to run 2 miles pain free was significantly different (P < .05) between the 2 groups at the 8-week time point with the compression garment group having a significantly increased ability to complete the run without pain. Conclusions: Although perceptions of pain at rest were not different between groups, the functional ability of running 2 miles pain free was significantly improved in the compression garment group. These findings suggest that there is a moderate benefit to using compression therapy as an adjunct treatment for TSS, promoting a return to training for military service members.

Objective: Dietary guidelines from the Kidney Disease Outcomes Quality Initiative (KDOQI) and the United States Department of Agriculture (USDA) are advised to individuals with mid-spectrum (stages G3a and G3b) chronic kidney disease (CKD), yet typical diets in individuals with CKD remain understudied. The purpose of this study is to assess the self-reported dietary pattern of subjects with diagnosed mid-spectrum CKD and compare the normal dietary intakes to the KDOQI and USDA recommendations. Methods: A cross-sectional analysis of 20 participants with mid-spectrum CKD (n = 6 male [M]; n = 14 female [F]) was conducted to assess subjects’ self-reported dietary intakes for an average of 5 days. Micro and macronutrient analyses were compared to the KDOQI and USDA guidelines by sex to assess nutrition, and an exploratory stepwise multiple linear regression model was used to identify predictors of poor renal function;p-values were considered significant at the α = 0.05 level. Results: All subjects met the recommended caloric intake, but the average consumptions of protein (F = 0.86 ± 0.29g/kg body weight/day, M = 1.18 ± 0.45g/kg body weight/day), saturated fat (F = 12.17 ± 2.28%, M = 13.86 ± 1.20%), and sodium (F = 3.78 ± 2.51g, M = 4.21 ± 0.39g) were high (p < 0.05 for all). The average fiber intakewas low (F = 13.64 ± 4.09g, M = 14.82 ± 7.28g) as well as folate, vitamins D and K, zinc, and calcium intakes compared with the recommendations (p < 0.05 for all). The only significant contributor to higher renal function in the exploratory regression analysis was male sex (p = 0.035).