Biomedical subjects

Alexander N Jordan

Publications and source records attributed to Alexander N Jordan.

8 recordsLinked to original sources

PubMed2006

Exercise as an augmentation strategy for treatment of major depression.

The use of augmentation strategies among patients with major depression is increasing because rates of complete remission with standard antidepressant monotherapy are quite low. Clinical and neurobiological data suggest that exercise may be a good candidate for use as an augmentation treatment for depression. This pilot study examined the use of exercise to augment antidepressant medication in patients with major depression. Seventeen patients with incomplete remission of depressive symptoms began a 12-week exercise program while continuing their antidepressant medication (unchanged in type or dose). Individual exercise prescriptions were calculated based on an exercise dose consistent with currently recommended public health guidelines. The exercise consisted of both supervised and home-based sessions. The 17-item Hamilton Rating Scale for Depression (HRSD17) and the Inventory of Depressive Symptomatology-Self-Report (IDS-SR30) were used to assess symptoms of depression on a weekly basis. Intent-to-treat analyses yielded significant decreases on both the HRSD17 (5.8 points, p < 0.008) and IDS-SR30 (13.9 points, p < 0.002). For patients who completed the study (n = 8), HRSD17 scores decreased by 10.4 points and IDS-SR30 scores decreased by 18.8 points. This study provides preliminary evidence for exercise as an effective augmentation treatment for antidepressant medication. This is a lower-cost augmentation strategy that has numerous health benefits and may further reduce depressive symptoms in partial responders to antidepressant treatment. Practical tips on how practitioners can use exercise to enhance antidepressant treatment are discussed. Longer-term use of exercise is also likely to confer additional health benefits for this population.

Adult↗

PubMed2006

TREAD: TReatment with Exercise Augmentation for Depression: study rationale and design.

BACKGROUND: Despite recent advancements in the pharmacological treatment of major depressive disorder (MDD), over half of patients who receive treatment with antidepressant medication do not achieve full remission of symptoms. There is evidence that exercise can reduce depressive symptomatology when used as a treatment for MDD. However, no randomized controlled trials have evaluated exercise as an augmentation strategy for patients with carefully diagnosed MDD who remain symptomatic following an adequate acute phase trial of antidepressant therapy. PURPOSE: TReatment with Exercise Augmentation for Depression (TREAD) is an NIMH-funded, randomized, controlled trial designed to assess the relative efficacy of two doses of aerobic exercise to augment selective serotonin reuptake inhibitor (SSRI) treatment of MDD. METHODS: The TREAD study includes 12 weeks of acute phase treatment with a 12-week post-treatment follow-up. In addition to looking at change in depressive symptoms as a primary outcome, it also includes comprehensive assessment of psychosocial function and treatment adherence. RESULTS: This paper reviews the rationale and design of TREAD and illustrates how we address several key issues in contemporary patient-oriented research on MDD: 1) the use of augmentation strategies in the treatment of depressive disorders in general, 2) the use of non-pharmacological strategies in the treatment of depressive disorders, 3) the considerations of designing a well-controlled trial using two active treatment groups, and 4) the implementation of an adherence program for the use of exercise as a treatment strategy. CONCLUSIONS: The TREAD study is uniquely designed to overcome sources of potential bias and threats to internal and external validity that have limited prior research on the mental health effects of exercise. The study is facilitated by the development of a multidisciplinary research team that includes experts in both depression treatment and exercise physiology, as well as other related fields.

Adolescent↗

PubMed2005

Cholesterol-lowering effects of bovine serum immunoglobulin in participants with mild hypercholesterolemia.

BACKGROUND: The consumption of milk products has been shown to lower cholesterol. The mechanism of action surrounding this observation has been attributed to the protein fraction of milk and serum. OBJECTIVE: We examined the effect of an oral serum bovine immunoglobulin protein fraction (bIg) derived from US Department of Agriculture-approved beef (aged <30 mo) on lipid indexes in humans. DESIGN: Participants included men and women (aged 25-70 y) with hypercholesterolemia (5.44-6.99 mmol/L) who were not receiving cholesterol-lowering medication. Treatment consisted of the randomized, double-blind, parallel-group, placebo-controlled administration of 5 g bIg for 6 wk in 52 participants (n = 26 each in treatment and control groups). RESULTS: Mean (+/-SD) total cholesterol (TC) at baseline was 6.33 +/- 0.1 mmol/L for bIg and 6.16 +/- 0.1 mmol/L for placebo. A repeated-measures multivariate analysis of covariance covaried for change in total energy and alcohol intake and Tukey's post hoc examination of our data showed that the bIg-treated group had a significant reduction in TC at 3 wk (5.98 +/- 0.5 mmol/L; P < 0.05) and 6 wk (5.97 +/- 0.7 mmol/L; P < 0.05). The concentration at 6 wk was significantly different from that in the placebo group (P < 0.05). This reduction was largely due to a decrease in LDL cholesterol in the bIg-treated group from baseline (4.12 +/- 0.6 mmol/L) at 3 wk (3.92 +/- 0.7 mmol/L, P < 0.05) and at 6 wk (3.84 +/- 0.6 mmol/L, P < 0.05); the 6-wk concentration differed significantly between the treatment and placebo groups (P < 0.05). We observed no significant changes in the placebo group or in any other lipid indexes or markers associated with hepatorenal or cardiovascular function. CONCLUSION: Consumption of bIg appears to positively modulate the primary lipid indexes associated with cardiovascular disease.

Adult↗

PubMed2005

Pedometer indices for weekly physical activity recommendations in postmenopausal women.

PURPOSE: The aim of this study was to quantify pedometer-determined steps per day associated with 50, 100, and 150% of the current public health recommendation for weekly physical activity in sedentary postmenopausal women. METHODS: A sample of 111 women from the DREW (Dose Response to Exercise in Women) study provided data. We randomly assigned women into one of three exercise groups expending 4, 8, or 12 kcal(-1).kg(-1).wk(-1) (KKW). Participants exercised alternately on a treadmill and recumbent cycle ergometer for a 6-month training period. Only treadmill sessions done with zero grade, at slow to moderate speeds (48-97 m.min(-1)) were used in this analysis. We controlled intensity at a HR equivalent to 50% of VO(2peak). Participants wore pedometers at baseline and throughout the study to assess their free-living physical activity (steps.d(-1)) RESULTS: Baseline averages were <5400 steps.d(-1) for the 4-, 8-, and 12-KKW groups. During 6 months of exercise training, free-living step counts remained <5400 steps.d(-1) and did not significantly differ from baseline for each group. Average speeds and distances per exercise session were 2.7 +/- 0.4 mph, 1.2 +/- 0.2 miles (4 KKW), 2.6 +/- 0.4 mph, 2.2 +/- 0.4 miles (8 KKW), and 2.8 +/- 0.3 mph, 2.7 +/- 0.4 miles (12 KKW). This yielded 2771 (4 KKW), 5457 (8 KKW), and 6534 (12 KKW) steps per exercise session 3-4 d.wk(-1). CONCLUSIONS: Initially sedentary postmenopausal women can meet 50% (4 KKW), 100% (8 KKW), and 150% (12 KKW) of the current public health recommendation of weekly physical activity through planned moderate-intensity walking, accumulating an average of about 2800 (50%), 5500 (100%), and 6500 steps.d(-1) (150%) 3-4 d.wk(-1).

Energy Metabolism↗

PubMed2004

Eight weeks of moderate-intensity exercise training increases heart rate variability in sedentary postmenopausal women.

BACKGROUND: Regular exercise is associated with increased heart rate variability (HRV). However, results from studies examining the effect of exercise training on HRV in postmenopausal women are inconclusive. In addition, the effect of hormone replacement therapy (HRT) on HRV remains a subject of speculation. METHODS: We examined 88 sedentary postmenopausal women in a randomized controlled trial who were assigned to exercise (n = 49) or control (n = 39) groups. The exercising women performed 8 weeks of aerobic exercise training at a heart rate equivalent to 50% of VO2max, consisting on average of 44 minutes per session, 3 to 4 times per week. Resting HRV was measured in each participant at baseline and after 8 weeks of intervention. Ten minutes of resting R-R intervals were analyzed by time (standard deviation of mean R-R intervals, root of mean square successive differences) and frequency domain methods: low-frequency (LF) was defined as 0.04 to 0.15 Hz, high-frequency (HF) as 0.15 to 0.40 Hz, and total spectral power as 0.00 to 0.40 Hz. The LF and HF components in normalized units were also calculated. RESULTS: At baseline, there were no significant differences in HRV between control and exercise groups. Additionally, there were no differences in any HRV variables when women were grouped by HRT use (no HRT, estrogen-only HRT, and progestin-containing HRT). After 8 weeks, women randomly assigned to the exercise group increased all absolute time and frequency domain indexes (all P <.001) and reduced resting heart rate (P =.002) compared with women in the control group. The LF and HF components expressed as normalized units remained unchanged after exercise intervention. Additionally, HRT use did not modify the exercise-induced changes in HRV. CONCLUSIONS: We conclude that moderate aerobic exercise increases HRV in sedentary postmenopausal women. This benefit is not influenced by the use of HRT.

Analysis of Variance↗

PubMed2004

Effects of a commercial herbal-based formula on exercise performance in cyclists.

INTRODUCTION/PURPOSE: We examined the effects of a commercially marketed herbal-based formula purported to increase endurance on oxygen consumption (VO2) in 17 competitive category III/IV amateur cyclists [mean (SEM) age: 31.1 (1.8) yr; height: 178.5 (1.8) cm; weight: 77.1 (1.6) kg]. METHODS: Each cyclist participated in two (pre/post) cycling tests progressing 25 W.4 min(-1) starting at 100 W administered in a randomized, placebo-controlled, double-blind fashion. The second trial was performed 14 d after the ingestion of a manufacturer recommended loading phase (4 d x 6 caps.d(-1)) and a maintenance phase (11 d x 3 caps.d(-1)). Three treatment capsules contained 1000 mg of Cordyceps sinensis (CS-4) and 300 mg Rhodiola rosea root extract as the primary ingredients; 800 mg of other ingredients included calcium pyruvate, sodium phosphate, potassium phosphate, ribose, and adenosine and 200 mcg of chromium. RESULTS: Using a 2 x 2 ANOVA, we observed no significant treatment effect for any between or within group variables including peak VO2 [treatment 4.14 (0.2) L.min(-1); placebo 4.10 (0.2) L.min(-1)], time to exhaustion [treatment 38.47 (1.7) min; placebo 36.95 (1.8) min], peak power output (PO) [treatment 300.00 (12.1) W; placebo 290.63 (12.9) W], or peak heart rate. We also observed no differences for any subpeak exercise variable including the PO eliciting 2 mmol.L(-1) blood lactate (BLa) [treatment 201.00 (18.1) W; placebo 167.50 (19.2) W] and 4 mmol.L(-1) BLa [treatment 235.88 (15.8) W; placebo 244.78 (14.9) W], ventilatory threshold, respiratory compensation point, or Vo2 L.min(-1) gross efficiency at each stage. CONCLUSION: A 2-wk ingestion schema of a commercial herbal-based formula is insufficient to elicit positive changes in cycling performance.

Adult↗

PubMed2004

Effects of oral ATP supplementation on anaerobic power and muscular strength.

PURPOSE: We examined 14 d of oral adenosine 5'-triphosphate (ATP) supplementation on indices of anaerobic capacity and muscular strength. METHODS: Twenty-seven healthy males successfully completed the trial, after randomly receiving in a double-blind manner an oral dose of low dose (150 mg) or high dose (225 mg) ATP, or matched placebo. To improve absorption characteristics, the ATP was enterically coated. Total blood ATP (whole blood and plasma ATP) concentrations, two Wingate anaerobic power tests (30 s), and muscular strength (1RM and three sets of repetitions to fatigue at 70% of 1RM) were measured under three conditions: (i) baseline; (ii) acutely (7d later, no prior supplementation and 75 min after ATP ingestion); and (iii) after 14 d of daily ingestion (post). RESULTS: Statistical analyses showed no significant between or within group treatment effects for whole blood ATP or plasma ATP concentrations for any treatment condition. We also did not observe any treatment effects for any Wingate testing parameter including peak PO, total work, average PO for 30 s, or post-Wingate lactate accumulation. Overall, we observed no significant between group treatment effects for any muscular strength parameter. We did observe several within group differences for the group ingesting the high ATP dosage including 1RM (6.6%; P < 0.04) and repetitions to fatigue during set 1 of posttesting (18.5%; P < 0.007) and total lifting volume at post (22%; P < 0.003). CONCLUSIONS: We conclude that enterically coated oral ATP supplementation may provide small ergogenic effects on muscular strength under some treatment conditions.

Adenosine Triphosphate↗

PubMed2004

Associations of muscle strength and fitness with metabolic syndrome in men.

PURPOSE: To examine the associations for muscular strength and cardiorespiratory fitness with the prevalence of metabolic syndrome among men. METHODS: Participants were 8570 men (20-75 yr) for whom an age-specific muscular strength score was computed by combining the body weight adjusted one-repetition maximum measures for the leg press and the bench press. Cardiorespiratory fitness was quantified by age-specific maximal treadmill exercise test time. RESULTS: Separate age and smoking adjusted logistic regression models revealed a graded inverse association for metabolic syndrome prevalence with muscular strength (beta = -0.37, P < 0.0001) and cardiorespiratory fitness (beta = -1.2, P < 0.0001). The association between strength and metabolic syndrome was attenuated (beta = -0.08, P < 0.01) when further adjusted for cardiorespiratory fitness. The association between cardiorespiratory fitness and metabolic syndrome was unchanged (beta = -1.2, P < 0.0001) after adjusting for strength. Muscular strength added to the protective effect of fitness among men with low (P trend = 0.0002) and moderate (P trend < 0.0001) fitness levels. Among normal weight (BMI < 25), overweight (BMI 25-30), and obese (BMI >or= 30) men, respectively, being strong and fit was associated with lower odds (73%, 69%, and 62% respectively, P < 0.0001) of having prevalent metabolic syndrome. CONCLUSIONS: Muscular strength and cardiorespiratory fitness have independent and joint inverse associations with metabolic syndrome prevalence.

Adult↗