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Biomedical subjects

Bengt Kayser

Publications and source records attributed to Bengt Kayser.

At least 19 recordsLinked to original sources
PubMed2007

Estimation of oxygen uptake during fast running using accelerometry and heart rate.

UNLABELLED: Previous investigations have reported that accelerometer counts plateau during running at increasingly faster speeds. PURPOSE: To assess whether biomechanical and/or device limitations cause this phenomenon and the feasibility of generating oxygen uptake (.VO2) prediction equations from the combined use of accelerometry and heart rate during walking and running. METHODS: : Sixteen endurance-trained subjects completed two exercise tests on a treadmill. The first was a continuous incremental test to volitional exhaustion to determine ventilatory threshold and peak .VO2. The second was a discontinuous incremental exercise test while walking (3, 5, and 7 km.h(-1)) and running (8, 10, 12, 14, 16, 18, and 20 km.h(-1), or until volitional exhaustion). Subjects completed 3 min of exercise at each speed, followed by 3-5 min of recovery. Activity counts from uni- and triaxial accelerometers, heart rate, and gas exchange were measured throughout exercise. RESULTS: All accelerometer outputs rose linearly with speed during walking. During running, uniaxial accelerometer outputs plateaued, whereas triaxial output rose linearly with speed up to and including 20 km.h(-1). Prediction of .VO2 during walking and running using heart rate (R2 = 0.42 and 0.59, respectively), accelerometer counts (R2 = 0.48-0.83 and 0.76, respectively), the combined methodologies (R2 = 0.54-0.85 and 0.80, respectively), and the combined methodologies calibrated with individual data (R2 = 0.99-1.00 and 0.99, respectively) was completed by linear regression. CONCLUSIONS: Uni- and triaxial accelerometer outputs have a linear relationship with speed during walking. During running, uniaxial accelerometer outputs plateau because of the biomechanics of running, whereas triaxial accelerometer output has a linear relationship. The combined methodologies predict .VO2 better than either predictor alone; a subject's individually calibrated data further improves .VO2 estimation.

Acceleration↗
PubMed2006

Evidence of negative energy balance using doubly labelled water in elite Kenyan endurance runners prior to competition.

Previous studies have found Kenyan endurance runners to be in negative energy balance during training and prior to competition. The aim of the present study was to assess energy balance in nine elite Kenyan endurance runners during heavy training. Energy intake and expenditure were determined over 7 d using weighed dietary intake and doubly labelled water, respectively. Athletes were on average in negative energy balance (mean energy intake 13 241 (SD 1330) kJ/d v. mean energy expenditure 14 611 (SD 1043) kJ/d; P=0.046), although there was no loss in body mass (mean 56.0 (SD 3.4) kg v. 55.7 (SD 3.6) kg; P=0.285). The calculation of underreporting was 13 % (range -24 to +9 %) and almost entirely accounted for by undereating (9 % (range -55 to +39 %)) as opposed to a lack of significant underrecording (i.e. total water intake was no different from water loss (mean 4.2 (SD 0.6) l/d v. 4.5 (SD 0.8) l/d; P=0.496)). Fluid intake was modest and consisted mainly of water (0.9 (SD 0.5) l/d) and milky tea (0.9 (SD 0.3) l/d). The diet was high in carbohydrate (67.3 (SD 7.8) %) and sufficient in protein (15.3 (SD 4.0) %) and fat (17.4 (SD 3.9) %). These results confirm previous observations that Kenyan runners are in negative energy balance during periods of intense training. A negative energy balance would result in a reduction in body mass, which, when combined with a high carbohydrate diet, would have the potential in the short term to enhance endurance running performance by reducing the energy cost of running.

Adult↗
PubMed2006

Eight-year longitudinal changes in body composition in healthy Swiss adults.

OBJECTIVE: Significant changes in body composition occur during lifetime. This longitudinal study (8.0 +/- 0.8 yrs) in a cohort of healthy sedentary and physically active men (n = 78) and women (n = 53), aged 20 to 74 yr describes: 1) the longitudinal changes in weight and body composition and 2) their associations with age and physical activity. METHOD: Fat-free mass (FFM) and body fat (BF) were assessed by bioelectrical impedance analysis (BIA). Subjects who regularly performed >3 hours per week of endurance type physical activity were classified as "Active". Others were classified as "Sedentary". Subjects were also separated by age (<45 yr vs > or =45 yr). RESULTS: FFM increased by 1.7 +/- 2.8 kg in men <45 yr who gained 4.0 +/- 5.0 kg of body weight and was maintained (0.5 +/- 1.6 kg) in women <45 y who gained 1.6 +/- 3.0 kg of weight. A weight gain of 1.2 +/- 3.3 kg in men > or =45 yr was accompanied by stable FFM (-0.1 +/- 2.3 kg), and of 1.0 +/- 3.2 kg was accompanied by a loss of FFM in women > or =45 yr. In active men > or =45 yr, maintenance of FFM was associated with smaller weight gains than in sedentary; sedentary men > or =45 yr decreased FFM with larger weight gains than active subjects. Sedentary women <45 yr were able to gain FFM; the active women maintained, but did not gain FFM with smaller weight gains than in sedentary women. FFM decreased in >/=45 yr women despite of small weight gains. CONCLUSION: Weight change is clearly associated with a change in FFM. Weight gain is necessary to offset age-related FFM loss between 20 and 74 yrs. In active men, a FFM increase was associated with less weight gain than sedentary men. Future studies should evaluate the threshold of weight change and the level of physical activity necessary to prevent age-related losses of FFM.

Adipose Tissue↗
PubMed2006

High altitude adaptation in Tibetans.

Since the beginning of the Himalayan climbing era, the anecdotal extraordinary physical performance at high altitude of Sherpas and Tibetans has intrigued scientists interested in altitude adaptation. These ethnic groups may have been living at high altitude for longer than any other population, and the hypothesis of a possible evolutionary genetic adaptation to altitude makes sense. Reviewed here is the evidence as to whether Tibetans are indeed better adapted for life and work at high altitude as compared to other populations and, if so, whether this better adaptation might be inborn. Tibetans, compared to lowlanders, maintain higher arterial oxygen saturation at rest and during exercise and show less loss of aerobic performance with increasing altitude. Tibetans have greater hypoxic and hypercapnic ventilatory responsiveness, larger lungs, better lung function, and greater lung diffusing capacity than lowlanders. Blood hemoglobin concentration is lower in Tibetans than in lowlanders or Andeans living at similar altitudes. Tibetans develop only minimal hypoxic pulmonary hypertension and have higher levels of exhaled nitric oxide than lowlanders or Andeans. Tibetans' sleep quality at altitude is better and they desaturate less at night. Several of these findings are also found in Tibetans born at low altitude when exposed for the first time to high altitude once adult. In conclusion, Tibetans indeed seem better adapted to life and work at high altitude, and this superior adaptation may very well be inborn, even though its exact genetic basis remains to be elucidated.

Acclimatization↗
PubMed2006

Body mass regulation at altitude.

Altitude exposure decreases energy intake and thus induces an energy deficit resulting in the loss of body mass. The energy deficit is worsened when energy expenditure is increased by exercise because the increase is not matched by an increased energy intake. The indicated fuel for the optimal use of the rarefied oxygen at altitude is carbohydrate. For optimal taste and maximizing energy intake, fat is the best. Protein should rather be limited because of its high thermic effect. Intestinal malabsorption probably does not play a role in the energy deficit. Even though the sensation of exertion during climbing at high altitude is intense, the actual energy expenditure is not high.

Altitude↗
PubMed2005

Effects of physical activity on food intake.

The understanding of the effect of physical activity (PA) on food intake is imperative for considering PA as an additional tool for prevention and treatment of many diseases. Prolonged strenuous PA performed on a regular basis causes an increase in overall energy turnover, and leads either to loss of body weight, or to an increased food intake. When leading to loss of body weight, PA may be used as a therapeutic adjunct in the treatment of obesity. When increasing food intake to compensate for increased energy expenditure and maintaining body weight, PA, by increasing intake of other constituents of food like minerals and vitamins, may contribute to micronutrient deficiency coverage. However, the type of activity, as well as body composition of the individuals engaging in sport, play an important role in food intake regulation and its changes with time. Some studies indicate that short-term exercise does not have the same effect on food intake as long-term exercise and that eventual increase in food intake due to increased PA does not follow the same pattern in obese as in lean individuals. To better understand the relationship between PA on food intake, current findings on this topic will be summarized in this paper.

Body Composition↗
PubMed2005

Nutrient intake and performance during a mountain marathon: an observational study.

In order to study nutrient intake of amateur runners during a mountain marathon, compliance with recommendations, and association with performance, an intake of 42 participants in a Swiss mountain marathon was assessed by direct observation. Data on demographics, dietary preparation and race experience were obtained by questionnaires. Anthropometrical measures were performed before and after the race. Mean hourly intakes (SD) of fluid, carbohydrate, energy and sodium were 545 (158) ml, 31 (14) g, 141 (63) kcal [or 590 (264) kJ], and 150 (203) mg respectively. A third of the runners drank 600 ml h(-1) or more, 52% consumed less than 30 g h(-1 )carbohydrates, 95% consumed less than 500 mg h(-1) sodium. Mean weight loss was 4 (1.5) kg; 30 runners (71%) lost over 3% body mass. Mean running time was 7 h 3 min (1 h 17 min). Most participants failed to meet nutritional recommendations. None were at risk of overhydration. Body composition and race experience were correlated with performance, but not nutrient intake. Because experienced runners are well trained, fitter, and know better their personal needs during such a race, it is difficult to disentangle these associations. As causal relationship cannot be proven with this cross-sectional design, non-compliance with intake recommendations requires additional experimental research on the impact of nutrient intake on field performance.

Adaptation, Physiological↗
PubMed2004

Second generation Tibetan lowlanders acclimatize to high altitude more quickly than Caucasians.

Tibetan highlanders develop at altitude peak aerobic power levels close to those of Caucasians at sea level. In order to establish whether this feature is genetic and, as a consequence, retained by Tibetan lowlanders, altitude-induced changes of peak aerobic performance were assessed in four groups of volunteers with different ethnic, altitude exposure and fitness characteristics, i.e. eight untrained second-generation Tibetans (Tib 2) born and living at 1300 m; seven altitude Sherpas living at approximately 2800-3500 m; and 10 untrained and five trained Caucasians. Measurements were carried out at sea level or at Kathmandu (1300 m, Nepal) (PRE), and after 2-4 (ALT1), 14-16 (ALT2), and 26-28 (ALT3) days at 5050 m. At ALT3, of untrained and trained Caucasians was -31% and -46%, respectively. By contrast, of Tib 2 and Sherpas was -8% and -15%, respectively. At ALT3, peak heart rate (HR(peak)) of untrained and trained Caucasians was 148 +/- 11 and 149 +/- 7 beats min(-1), respectively; blood oxygen saturation at peak exercise was 76 +/- 6% and 73 +/- 6%, and haemoglobin concentration ([Hb]) was 19.4 +/- 1.0 and 18.6 +/- 1.2 g dl(-1), respectively. Compared to Caucasians, Tib 2 and Sherpas exhibited at ALT3 higher HR(peak) (179 +/- 9 and 171 +/- 4 beats min(-1), P < 0.001), lower [Hb] (16.6 +/- 0.6 and 17.4 +/- 0.9 g dl(-1), respectively, P < 0.001), and slightly but non-significantly greater average values (82 +/- 6 and 80 +/- 7%). The above findings and the time course of adjustment of the investigated variables suggest that Tibetan lowlanders acclimatize to chronic hypoxia more quickly than Caucasians, independent of the degree of fitness of the latter.

Acclimatization↗
PubMed2004

Magnesium for the prevention and treatment of acute mountain sickness.

Magnesium is a physiological N-methyl-D-aspartate (NMDA) antagonist. The NMDA receptor may be involved in the pathogenesis of acute mountain sickness (AMS). In the present study, healthy subjects were randomized to receive either 400 mg of oral magnesium citrate (16 mmol) or matching placebo every 8 h for 5 days (prevention trial). Subjects then climbed to 4559 m in approx. 24 h and stayed there for 48 h. A Lake Louise Score <3 at any time was defined as the absence of AMS, whereas a score >6 (with ataxia, headache and nausea) was defined as a prevention failure. In a subsequent trial (treatment trial), subjects with a Lake Louise Score >6 (with ataxia, headache and/or nausea) were randomized to receive either 4 g of intravenous magnesium sulphate (16 mmol) or matching placebo. A decrease in the score >50% within 60 min was regarded as a treatment success. Dichotomous data were analysed using relative risk (RR) or odds ratio (OR), and continuous data using Student's t test or Wilcoxon's rank-sum test. In the prevention trial, data from 61 subjects (30 receiving magnesium and 31 placebo) were analysed. With oral magnesium, 20% of subjects had no AMS compared with 16.1% in the placebo group [RR (95% CI), 1.2 (0.4-3.6); where CI is confidence interval]. With magnesium, 40% were prevention failures compared with 35.5% in the placebo group [RR (95% CI), 1.13 (0.59-2.15)]. The mean time to failure and severity of AMS was similar between the two groups. With magnesium, 38.2% had loose stools compared with 11.8% in placebo group [RR (95% CI), 3.25 (1.18-8.97)]. In the treatment trial, 12 subjects received magnesium and 13 received the placebo. With intravenous magnesium, 25% were regarded as treatment successes compared with none in the placebo group [OR (95% CI), 9.71 (0.91-103.4)]. With magnesium, mean (+/- S.D.) scores decreased from 11.6 +/- 1.7 before treatment to 9.0 +/- 3.5 after treatment (P=0.009); scores remained unchanged in the placebo group. With magnesium, 75% of subjects experienced a transient flushing compared with 7.7% in the placebo group [RR (95% CI), 0.05 (0.01-0.25)]. In conclusion, oral magnesium does not prevent AMS. In subjects with established AMS, intravenous magnesium reduces the severity of symptoms to some extent, but this effect is of no clinical importance.

Acute Disease↗
PubMed2004

Effect of magnesium, high altitude and acute mountain sickness on blood flow velocity in the middle cerebral artery.

Cerebral blood flow is thought to increase at high altitude and in subjects suffering from acute mountain sickness (AMS); however, data from the literature are contentious. Blood flow velocity in the middle cerebral artery (MCAv) may be used as a proxy measure of cerebral blood flow. Using transcranial Doppler sonography, MCAv was measured during normo- and hyper-ventilation in subjects who participated in a trial that tested the effect of magnesium supplementation on the prevention of AMS. First, MCAv was recorded at 353 m (baseline). Subjects were then randomized to receive oral magnesium citrate and matching placebo. A second measurement was taken after a 24 +/- 2 h ascent from 1130 m to 4559 m (altitude I), and a third after a 20-24 h stay at 4559 m (altitude II). Using multivariate linear regression, an association was sought between MCAv and magnesium supplementation, subjects' age and gender, altitude itself, a temporary stay at altitude, and the presence of AMS (Lake Louise Score >6 with ataxia, nausea and/or headache). Subjects with AMS had additional Doppler recordings immediately before and after rescue medication (oxygen, dexamethasone and acetazolamide). Forty-seven subjects had measurements at baseline, 39 (21 receiving magnesium and 18 placebo) at altitude I and 26 (13 receiving magnesium and 13 placebo) at altitude II. During hyperventilation, MCAv decreased consistently (for each measurement, P<0.001). Magnesium significantly increased MCAv by 8.4 cm.s(-1) (95% confidence interval, 1.8-15), but did not prevent AMS. No other factors were associated with MCAv. Eleven subjects had severe AMS [median score (range), 11 (8-16)] and, after rescue medication, the median score decreased to 3 (range, 0-5; P=0.001), but MCAv remained unchanged (65 +/- 18 cm.s(-1) before compared with 67 +/- 16 cm.s(-1) after rescue medication; P=0.79). MCAv was increased in subjects who received magnesium, but was not affected by exposure to high altitude or by severe AMS.

Administration, Oral↗
PubMed2004

Awareness, prevalence, medication use, and risk factors of acute mountain sickness in tourists trekking around the Annapurnas in Nepal: a 12-year follow-up.

Acute altitude exposure may lead to acute mountain sickness (AMS). Increased awareness of altitude-related health hazards in trekkers may accompany a decrease in AMS prevalence. We compared awareness and AMS prevalence in trekkers in two cohorts on an altitude trek up to 5400 m and assessed risk factors for AMS by repeating an observational cohort study 12 yr after an initial study. Questionnaires in English were distributed to two cohorts of 500 trekkers in 1986 and 1998. All trekkers over a several day period were asked to participate. Average participation rate was 62% (71% in 1986 and 53% in 1998). We found an increase in AMS awareness in trekkers from 80% to 95%, a decrease in AMS prevalence from 43% to 29%, and significant slower climbing profiles. We found no relationship between AMS and smoking habits, body mass index, oral contraception intake, or training status. By contrast, age was a strong independent risk factor inversely related to AMS. Subjects over 55 yr were 2.6 times less likely to suffer from AMS than subjects under 25 yr. Self-medication, including acetazolamide and analgesics, had increased importantly from 17% to 56%, and contraception intake in women had increased from 19% to 32%. In conclusion, in 1998 as compared to 1986, trekkers were older, climbed more slowly, had better awareness of altitude illness, used more medication, and suffered less from AMS.

Acclimatization↗
PubMed2004

Physical activity: the health benefits outweigh the risks.

PURPOSE OF REVIEW: This article will summarize the current findings on the effects of physical activity on human health and well-being. RECENT FINDINGS: Physical activity is associated with enhanced health and reduced risk of all-cause mortality such as cardiovascular disease, hypertension, type 2 diabetes, obesity, osteoporosis, sarcopenia, cognitive disorders, and some forms of cancer. Nevertheless, the effects of exercise with respect to potential health consequences are complex. When untrained or previously sedentary persons undertake vigorous exertion suddenly, the undesired side effects of injuries, dehydration or cardiac arrest are amplified. SUMMARY: It is reasonable to conclude that the risk exposure through physical activity is outweighed by its overall benefits, and health authorities strongly encourage participation in moderate intensity physical activity on a daily basis. In the future, the identification and characterization of particularly inactive sub-groups of the population may facilitate and optimize the planning of public health interventions.

Chronic Disease↗
PubMed2004

Chronic hypoxia: common traits between chronic obstructive pulmonary disease and altitude.

PURPOSE OF REVIEW: Loss of body mass and exercise intolerance are common findings in chronic obstructive pulmonary disease and are often difficult to reverse despite optimal nutritional intake. Similar findings have been reported in healthy individuals during high-altitude exposure. The role of hypoxia in modulating metabolism has been largely investigated in vitro and in animal studies. More fragmentary is the knowledge regarding hypoxia effects on in-vivo human metabolism. This paper reviews recent literature regarding the effects of chronic exposure to hypoxia on metabolism, particularly comparing chronic obstructive pulmonary disease patients with humans exposed to high altitude. RECENT FINDINGS: Hypoxia has important metabolic effects. Many oxygen-sensitive regulatory mechanisms work through hypoxia inducible factor 1, and recent literature regarding the hypoxic stimulus and its pathological implications deals largely with hypoxia inducible factor 1-related findings. Hypoxia inducible factor 1 is pivotal in the adaptation to chronic hypoxia: it induces gene expression for fructose-2-6-biphosphatase, an enzyme switching glucose metabolism towards glycolysis, allowing energy production in anaerobic conditions. Hypoxia inducible factor 1 is also involved in the development of anorexia because it induces the promoter of the leptin gene. Particularly important for future therapeutic implications are findings related to hypoxia inducible factor 1 polymorphism and interaction with other molecules, especially estrogens, in the clinical evolution of disease. SUMMARY: Malnutrition is a worsening factor in chronic obstructive pulmonary disease. Similarities between chronic obstructive pulmonary disease and altitude exposure point to the importance of hypoxia in this regard. A better understanding of the underlying mechanisms will help to find alternative therapeutic approaches.

Altitude↗
PubMed2003

Effects of 17-day spaceflight on electrically evoked torque and cross-sectional area of the human triceps surae.

The effects of spaceflight on triceps surae muscle torque and cross-sectional area (CSA) were investigated on four astronauts using electrically evoked contractions to by-pass neural control. Muscle twitch characteristics, ankle joint angle-twitch torque relation, frequency-torque relation, tetanic torque and fatigability were assessed before, during and after a 17-day Space Shuttle flight (STS-78). Muscle plus bone cross-sectional area (CSAm+b) was evaluated before and after the flight. Whereas no changes in muscle function were observed during the flight, marked alterations were found during the recovery period. Peak twitch (PTw) and tetanic torques at 50 Hz (PT50) continued to fall up to the 8th recovery day (R+8) on which losses in PTw and PT50 were 24.4% (P<0.01) and 22.0% (P<0.01), respectively. The decline in PTw was not joint-angle-specific. Post-flight, especially on R+8, torque decreased at all stimulation frequencies (1, 20, 30 and 50 Hz); however the shape of the frequency-torque curve, normalised for PT50, was not modified. Similarly, no changes in twitch kinetics were observed. Post- flight, an 8% (P<0.01) reduction in CSAm+b was found on R+2. Normalisation of PT50 values for CSAm+b showed a progressive loss in specific torque (PT50/CSAm+b), which was maximal on R+2 (19.5%, P<0.05). Also, fatigability during 2-min intermittent stimulation at 20 Hz increased throughout recovery, reaching a nadir of 16.4% (P<0.01) on R+15. In conclusion, 17 days of spaceflight resulted in significant changes in muscle function during the recovery phase, but not in microgravity. The disproportionate loss of torque compared with that of muscle size suggests the presence of muscle damage due to reloading in 1 g.

Adult↗
PubMed2003

Exercise starts and ends in the brain.

Classically the limit to endurance of exercise is explained in terms of metabolic capacity. Cardio-respiratory capacity and muscle fatigue are thought to set the limit and the majority of studies on factors limiting endurance exercise discuss issues such as maximal oxygen uptake (VO2max), aerobic enzyme capacity, cardiac output, glycogen stores, etc. However, this paradigm does not explain the limitation to endurance exercise with large muscle groups at altitude, when at exhaustion exercise is ended without limb locomotor muscle fatigue and with sub-maximal cardiac output. A simple fact provides a basis for an explanation. Voluntary exercise starts and ends in the brain. It starts with spatial and temporal recruitment of motor units and ends with their de-recruitment. A conscious decision precedes a voluntary effort. The end of effort is again volitional and a forced conscious decision to stop precedes it, but it is unknown what forces the off-switch of recruitment at exhaustion although sensation of exertion certainly plays a role. An alternative model explaining the limitation of exercise endurance thus proposes that the central nervous system integrates input from various sources all related to the exercise and limits the intensity and duration of recruitment of limb skeletal muscle to prevent jeopardizing the integrity of the organism. This model acknowledges the cardio-respiratory and muscle metabolic capacities as prime actors on the performance scene, while crediting the central nervous system for its pivotal role as the ultimate site where exercise starts and ends.

Adolescent↗
PubMed2003

Task failure from inspiratory resistive loaded breathing: a role for inspiratory muscle fatigue?

The use of non-invasive resistive breathing to task failure to assess inspiratory muscle performance remains a matter of debate. CO2 retention rather than diaphragmatic fatigue was suggested to limit endurance during inspiratory resistive breathing. Cervical magnetic stimulation (CMS) allows discrimination between diaphragmatic and rib cage muscle fatigue. We tested a new protocol with respect to the extent and the partitioning of inspiratory muscle fatigue at task failure. Nine healthy subjects performed two runs of inspiratory resistive breathing at 67 (12)% of their maximal inspiratory mouth pressure, respiratory rate (fR), paced at 18 min(-1), with a 15-min pause between runs. Diaphragm and rib cage muscle contractility were assessed from CMS-induced esophageal (P(es,tw)), gastric (P(ga,tw)), and transdiaphragmatic (P(di,tw)) twitch pressures. Average endurance times of the first and second runs were similar [9.1 (6.7) and 8.4 (3.5) min]. P(di,tw) significantly decreased from 33.1 to 25.9 cmH2O in the first run, partially recovered (27.6 cmH2O), and decreased further in the second run (23.4 cmH2O). P(es,tw) also decreased significantly (-5.1 and -2.4 cmH2O), while P(ga,tw) did not change significantly (-2.0 and -1.9 cmH2O), indicating more pronounced rib cage rather than diaphragmatic fatigue. End-tidal partial pressure of CO2 ( PETCO2) rose from 37.2 to 44.0 and 45.3 mmHg, and arterial oxygen saturation (SaO2) decreased in both runs from 98% to 94%. Thus, task failure in mouth-pressure-targeted, inspiratory resistive breathing is associated with both diaphragmatic and rib cage muscle fatigue. Similar endurance times despite different degrees of muscle fatigue at the start of the runs indicate that other factors, e.g. increases in PETCO2, and/or decreases in SaO2, probably contributed to task-failure.

Adult↗