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Authors:Nick W Bray, Myles W O'Brien, Michelle YS Wong, Wuyou Sui, M Lauren Voss, Nolan Turnbull, Taniya S Nagpal, Jonathan R Fowles Abstract: Applied Physiology, Nutrition, and Metabolism, Ahead of Print. Physical activity has declined further during the coronavirus disease 2019 (COVID-19) pandemic. Physicians are at the front lines of proactively educating and promoting physical activity to patients; however, physicians do not feel confident and face numerous barriers in prescribing exercise to patients. Exercise referral schemes, comprising collaborations with qualified exercise professionals, represent a fruitful option for supporting physicians hoping to promote physical activity to more patients. Herein, we provide practical suggestions for establishing and creating a successful referral scheme. Ultimately, exercise referral schemes offer an alternative to help physician burnout and mitigate patient physical inactivity during and beyond the COVID-19 pandemic. Citation: Applied Physiology, Nutrition, and Metabolism PubDate: 2022-10-26T07:00:00Z DOI: 10.1139/apnm-2022-0312
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Authors:Cindy Wei, Marla K. Beauchamp, Brenda Vrkljan, Elisabeth Vesnaver, Lora Giangregorio, Luciana G. Macedo, Heather H. Keller Abstract: Applied Physiology, Nutrition, and Metabolism, Ahead of Print. Nutrition risk is linked to hospitalization, frailty, depression, and death. Loneliness during the coronavirus disease 2019 (COVID-19) pandemic may have heightened nutrition risk. We sought to determine prevalence of high nutrition risk and whether loneliness, mental health, and assistance with meal preparation/delivery were associated with risk in community-dwelling older adults (65+ years) after the first wave of COVID-19 in association analyses and when adjusting for meaningful covariates. Data were collected from 12 May 2020 to 19 August 2020. Descriptive statistics, association analyses, and linear regression analyses were conducted. For our total sample of 272 participants (78 ± 7.3 years old, 70% female), the median Seniors in the Community: Risk evaluation for Eating and Nutrition (SCREEN-8) score (nutrition risk) was 35 [1st quartile, 3rd quartile: 29, 40], and 64% were at high risk (SCREEN-8 Citation: Applied Physiology, Nutrition, and Metabolism PubDate: 2022-10-11T07:00:00Z DOI: 10.1139/apnm-2022-0201
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Authors:Monique Potvin Kent, Elise Pauzé, Mariangela Bagnato, Julia Soares Guimarães, Adena Pinto, Lauren Remedios, Meghan Pritchard, Mary L'Abbé, Christine Mulligan, Laura Vergeer, Madyson Weippert Abstract: Applied Physiology, Nutrition, and Metabolism, Ahead of Print. This research estimated and characterized advertising expenditures on food products heavily advertised on youth-appealing television stations in Canada in 2019 overall, by media, by food category, and compared expenditures in two policy environments (Quebec and the rest of Canada, excluding the territories) and on “healthier” versus “less healthy” products. Advertising expenditure estimates for 57 selected food categories promoted on television, radio, out-of-home media, print media, and popular websites were licensed from Numerator. Sixty-one products or brands were identified as heavily advertised on youth-appealing stations and classified as “healthier” or “less healthy” based on a nutrient profile model proposed by Health Canada. Total expenditures and expenditures per adolescent capita were calculated. Approximately, $110.9 million was spent advertising food products heavily advertised to adolescents in Canada in 2019, with television accounting for 77% of total expenditures and fast food restaurants accounting for 51%. Most expenditures (77%; $80.6 million) were devoted to advertising “less healthy” products. In Quebec, advertising expenditures on examined products were 23% lower per capita ($45.15/capita) compared to the rest of Canada ($58.44/capita). Advertising expenditures in Quebec were lower for energy drinks (−47%; −$0.80/capita) and candy and chocolate (−41%; −$1.00/capita) and higher for yogurt (+85%; +$1.22/capita) and portable snacks (+25%; +$0.15/capita). Quebec's restriction of commercial advertising directed to children under 13 may explain lower per capita advertising expenditures on some “less healthy” foods heavily advertised to adolescents in Quebec. Nevertheless, this spending remains high in Quebec and nationally. Continued monitoring of these expenditures is warranted. Citation: Applied Physiology, Nutrition, and Metabolism PubDate: 2022-09-29T07:00:00Z DOI: 10.1139/apnm-2022-0219
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Authors:Chao-Yu Loung, Sidra Sarfaraz, Allie S. Carew, Dylan MacKay, Leah E. Cahill Abstract: Applied Physiology, Nutrition, and Metabolism, Ahead of Print. The accuracy of books as public nutrition resources varies substantially; whether authors of publicly available nutrition books possess related experience, cite scientific evidence, or have other financial incentives has not been assessed thoroughly. This study aimed to determine if publicly available top-selling nutrition books are written by authors who (1) have relevant expertise, (2) cite scientific evidence, and (3) benefit financially in other ways. Best-selling nutrition books were gathered from Amazon Canada. Differences in scientific citations and financial incentives were compared between authors with and without credentials. Authors who were Doctor of Medicine (MD), registered dietitians (RD), chiropractors, or naturopathic doctors had more in-text citations (56% versus 25%; p = 0.014) and cited more scientific articles (83% versus 50%; p = 0.0045) compared to all other authors. The majority of authors of publicly available top-selling nutrition books in Canada did not have MD/RD credentials. Many of the authors promoted their own services or products, regardless of credentials. Citation: Applied Physiology, Nutrition, and Metabolism PubDate: 2022-09-29T07:00:00Z DOI: 10.1139/apnm-2022-0051
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Authors:Ellen Wang, Heather Keller, Marina Mourtzakis, Isabel B. Rodrigues, Alex Steinke, Maureen C. Ashe, Lehana Thabane, Sheila Brien, Larry Funnell, Angela M. Cheung, Jamie Milligan, Alexandra Papaioannou, Zachary J. Weston, Sharon Straus, Lora Giangregorio Abstract: Applied Physiology, Nutrition, and Metabolism, Ahead of Print. Exercise and nutrition interventions are often recommended for frailty; however, effective strategies are required for real-world implementation. Our primary aim was to assess the feasibility and acceptability of telephone and virtual delivery of MoveStrong, an 8-week exercise and nutrition program with a 4-week follow-up for older pre-frail and frail adults. A priori criteria for success included: recruitment (≥25/12 weeks), retention at follow-up (≥80%), and adherence to exercise and nutrition sessions (≥70%). We recruited community-dwelling Ontario residents; ≥60 years, ≥1 chronic condition, ≥1 FRAIL scale score. Participants received mailed materials, a personalized exercise program, 11 remote one-on-one training sessions with an exercise physiologist and 3 online dietitian-led nutrition education sessions. We completed exploratory analyses of secondary outcomes including physical function and dietary protein intake. Semi-structured interviews supported program evaluation. In total, 30 participants were enrolled. 28 (93%) participants completed program and follow-up assessments. Adherence to exercise and nutrition sessions (CI) was 84% (77%–91%) and 82% (70%–93%) respectively. At program end and follow-up [mean change (CI)], significant improvements were measured in 30-second chair stand test [3.50 (1.12–5.86), 4.54 (1.94–7.13) chair stands] and dietary protein intake [12.9 (5.7–20.0), 9.2 (0.4–18.1) g]. Overall, participants were satisfied with program delivery. Trial registration number: NCT04663685. Citation: Applied Physiology, Nutrition, and Metabolism PubDate: 2022-09-15T07:00:00Z DOI: 10.1139/apnm-2022-0195
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Authors:Austin T. Beever, Andrea Y. Zhuang, Saied Jalal Aboodarda, Juan M. Murias, Martin J. MacInnis Abstract: Applied Physiology, Nutrition, and Metabolism, Ahead of Print. Hypoxia negatively impacts aerobic exercise, but exercise testing in hypoxia has not been studied comprehensively. To determine the effects of simulated altitude on the gas exchange threshold (GET), respiratory compensation point (RCP), and maximal oxygen uptake (V̇O2max), 24 participants (mean [SD]; 26 [4] years; 171.6 [9.7] cm; 69.2 [11.9] kg) acclimatized to mild altitude (MILD; ∼1100 m) performed three cycling ramp-incremental exercise tests (with verification stages performed at 110% of peak power output (PPO)) in simulated altitudes of 0 m (sea level, SL), 1111 m (MILD), and 2222 m (moderate altitude, MOD), in a randomized order. There were significant effects of condition (i.e., fraction of inspired oxygen [FIO2]) for GET (p = 0.001), RCP (p Citation: Applied Physiology, Nutrition, and Metabolism PubDate: 2022-09-14T07:00:00Z DOI: 10.1139/apnm-2022-0204
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Authors:Shalaya Kipp, Michael G. Leahy, Jacob A. Hanna, A. William Sheel Abstract: Applied Physiology, Nutrition, and Metabolism, Ahead of Print. Rating of perceived exertion (RPE) is used to subjectively quantify the perception of physical activity, breathlessness or dyspnea, and leg discomfort (RPElegs) during exercise. However, it is unknown how dyspnea or RPElegs can be influenced by expectations. Thirty healthy, active participants (19 males, 11 females) completed five, 5-minute submaximal cycling trials at 60% peak work rate. We deceived participants by telling them they were inspiring different hypoxic and hyperoxic gases, when in fact they breathed room air. Cardiorespiratory variables were similar between the trials, however, dyspnea and RPElegs evaluated with a Borg scale changed in a dose–response manner. When participants believed they were breathing 15% O2, they significantly increased dyspnea +0.70 ± 0.2 units (p = 0.03) compared to room air, whereas RPElegs was unchanged +0.35 ± 0.1 units (p = 0.70). When participants believed they were breathing 15% O2, they significantly increased dyspnea +1.05 ± 0.4 units (p = 0.003) compared to 23% hyperoxic condition, whereas RPElegs was unchanged +0.35 ± 0.1 units (p = 0.70). We found that dyspnea during exercise is susceptible to expectancy, without any accompanying physiological changes. Given coaches and clinicians use perceived exertion to prescribe exercise intensity and evaluate treatments, our findings show that the effect of expectations must be considered when interpreting sensations of breathlessness. Citation: Applied Physiology, Nutrition, and Metabolism PubDate: 2022-08-29T07:00:00Z DOI: 10.1139/apnm-2022-0179
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Authors:Matthew D. Fliss, Jordan Stevenson, Sobhan Mardan-Dezfouli, Donna C.W. Li, Cameron J. Mitchell Abstract: Applied Physiology, Nutrition, and Metabolism, Ahead of Print. The effect of resistance training with higher- and lower-loads on muscle mass and strength has been extensively studied, while changes in muscle endurance have received less attention. This trial aimed to assess the effect of training load on absolute muscle endurance (AME) and relative muscle endurance (RME). Sixteen untrained women (22.7 ± 3.3 yr: mean ± SD) had one arm and leg randomly assigned to train with higher loads (HL; 80–90% 1RM), and the contralateral limbs trained with lower loads (LL; 30–50% 1RM) thrice weekly to volitional fatigue for 10 weeks. Heavy and light load AME and RME, strength, and muscle mass were assessed pre- and post-training. Strength increased more in the HL compared to LL leg (P < 0.01), but similar increases in strength were observed between upper body conditions (P = 0.46). Lower body heavy and light load AME improved in both conditions, but HL training induced a larger improvement in heavy load AME (HL: 9.3 ± 4.3 vs. LL: 7.5 ± 7.1 repetitions, time × limb P Citation: Applied Physiology, Nutrition, and Metabolism PubDate: 2022-08-26T07:00:00Z DOI: 10.1139/apnm-2022-0263
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Authors:Sarah E. Jarvis, Michelle Nguyen, Vasanti S. Malik Abstract: Applied Physiology, Nutrition, and Metabolism, Ahead of Print. The worldwide prevalence of obesity and its comorbidities is staggering, and elevated body mass index represents a leading risk factor of death globally. Consistent evidence demonstrates a high-quality plant-based diet as an effective intervention for weight management, although it may be particularly challenging to adopt in its entirety for habitual meat consumers or individuals with especially poor-quality diets. Plant-based diets are increasingly studied using indices such as the overall plant-based diet index (PDI), healthful PDI, and unhealthful PDI, which offer more flexibility than a binary classification of vegetarianism and better facilitate translation into dietary recommendations. We summarized these recently accumulated studies to comprehensively evaluate plant-based diets in relation to obesity risk. We searched Medline, Embase, and CINAHL databases through January 2022 and identified 9 prospective adult cohorts. Reporting of results was consistent with Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and certainty of the evidence was assessed using domains from GRADE. The PDI had a protective association with body weight gain and adiposity. Emphasis of healthful plant foods strengthened this association and emphasis of unhealthful plant foods demonstrated either a positive or null association. The certainty of the evidence was considered moderate. These findings have wide application to inform dietary interventions and sustainable policy recommendations. (Prospero ID: CRD42020198143) Citation: Applied Physiology, Nutrition, and Metabolism PubDate: 2022-08-19T07:00:00Z DOI: 10.1139/apnm-2022-0059
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Authors:Renata F. Valaitis, Louise W. McEachern, Sandra Harris, Tania Dick, Joanne Yovanovich, Jennifer Yessis, Barbara Zupko, Kitty K. Corbett, Rhona M. Hanning First page: 1051 Abstract: Applied Physiology, Nutrition, and Metabolism, Ahead of Print. Integrated knowledge translation (IKT) and community-based participatory research (CBPR) are recognized as effective approaches when Indigenous and non-Indigenous partners work together to focus on a common goal. The “Learning Circles: Local Healthy Food to School” (LC:LHF2S) study supported the development and implementation of Learning Circles (LC) in 4 Canadian Indigenous communities with the goal of improving local, community-based healthy food systems. Critical to the research process were annual gatherings (AG) where diverse stakeholders (researchers, Indigenous community members, and partners) visited each community to share knowledge, experiences, and provide support in the research process. Using a qualitative, descriptive method, this paper explores how the AG supported IKT across partners. Yearly interviews involving 19 total participants (with some participating multiple times across the 4 gatherings) elicited their AG experiences in supporting local LC:LHF2S. Three themes with multiple sub-themes were identified: (a) setting the stage for IKT (importance of in-person gatherings for building relationships across partners, learning from each other), (b) enabling meaningful engagement (aligning research with Indigenous values, addressing tensions and building trust over time, ensuring flexibility, and Indigenous involvement and leadership), and (c) supporting food system action at the local level (building local community engagement and understanding, and integrating support for implementation and scale-up of LC). This paper provides useful and practical examples of the principles of Indigenous-engaged IKT and CBPR in action in healthy, local, and traditional food initiatives. AG are a valuable IKT strategy to contribute to positive, transformative change and ethical research practice within Indigenous communities. Citation: Applied Physiology, Nutrition, and Metabolism PubDate: 2022-08-22T07:00:00Z DOI: 10.1139/apnm-2021-0780
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Authors:Song Huang, Xinyue Zheng, Xinyu Zhang, Zhe Jin, Sujuan Liu, Li Fu, Yanmei Niu First page: 1062 Abstract: Applied Physiology, Nutrition, and Metabolism, Ahead of Print. Histone deacetylase 4/5 (HDAC4/5) are essential for regulating metabolic gene expression; AMPKα2 regulates HDAC4/5 activity and the expression of MuRF1 during exercise. In this study, we used wild-type and AMPKα2−/− mice to explore the potential regulatory relationship between AMPKα2 and HDAC4/5 expression during exercise. Firstly, we fed C57BL/6J mice with high-fat diet for 8 weeks to assess the effects of high-fat diet on skeletal muscle metabolism and HDAC4/5 expression. We then performed a 6-week treadmill exercise on both wild-type and AMPKα2−/− mice. After exercise, the expressions of HDAC4/5 were examined in both gastrocnemius and soleus. The citrate synthase activity and proteins involved in skeletal muscle oxidative process were assessed. To determine the relationship of HDAC4/5 and skeletal muscle oxidative capacity, citrate synthase activity was assessed after silencing HDAC4/5. Moreover, HDAC5 ubiquitination and the association of MuRF1 to HDAC5 were also investigated. Our results showed that 6-week exercise increased the skeletal muscle oxidative capacity and decreased HDAC4/5 expression only in soleus. HDAC5 silencing increased C2C12 cell oxidative capacity. Proteasome inhibition by MG132 abolished exercise-induced HDAC5 degradation mediated by MuRF1–ubiquitin–proteasome system. However, the ubiquitin–proteasome system (UPS) did not dominantly account for exercise-induced HDAC4 degradation. Exercise upregulated MuRF1–HDAC5 association in wild-type mice but not in AMPKα2−/− mice. Our results revealed that 6-week exercise increased the skeletal muscle oxidative capacity and promoted HDAC5 degradation in soleus through the UPS, MuRF1-mediated HDAC5 ubiquitination. Although AMPKα2 played a partial role in regulating MuRF1 expression and HDAC5 ubiquitination, exercise-induced HDAC5 degradation did not fully depend on AMPKα2. Citation: Applied Physiology, Nutrition, and Metabolism PubDate: 2022-08-23T07:00:00Z DOI: 10.1139/apnm-2022-0174
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Authors:Robyn F. Madden, Sophie Lalonde-Bester, Ranita H.K. Manocha, Julia M. Martin, Joelle Leonie Flueck, Anneke Hertig-Godeschalk, Jane Shearer, Jill A. Parnell First page: 1075 Abstract: Applied Physiology, Nutrition, and Metabolism, Ahead of Print. Sports nutrition for athletes with a spinal cord injury (SCI) is complex, making it challenging for athletes to stay informed. The aim of this study was to assess sports nutrition knowledge in athletes with an SCI and coaches of para sports. The secondary aim was to report sources of sports nutrition information. Eighty athletes and 26 coaches across various adapted sports were recruited. The Nutrition for Sport Knowledge Questionnaire was used to assess nutrition knowledge for both groups. Athletes achieved their highest score among the alcohol (65 ± 19%) category and the lowest in sports nutrition (43 ± 17%). Coaches demonstrated the most knowledge in the alcohol (73 ± 17%) category and lowest knowledge in the supplementation (45 ± 19%) category. Both groups relied on the internet, dietitians, and coaches for sports nutrition information. Future studies should explore the effects of nutrition education on nutrition knowledge and dietary intakes among these populations. Citation: Applied Physiology, Nutrition, and Metabolism PubDate: 2022-08-29T07:00:00Z DOI: 10.1139/apnm-2022-0251
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Authors:Karolina Łagowska, Nicole C.A. Strock, Kristen J. Koltun, Nancy I. Williams, Mary Jane De Souza First page: 1085 Abstract: Applied Physiology, Nutrition, and Metabolism, Ahead of Print. Diet plays a role in the pathophysiology and treatment of women with hyperandrogenic menstrual disturbances; however, limited research exists examining components of dietary intake in women with subclinical menstrual disturbances. The aim of this investigation was to evaluate the relationship between diet quality and hormonal status in exercising women with menstrual disturbances. Eighty exercising women with ovulatory menstrual cycles (OV; n = 32), women with oligo/amenorrhea without evidence of hyperandrogenism (Oligo/Amen-LowFAI; n = 28), and women with oligo/amenorrhea and evidence of subclinical hyperandrogenism (Oligo/Amen-HighFAI; n = 32) participated in the cross-sectional observational study (Clinical Trial Number: NCT00392873). Self-reported menstrual history, resting energy expenditure, body composition, hormonal and metabolic hormone concentrations determined reproductive and metabolic status. Serum androgens and calculated free androgen index (FAI) determined androgen status. The Diet Quality Index International (DQI-I) and the Dietary Inflammatory Index (DII) evaluated quality of diet. Oligo/Amen-HighFAI group had the highest androgen concentrations (P Citation: Applied Physiology, Nutrition, and Metabolism PubDate: 2022-09-09T07:00:00Z DOI: 10.1139/apnm-2021-0789
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Authors:Flora Zhang, Amar Laila, Ana Carolina Barco Leme, David W.L. Ma, Jess Haines First page: 1096 Abstract: Applied Physiology, Nutrition, and Metabolism, Ahead of Print. To support Canadians ages 2 years and older in improving their dietary intake, Health Canada released a revised Canada's Food Guide (CFG) in 2019. This study aimed to explore the knowledge and perceptions of the 2019 CFG among children ages 9–12 years old from Southwestern Ontario. From September–November 2021, interviews were conducted with children by video conference. Thirty-five children (50% girls, 80% White; mean age 9.9 years) participated. Data were analyzed using a hybrid thematic approach with inductive and deductive analyses. Children expressed a lack of knowledge on certain foods (i.e., plant-based proteins, whole grains, and highly processed foods) that are highlighted in the CFG. Children also expressed confusion around food groups, including recommended proportions and categorization of some foods (e.g., dairy products and plant-based proteins). Children generally expressed positive perceptions regarding CFG and its eating habit recommendations, i.e., “Cook more often”, “Eat meals with others”, and “Enjoy your food”, and they suggested strategies to improve adherence to these recommendations, including providing children more responsibility and independence with food preparation tasks and minimizing family time conflicts. Children's perceptions of the CFG can help inform public health policies and programmatic strategies designed to support children's food choices and eating habits. Citation: Applied Physiology, Nutrition, and Metabolism PubDate: 2022-09-12T07:00:00Z DOI: 10.1139/apnm-2022-0271
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Authors:Changhyun Lim, Daniel A. Traylor, Chris McGlory, Sophie Joanisse, James McKendry, Tavneet Grewal, Jonathan C. Mcleod, Todd Prior, Everson A. Nunes, Matthew Lees, Stuart M. Phillips First page: 1104 Abstract: Applied Physiology, Nutrition, and Metabolism, Ahead of Print. Leucine is a critical amino acid stimulating myofibrillar protein synthesis (MyoPS). The consumption of higher leucine-containing drinks stimulates MyoPS, but we know less about higher leucine solid foods. Here, we examined the effect of short-term resistance exercise training (STRT) combined with supplementation of a protein and leucine-enriched bar, compared with STRT alone, on integrated (%/day) rates of MyoPS and anabolic protein signaling. In a nonblinded, randomized crossover trial, eight young adults performed four sessions of STRT without or while consuming the study bar (STRT+Leu, 16 g of protein containing ∼3 g of leucine) for two 4-day phases, separated by 2 days nonexercise (Rest) washout. In combination with serial muscle biopsies, deuterated water permitted the measurement of MyoPS and protein signaling phosphorylation. MyoPS during STRT (1.43 ± 0.06%/day) and STRT+Leu (1.53 ± 0.06%/day) were greater than Rest (1.31 ± 0.05%/day), and MyoPS during STRT+Leu (1.53 ± 0.06%/day) was greater than STRT alone (1.43 ± 0.06%/day). STRT+Leu increased the ratio of phosphorylated to total mechanistic target of rapamycin and 4EBP1 compared to Rest. Engaging in STRT increased integrated MyoPS and protein signaling in young adults and was enhanced with increased protein intake derived from a leucine-enriched protein bar. This study was registered at clinicaltrials.gov as NCT03796897. Citation: Applied Physiology, Nutrition, and Metabolism PubDate: 2022-09-20T07:00:00Z DOI: 10.1139/apnm-2022-0164
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