Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme最新文献

Newfoundland and Labrador (NL) became the first Canadian province to implement a tax on sugar sweetened beverages (SSBs) in 2022 as an effort to reduce consumption and lower the rate obesity and diabetes. NL also launched a "Rethink Your Drink" campaign to promote water as the drink of choice. However, there may be barriers to choosing water such as the presence of boil water advisories and negative attitudes towards tap water. The objective of this study is to explore the factors influencing total water consumption in NL and assess the impact of attitudes towards tap water and boil water advisories as a predictor of total water and SSB intake. We conducted a cross-sectional online study with adults in NL before and after the implementation of the SSB tax. Attitudes towards tap water and perceptions about being under a boil water advisory impacted beverage consumption. Having negative attitudes towards tap water predicted lower total water consumption (-221 mL/week, p = 0.002) as well as reported being under a boil water advisory (-213 mL/week, p = 0.042), after accounting for sociodemographic variables. Having negative attitudes towards tap water was not a significant predictor of SSB intake after controlling for sociodemographic factors (p = 0.090). Positive health impacts of the NL SSB tax may not be fully realized if SSBs are not substituted for healthier beverage choices, such as water. Policy makers should be aware of the relationship between negative attitudes towards tap water, boil water advisories, and beverage consumption when implementing initiatives to improve public health.

Endurance athletes have an increased risk of bone stress injuries due to high training and energy demands. Endurance training with inadequate recovery triggers a pro-inflammatory response, which can upregulate bone resorption for hours to days. Combined dietary protein and carbohydrate supplementation post-exercise has shown to attenuate bone resorption and pro-inflammatory cytokine responses, though the effect of dietary protein intake alone remains to be elucidated. This randomized cross-over, double-blinded study examined the acute effects of post-exercise protein supplementation on serum concentrations of osteokine and inflammatory cytokines in endurance runners. Fourteen young male and female (n = 7 each) endurance runners with a weekly training distance ≥40 km were included. Participants underwent (i) a protein treatment (0.5 g/kg whey isolate), and (ii) a control/water treatment; consumed immediately after a treadmill run to volitional exhaustion at 70% maximal oxygen consumption. Blood samples were taken at baseline, 0, 1, 2, 3, 4, and 24 h post-exercise, and analyzed with immunosorbent and multiplex assays. A linear mixed model assessed the effects of time and treatment for each marker, and interactions (sex, sequence, period, and baseline difference as covariates). There were no significant treatment by time effects for any blood markers. There were significant main effects of time for serum sclerostin (p < 0.0001), dickkopf-1 (p < 0.0001), osteoprotegerin (p < 0.0001), and tumor necrosis factor-alpha (p = 0.004); these markers increased immediately post-exercise and returned to baseline by 24 h. Acute whey protein supplementation did not induce a different bone or inflammatory response following exhaustive running exercise in young endurance runners compared to the control. Registration number: NCT06645119.

In females, menopause reduces estrogen and its cardioprotective effects, doubling cardiovascular disease risk, and nearly doubling stroke risk within 10 years post-menopause. Poor cardiovascular health markers are common post-stroke, increasing recurrent stroke risk. Physical activity improves cardiovascular health in postmenopausal females and post-stroke individuals, yet no studies have explored its relationship with cardiovascular health and menopausal status in females post-stroke. This study investigated (1) the association between physical activity and cardiovascular health in females with stroke and (2) the moderating role of menopausal status on this association. Baseline data from the Canadian Longitudinal Study on Aging were analyzed, including females with stroke who provided menopausal status, self-reported physical activity, cardiovascular outcomes, and covariates. Generalized linear models with analytic weights assessed associations between cardiovascular health measures and physical activity, controlling for age, and smoking history. Subsequent models evaluated the interaction between physical activity and menopausal status. Among 1468 females with stroke (n = 103 (7%) pre- or perimenopausal females), physical activity was beneficially associated with reductions in systolic blood pressure (ß = -0.02, p = 0.04), waist circumference (ß = -0.03, p < 0.01), waist-to-hip ratio (ß = -0.00009, p = 0.03), and C-Reactive protein (ß = -0.007, p < 0.02). There were no significant interactions between physical activity and menopausal status for all outcomes. Physical activity positively impacts cardiovascular health in females with stroke, irrespective of menopausal status. This study lays groundwork for longitudinal research examining cardiovascular differences between pre- and postmenopausal females with stroke.

This study explored the effects of combining repeated-sprint training with end-expiratory breath-hold (EBH) and inspiratory muscle training (IMT) on cardiorespiratory fitness and performance in artistic swimming. In a quasi-experimental study, 15 artistic swimmers (15.7 ± 1.5 years) completed, over 3 weeks, nine training sessions (each involving 32 15-m swim sprints) with EBH complemented with daily IMT at 50% of inspiratory muscle strength (EBH + IMT, n = 8) or the same EBH training with a placebo IMT procedure (EBH, n = 7). Laboratory outcomes and performance measures included inspiratory muscle pressure, peak power output, peak O₂ uptake ( $\dot{V}$ O_2peak), muscle oxygenation, ventilatory thresholds markers, and a 275 m underwater swim test (UWST). Both groups increased maximal inspiratory muscle strength (∼21%, time effect p < 0.001, Cohen's ES = 0.72). There was a significant interaction for $\dot{V}$ O_2peak, which increased more in EBH + IMT than EBH alone (3.1 mL·kg^-1·min^-1, interaction p = 0.036, ES = 0.73). The deoxygenation of the vastus lateralis muscle during the incremental test increased following EBH + IMT only (38%, interaction p = 0.01). No change occurred in ventilatory threshold markers nor in UWST performance in any groups. These results suggest that combining repeated-sprint training with EBH and daily IMT for 3 weeks led to greater peripheral muscle O₂ extraction, conducive to an increased $\dot{V}$ O_2peak gain, but exerted no influence on a more specific swimming/breath-hold performance.

This study investigated the effect of the MC4R rs17782313 (T > C) polymorphism on substrate oxidation and metabolic responses during exercise in healthy sedentary men. Forty-eight participants (aged 20-30 years) underwent genotyping and completed a graded exercise test with respiratory gas analysis to assess oxygen consumption (VO₂), respiratory quotient (RQ), and fat and carbohydrate oxidation rates. Participants were grouped as C-allele carriers (risk allele) and TT homozygotes. Group comparisons were conducted for VO₂, RQ, substrate oxidation rates, and body mass index (BMI). Statistical analysis revealed no significant differences between genotypes in RQ, fat oxidation percentage, or carbohydrate oxidation percentage during moderate-intensity exercise (p > 0.05). However, significant differences were observed in BMI, with C-allele carriers exhibiting higher BMI values compared to TT homozygotes (p < 0.05). These results indicate that while the MC4R rs17782313 variant is associated with increased adiposity, it does not appear to affect acute substrate utilization during exercise. Thus, its contribution to obesity risk may be primarily mediated by behavioral and neuroendocrine mechanisms influencing energy intake rather than impairments in metabolic flexibility.

Clinical exercise physiologists (CEPs) play an essential role in delivering exercise-based interventions for individuals with chronic disease. While Canada's primary CEP certification, governed by the Canadian Society for Exercise Physiology (CSEP), outlines core competencies, the absence of program-level accreditation may lead to variability in academic preparation. This environmental scan evaluated the extent to which a subset of Canadian undergraduate programs align with CSEP-CEP certification requirements. Thirteen programs that participate in CSEP's Recommended Course Map initiative were examined from among 50+ kinesiology and exercise science programs operating nationally. Curricula were reviewed using structured coding of course content, skill assessment practices, and practicum integration. All programs demonstrated strong coverage of foundational knowledge; however, inconsistencies were observed in clinically-focused domains (e.g., health behaviour change, pharmacology), structured skill assessment, and supervised practicum experiences. Only 69% of programs included formal in-curriculum applied skill evaluations that directly address CSEP-CEP competency requirements, and 54% required a for-credit practicum. Practicum hours and settings varied widely, often falling short of national and international benchmarks. Findings highlight the need for stronger curriculum alignment, particularly in applied competencies and experiential learning. These results suggest that integrating structured, competency-based instruction and assessment across coursework and clinical placements would strengthen graduate readiness for both certification and clinical practice in healthcare contexts. This study provides timely insights to inform national CEP education standards and support strategic workforce planning as provinces expand CEP integration into healthcare systems.

Despite growing evidence on the role of physical activity in preventing and managing chronic disease, integration of qualified exercise professionals (QEPs) into the Canadian healthcare system remains limited and inconsistent. We explore the systemic and professional challenges hindering QEP integration, based on findings from a national initiative led by Exercise is Medicine Canada. Consultation occurred with numerous stakeholders across Canada and 10 leaders in health and exercise professions were interviewed. Using thematic analysis, four key barriers were identified: (1) overlapping and unclear scopes of practice; (2) insufficient clinical training and experiential education; (3) limited public and provider understanding of QEP roles; and (4) a reactive healthcare system that undervalues prevention. Participants emphasized the need for standardized, competency-based education and credentialling pathways aligned with clinical expectations, as well as improved communication of the distinct value QEPs offer in chronic disease management and health promotion. These findings highlight opportunities for coordinated action among academic institutions, professional bodies, and healthcare policymakers to advance the integration of QEPs and better support physical activity and exercise as a cornerstone of healthcare.

Health-care professionals (HCPs) have an important role in disseminating and implementing exercise and nutrition care to older adults to support aging in place. We performed an environmental scan to examine the availability of exercise- and nutrition-based continuing education (CE) resources for kinesiologists, physiotherapists, exercise physiologists, occupational therapists, dietitians, and pharmacists in Canada relating to the specific needs of community-living older adults. Data were collected between 2023 and 2024 using websites of provincial and national organizations for HCPs, advocacy organizations for chronic conditions, and aging institutes; communication with knowledge users; and a targeted Google search. Sixty-nine courses were identified that have been active within the past 5 years. Notably, only 9% focused exclusively on nutrition compared to 64% that focused exclusively on exercise. Also, most courses (74%) delivered content aimed at age-adjacent chronic health conditions, while few described their content with respect to healthy aging specifically. While courses emphasized evaluation and application in their course objectives, these goals were inconsistent with the fact that most courses had short durations (<1.5 h) and were delivered virtually and asynchronously. Our work suggests that the organizations we scanned provide limited education on nutrition for older Canadians. Furthermore, across both exercise and nutritional education, in-person or hybrid options to support the training and application of practical skills are lacking. Exercise and nutrition-focused CE development would support HCP learners to help their older clients age in place.

Referral to, participation in, and execution of cardiac rehabilitation programs are comparatively lower in females than in males. The current study aimed to explore potential sex disparities in cardiorespiratory capacity and clinical outcomes after cardiac rehabilitation for coronary artery disease. Systematic searches were conducted across the PubMed, Embase, Cochrane Library, and Web of Science databases to identify studies assessing primary outcomes of cardiorespiratory capacity (peak oxygen uptake, peak metabolic equivalents, and its changes), secondary outcomes of cardiovascular endpoints (all-cause mortality, myocardial infarction, rehospitalization) and quality of life following cardiac rehabilitation in both female and male patients with coronary artery disease. A total of 22 predominantly observational studies involving 27 624 patients were analyzed, with 7441 (26.9%) being female and 20 183 (73.1%) being male. After cardiac rehabilitation, females showed lower peak oxygen uptake (mean difference -4.82, 95% confidence intervals -6.30 to -3.34 mL/kg/min, P < 0.00001), peak metabolic equivalents (-1.74, -2.34 to -1.14 units, P < 0.001) and its absolute changes from baseline (-0.40, -0.44 to -0.36 units, P < 0.001), as well as the worse quality of life when compared to males. However, there were no significant sex variations in all-cause mortality, myocardial infarction, and rehospitalization. In conclusion, females exhibited lower cardiorespiratory capacity and quality of life than males following cardiac rehabilitation. Despite these disparities, no sex-based differences existed in cardiovascular outcomes during the follow-up period after cardiac rehabilitation in patients with coronary artery disease. (Registration No. CRD42021269222).