Background Many clinicians believe that statins cause muscle pain, but this has not been observed in clinical trials and the effect of statins on muscle performance has not been carefully studied. Methods and Results The Effect of STatins On Skeletal Muscle Function and Performance (STOMP) study assessed symptoms and measured creatine kinase (CK), exercise capacity, and muscle strength before and after atorvastatin 80 mg or placebo were administered for 6 months to 420 healthy, statin-naive subjects. No individual CK value exceeded 10 times normal, but average CK increased 20.8 ± 141.1 U/L (p<0.0001) with atorvastatin. There were no significant changes in several measures of muscle strength or exercise capacity with atorvastatin, but more atorvastatin than placebo subjects developed myalgia (19 vs 10; p = 0.05). Myalgic subjects on atorvastatin or placebo decreased muscle strength in 5 of 14 and 4 of 14 variables respectively (p = 0.69). Conclusions These results indicate that high-dose atorvastatin for 6 months does not decrease average muscle strength or exercise performance in healthy, previously untreated subjects. Nevertheless, this blinded, controlled trial confirms the undocumented impression that statins increase muscle complaints. Atorvastatin also increased average CK suggesting that statins produce mild muscle injury even among asymptomatic subjects. This increase in CK should prompt studies examining the effects of more prolonged, high-dose statin treatment on muscular performance. Clinical Trial Registration Information: www.clinicaltrials.gov; Identifier: NCT00609063.

Young adults 18–24 years have the highest rates of problems associated with alcohol use among all age groups, and substance use is inversely related to engagement in substance-free activities. This pilot study investigated the promotion of one specific substance-free activity, exercise, on alcohol use in college students. Thirty-one sedentary college students who engaged in hazardous drinking (Alcohol Use Disorders Identification Test scores ≥ 8) were randomized to one of two conditions: (a) one 50-minute session of motivational enhancement therapy (MET) focused on increasing exercise, or (b) one 50-minute session of MET focused on increasing exercise plus 8 weeks of contingency management (CM) for adhering to specific exercise activities. All participants completed evaluations at baseline and post-treatment (2-months later) assessing exercise participation and alcohol use. Results of the pilot study suggest the interventions were well received by participants, the MET+CM condition showed an increased self-reported frequency of exercise in comparison to the MET alone condition, but other indices of exercise, physical fitness, and alcohol use did not differ between the interventions over time. These results suggest that a larger scale trial could better assess efficacy of this well received combined intervention. Investigation in other clinically relevant populations is also warranted.

Purpose The purpose of the study was to examine the relationship between serum 25-hydroxy vitamin D (25(OH)D) levels and muscle strength in 419 healthy men and women over a broad age range (20-76 years of age). Methods Isometric and isokinetic strength of the arms and legs was measured using computerized dynamometry and its relation to vitamin D was tested in multivariate models controlling for age, gender, resting heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), maximal oxygen uptake (VO2max,), physical activity counts, and season of vitamin D measurement. Results Vitamin D was significantly associated with arm and leg muscle strength when controlling for age and gender. When controlling for other covariates listed above, vitamin D remained directly related to both isometric and isokinetic arm strength but only to isometric leg strength. Conclusion These data suggests that there may be a differential effect of vitamin D on upper and lower body strength. The mechanism for this difference remains unclear but could be related to differences in androgenic effects or to differences in vitamin D receptor expression. Our study supports a direct relationship between vitamin D and muscle strength and suggests that vitamin D supplementation be evaluated to determine if it is an effective therapy to preserve muscle strength in adults.

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