High-intensity resistance exercise training is a feasible and effective means of counteracting muscle weakness and physical frailty in very elderly people. In contrast, multi-nutrient supplementation without concomitant exercise does not reduce muscle weakness or physical frailty.
Unsupervised weight-lifting exercise maintains its antidepressant effectiveness at 20 weeks in depressed elderly patients. Long-term changes in exercise behavior are possible in some patients even without supervision.
To assess muscle remodeling and functional adaptation to exercise and diet interventions, 26 men and women aged 72–98 yr underwent a vastus lateralis biopsy before and after placebo control condition, and progressive resistance training, multinutrient supplementation, or both. Type II atrophy, Z band, and myofibril damage were present at baseline. Combined weight lifting and nutritional supplementation increased strength by 257 ± 62% ( P = 0.0001) and type II fiber area by 10.1 ± 9.0% ( P = 0.033), with a similar trend for type I fiber area (+12.8 ± 22.2%). Exercise was associated with a 2.5-fold increase in neonatal myosin staining ( P = 0.0009) and an increase of 491 ± 137% ( P < 0.0001) in IGF-I staining. Ultrastructural damage increased by 141 ± 59% after exercise training ( P = 0.034). Strength increases were largest in those with the greatest increases in myosin, IGF-I, damage, and caloric intake during the trial. Age-related sarcopenia appears largely confined to type II muscle fibers. Frail elders respond robustly to resistance training with musculoskeletal remodeling, and significant increases in muscle area are possible with resistance training in combination with adequate energy intakes.
Dating violence is prevalent among US adolescent girls, especially those reporting having had sexual intercourse. Adolescent girls intentionally hurt by a date in the previous year are more likely to experience sexual health risks, including those increasing vulnerability to human immunodeficiency virus infection and other sexually transmitted infections, and to have been pregnant. Dating violence should be integrated into sexual health and pregnancy prevention programs, and greater efforts to identify girls experiencing dating violence are needed among those providing care related to adolescent sexual and reproductive health.
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