The aim of the present study was to test the hypotheses that exercise is associated with generation of peroxisome proliferator-activated receptor-γ (PPARγ) ligands in the plasma and that this may activate PPARγ signaling within circulating monocytes, thus providing a mechanism to underpin the exercise-induced antiatherogenic benefits observed in previous studies. A cohort of healthy individuals undertook an 8-wk exercise-training program; samples were obtained before (Pre) and after (Post) standardized submaximal exercise bouts (45 min of cycling at 70% of maximal O(2) uptake, determined at baseline) at weeks 0, 4, and 8. Addition of plasma samples to PPARγ response element (PPRE)-luciferase reporter gene assays showed increased PPARγ activity following standardized exercise bouts (Post/Pre = 1.23 ± 0.10 at week 0, P < 0.05), suggesting that PPARγ ligands were generated during exercise. However, increases in PPARγ/PPRE-luciferase activity in response to the same standardized exercise bout were blunted during the training program (Post/Pre = 1.18 ± 0.14 and 1.10 ± 0.10 at weeks 4 and 8, respectively, P > 0.05 for both), suggesting that the relative intensity of the exercise may affect PPARγ ligand generation. In untrained individuals, specific transient increases in monocyte expression of PPARγ-regulated genes were observed within 1.5-3 h of exercise (1.7 ± 0.4, 2.6 ± 0.4, and 1.4 ± 0.1 fold for CD36, liver X receptor-α, and ATP-binding cassette subfamily A member 1, respectively, P < 0.05), with expression returning to basal levels within 24 h. In contrast, by the end of the exercise program, expression at the protein level of PPARγ target genes had undergone sustained increases that were not associated with an individual exercise bout (e.g., week 8 Pre/week 0 Pre = 2.79 ± 0.61 for CD36, P < 0.05). Exercise is known to upregulate PPARγ-controlled genes to induce beneficial effects in skeletal muscle (e.g., mitochondrial biogenesis and aerobic respiration). We suggest that parallel exercise-induced benefits may occur in monocytes, as monocyte PPARγ activation has been linked to beneficial antidiabetic effects (e.g., exercise-induced upregulation of monocytic PPARγ-controlled genes is associated with reverse cholesterol transport and anti-inflammatory effects). Thus, exercise-triggered monocyte PPARγ activation may constitute an additional rationale for prescribing exercise to type 2 diabetes patients.

BackgroundTo evaluate the ability of community-based exercise programmes to facilitate public participation in exercise and hence improved cardiovascular health, we assessed the respective impacts of: a continuously monitored exercise programme based within our university (study 1); a Valleys Regional Park-facilitated community-based outdoor exercise programme (study 2); a Wales National Exercise Referral Scheme-delivered exercise-referral programme (study 3).MethodsBiomolecular (monocytic PPARγ target gene expression), vascular haemodynamic (central/peripheral blood pressure, arterial stiffness), clinical (insulin sensitivity, blood lipids) and anthropometric (body mass index, waist circumference, heart rate) parameters were investigated using RT-PCR, applanation tonometry, chemical analysis and standard anthropometric techniques.ResultsIn studies 1–3, 22/28, 32/65 and 11/14 participants adhered to their respective exercise programmes, and underwent significant increases in physical activity levels. Importantly, beneficial effects similar to those seen in our previous studies (eg, modulations in expression of monocytic PPARγ target genes, decreases in blood pressure/arterial stiffness, improvements in blood lipids/insulin sensitivity) were observed (albeit to slightly differing extents) only in participants who adhered to their respective exercise programmes. While study 1 achieved more intense exercise and more pronounced beneficial effects, significant cardiovascular risk-lowering health benefits related to biomolecular markers, blood pressure, arterial stiffness and blood lipids were achieved via community/referral-based delivery modes in studies 2 and 3.ConclusionsBecause cardiovascular health benefits were observed in all 3 studies, we conclude that the majority of benefits previously reported in laboratory-based studies can also be achieved in community-based/exercise-referral settings. These findings may be of use in guiding policymakers with regard to introduction and/or continued implementation of community/referral-based exercise programmes.

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The Foot and Ankle Online Journal 3 (3): 1 Background: Although changes in kinematics and repetitive impact forces produced by high heeled footwear can be minimized by prefabricated foot orthoses, their effects on energy efficiency and comfort are less understood. The purpose of this study was to investigate if an increase in high heeled footwear and selected prefabricated foot orthoses altered energy consumption and improved comfort. Materials and Method: Ten healthy females (age range 21-34 years) who were regular high heel wearers volunteered for the study. Five footwear conditions were randomly assigned: heel height of 15mm (flat), 45mm (low), 70mm (high), high with McConnell ® orthosis and high with Insolia ® orthosis. Heart rate (HR), volume of oxygen consumed in liters per kilogram (VO 2 /kg), respiration exchange ratio (RER), physiological cost index (PCI) and the number of steps (oS) were monitored whilst walking on a treadmill at a speed of 4.2km/hour and 0% incline for 10 minutes. The Footwear Comfort Scale was also completed following each condition. Results: HR, VO 2 /kg, RER, PCI and oS were significantly increased for the high (p<0.001) condition compared to the flat and low conditions. Significant differences (p<0.001) were also noted between the high and high with McConnell ® and Insolia ® conditions with a reduced HR, VO 2 /kg, RER, oS and PCI. A significantly improved overall Footwear Comfort Scale was also noted between the high, McConnell ® and Insolia ® conditions (p<0.001). Conclusions: This study supports previous work that wearing high heels are less energy efficient than flat shoes. It also suggests that selected prefabricated foot orthoses in high heeled footwear may improve energy efficiency and perceived comfort to wearing high heels alone. These combined benefits and the specific design of biomechanical interventions of orthoses for high heeled footwear should be explored further.

Results: As expected, eGFR fell from 85AE18ml/min at baseline to 59AE12ml/ min, 12 months post-donation (P<0.001). Clinic BP was 123AE15/79AE9mmHg at baseline and 126AE14/75AE9mmHg, 12 months post-donation (PZ0.09 and P<0.001 for systolic and diastolic BP, respectively). There was no change in aPWV from baseline, 12 months following donation (7.33AE1.53m/s versus 7.35AE1.1.58m/s, PZ0.8).Conclusion: These data demonstrate that it is feasible to recruit patients undergoing living-donor nephrectomy and to examine the effects on aortic stiffness up to 12 months following donation. Moreover, the results provide important data on which to base larger studies aimed at investigating longerterm effects of kidney donation on aortic stiffness and cardiovascular health.