insulin sensitivity was obtained from an oral glucose tolerance test. Body composition was measured by dual-energy X-ray absorptiometry and magnetic resonance imaging. Fat oxidation and energy expenditure were measured during an acute exercise bout of 45 min of ergometer biking at 50% of maximal oxygen consumption (V O2 max). Muscle biopsies from the vastus lateralis of the quadriceps muscle were obtained before and immediately after the exercise bout. Postmenopausal women had 33% [confidence interval (CI) 95%: 12-55] lower whole body fat oxidation (P ϭ 0.005) and 19% (CI 95%: 9 -22) lower energy expenditure (P ϭ 0.02) during exercise, as well as 4.28 kg lower lean body mass (LBM) than premenopausal women. Correction for LBM reduced differences in fat oxidation to 23% (P ϭ 0.05), whereas differences in energy expenditure disappeared (P ϭ 0.22). No differences between groups were found in mRNA [carnitine palmitoyltransferase I, ␤-hydroxyacyl-CoA dehydrogenase (␤-HAD), peroxisome proliferator-activated receptor-␣, citrate synthase (CS), pyruvate dehydrogenase kinase 4, peroxisome proliferator-activated receptor-␥ coactivator-1␣ (PGC-1␣)], protein [phosphorylated AMPactivated protein kinase (AMPK), vascular endothelial growth factor, pyruvate dehydrogenase-1E␣, cytochrome oxidase I], or enzyme activities (␤-HAD, CS) in resting skeletal muscle, except for an increased protein level of cytochrome c in the post-and perimenopausal women relative to premenopausal women. Postmenopausal women demonstrated a trend to a blunted exercise-induced increase in phosphorylation of AMPK compared with premenopausal women (P ϭ 0.06). We conclude that reduced whole body fat oxidation after menopause is associated with reduced LBM. menopause; skeletal muscle; fat oxidation; biopsy MENOPAUSE SIGNALS THE END of the fertile phase of a woman's life and is defined after 12 mo of amenorrhea, as the last menstrual bleeding. At this time point, a marked increase in the incidence of the metabolic syndrome (19, 37), cardiovascular diseases (1, 27, 35), and type 2 diabetes (48) is observed. The increased occurrence of metabolic diseases is likely to be related to changes in body composition, such as an increased amount of body fat (22,29,30,49), changed body fat distribution (22,30,51), and loss of lean body mass (LBM) (12,49,53).Menopause leads to a significant decrease in circulating levels of estrogen as well as increases in gonadotropins. Estrogen seems to influence the substrate choice in humans toward fat oxidation. Hence, fat oxidation is lower in males than in females during endurance exercise (8,17,26,50) and increases in males taking estrogen supplementation (11,16). Furthermore, these gender differences in substrate utilization are only seen when comparing males with females at fertile ages (8,17,26,50). Therefore, it has been hypothesized that reduced estrogen levels with menopause may influence substrate utilization.To our knowledge, only a single previous study has investigated whole body fat oxidation in relation to menopause show...

Free-living participants were able to comply with 14 h of daily daytime abstinence from food and drinking for 28 d with only a minor effect on body mass index and without any effects on body composition, glucose metabolism, and cognitive function.

Recent years have seen an increase in the frequency of extreme rainfall and subsequent flooding across the world. Climate change models predict that such flooding will become more common, triggering sewer overflows, potentially with increased risks to human health. In August 2010, a triathlon sports competition was held in Copenhagen, Denmark, shortly after an extreme rainfall. The authors took advantage of this event to investigate disease risks in two comparable cohorts of physically fit, long distance swimmers competing in the sea next to a large urban area. An established model of bacterial concentration in the water was used to examine the level of pollution in a spatio-temporal manner. Symptoms and exposures among athletes were examined with a questionnaire using a retrospective cohort design and the questionnaire investigation was repeated after a triathlon competition held in non-polluted seawater in 2011. Diagnostic information was collected from microbiological laboratories. The results showed that the 3.8 kilometer open water swimming competition coincided with the peak of post-flooding bacterial contamination in 2010, with average concentrations of 1.5x104 E. coli per 100 ml water. The attack rate of disease among 838 swimmers in 2010 was 42% compared to 8% among 931 swimmers in the 2011 competition (relative risk (RR) 5.0; 95% CI: 4.0-6.39). In 2010, illness was associated with having unintentionally swallowed contaminated water (RR 2.5; 95% CI: 1.8-3.4); and the risk increased with the number of mouthfuls of water swallowed. Confirmed aetiologies of infection included Campylobacter, Giardia lamblia and diarrhoeagenic E. coli. The study demonstrated a considerable risk of illness from water intake when swimming in contaminated seawater in 2010, and a small but measureable risk from non-polluted water in 2011. This suggests a significant risk of disease in people ingesting small amounts of flood water following extreme rainfall in urban areas.