The Effect of a Six-Week Nordic Walking Training Cycle on Oxidative Damage of Macromolecules and Iron Metabolism in Older Patients with Multiple Myeloma in Remission—Randomized Clinical Trial

Abstract

Multiple myeloma (MM) is an incurable hematologic malignancy originating from clonal plasma cell proliferation within the bone marrow, predominantly affecting older individuals. While anemia serves as a diagnostic criterion for MM, it often ameliorates upon achieving disease remission. Iron metabolism parameters have emerged as potential prognostic indicators in MM. Notably, physical exercise has been established to influence iron metabolism. This study aimed to assess alterations in serum iron, ferritin, and transferrin concentrations, as well as leukocyte gene expression, in MM patients undergoing a six-week cycle of Nordic walking training. Thirty patients divided into an exercise group (NW, n = 15, mean age 63.1 ± 8.4 years) and a control group (CG, n = 15, mean age: 63.5 ± 3.6 years) completed the study protocol. Blood samples were collected at baseline, after three and six weeks of training, and after nine weeks. Serum ferritin, transferrin, and iron concentrations were measured, along with the leukocyte expression of genes. Additionally, serum oxidative damage marker levels were determined. Following the Nordic walking training cycle, a declining trend in serum ferritin concentrations was observed. Intracellular mRNA levels of genes associated with iron metabolism were positively influenced by the training regimen, indicating the potential impact of this physical activity on gene expression and ferritin concentrations. Although positive trends were noted, extended training periods might be requisite for significant changes. To conclude, moderate-intensity exercise induces favorable shifts in the analyzed parameters among MM patients, potentially influencing disease progression. Consequently, Nordic walking training is a safe recommendation for MM patients, though sustained training beyond six weeks could be necessary for notable effects on iron metabolism factors.

The Beneficial Effects of Nordic Walking Training Combined with Time-Restricted Eating 14/24 in Women with Abnormal Body Composition Depend on the Application Period

“…Meanwhile, in both fasting groups, the leukocyte count increased, which may be related to the training effect, similar to the observed increases in neutrophil and lymphocyte counts. A similar effect was observed in patients with multiple myeloma participating in a 6-week cycle of Nordic walking training, where an increase in leukocyte count was also noted [8].…”

“…Due to the engagement of both upper and lower body muscles, the energy cost of this activity is higher than that of regular walking [5], with a simultaneous reduction in load on the knee and intervertebral joints [6]. This type of training may be recommended for patients with cardiovascular diseases [7], oncological conditions [8,9], or neurological disorders [10][11][12]. Such a wide range underscores the safety of this training modality.…”

The Impact of a 6-Week Nordic Walking Training Cycle and a 14-Hour Intermittent Fasting on Disease Activity Markers and Serum Levels of Wnt Pathway-Associated Proteins in Patients with Multiple Myeloma

“…On contrary, the proposed interventions improved the concentrations of some bone formation-related markers analyzed in this study. Previous publications on exercise interventions in patients with MM or pre mm conditions also did not show significant differences in weight and body composition [26][27][28].…”

The Impact of a 6-Week Nordic Walking Training Cycle and a 14-Hour Intermittent Fasting on Disease Activity Markers and Serum Levels of Wnt Pathway-Associated Proteins in Patients with Multiple Myeloma

“…On contrary, the proposed interventions improved the concentrations of some bone formation-related markers analyzed in this study. Previous publications on exercise interventions in patients with MM or pre-MM conditions also did not show significant differences in weight and body composition [19][20][21].…”

“…Intermittent fasting (IF), which involves maintaining set time intervals of food intake, is being used increasingly for health purposes [21]. Under the influence of applied fasting, the body derives energy not only from liver glycogen, but also from ketones derived from adipose tissue [22].…”