Thomas W Buford

Thomas W Buford
University of Alabama at Birmingham | UAB · Medicine - Division of Gerontology Geriatrics and Palliative Care

PhD

About

205
Publications
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Introduction
Dr. Buford is a Professor in the Departments of Medicine and Nutrition at the University of Alabama at Birmingham (UAB). He is also the Director of the UAB Center for Exercise Medicine and Co-Director of the UAB Nathan Shock Center of Excellence in the Basic Biology of Aging.

Publications

Publications (205)
Article
Importance: Observational evidence suggests that higher physical activity is associated with slower kidney function decline; however, to our knowledge, no large trial has evaluated whether activity and exercise can ameliorate kidney function decline in older adults. Objective: To evaluate whether a moderate-intensity exercise intervention can af...
Article
Background: Resistance training (RT) is the main modality of exercise used to induce hypertrophic and neuromuscular adaptations. RT done at high intensities (HI-RT) is also capable of inducing epigenetic modifications leading to altered protein expression. HI-RT increases protein expression of many enzymes that play key roles in disease prevention...
Article
Knee osteoarthritis is a leading cause of chronic pain in adults (1, 2). Yet its impact varies (3, 4), and may be influenced by changes in the central nervous system (5, 6), similar to neuroplasticity observed in aging (7, 8), including increased brain atrophy, placing individuals at a greater risk for negative outcomes (9). We used an established...
Article
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Both ketogenic diets (KD) and time-restricted feeding (TRF) regimens have the ability to influence several parameters of physical health, including gut microbiome composition and circulating cytokine concentration. Moreover, both of these dietary interventions prevent common impairments associated with the aging process. However, significantly alte...
Chapter
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For centuries, regular exercise has been acknowledged as a potent stimulus to promote, maintain, and restore healthy functioning of nearly every physiological system of the human body. With advancing understanding of the complexity of human physiology, continually evolving methodological possibilities, and an increasingly dire public health situati...
Article
Introduction: Cardiometabolic diseases (CMDs) are prevalent among middle-aged and older people living with HIV (OPLWH), particularly in the Deep South. However, the role CMDs play on quality-of-life outcomes among OPLWH remain understudied. Purpose: The purpose of this observational study was to examine the association between CMDs and physical hea...
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Chronic low back pain (cLBP) is the most common reason for individual suffering and health care utilization in adults. Ample evidence suggests sociodemographic variables and socioeconomic status (SES) influence pain. However, a framework informing associations on race, SES, and the utilization of pharmacologic therapies and provider type are limite...
Article
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Chronic low back pain (cLBP) can lead to severe pain symptoms as well as disability in adults. As individuals age, pain symptoms and mobility outcomes can become increasingly debilitating. However, current findings regarding the influence of age on symptoms and outcomes are mixed and may be attributed to the assessment methodologies for pain and mo...
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Hospital-associated disability (HAD), defined as a loss of activities of daily living (ADLs) occurring during hospitalization, is a common complication among older adults. Delirium is also a common complication during hospitalization and is associated with multiple long-term sequelae. We sought to determine the effect of delirium and known covariat...
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Background: While extensive research on the brain has failed to identify effective therapies, using probiotics to target the gut microbiome has shown therapeutic potential in Alzheimer's disease (AD). Genetically modified probiotics (GMP) are a promising strategy to deliver key therapeutic peptides with high efficacy and tissue specificity. Angiot...
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Introduction Neutrophil to Lymphocyte Ratio (NLR) combines a marker of inflammation and reduced cell turnover to reflect age related alterations in the immune system. Whether NLR can serve as a biomarker of frailty and predict survival among older adults with Multiple Myeloma (MM) is unknown. Materials and methods We used an electronic health reco...
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Purpose Fatigue is a component of frailty and may undermine functional well-being and independent living. The prevalence of fatigue and its impact on functional limitations among older adults with cancer remains understudied. Methods Using participants enrolled in the Cancer and Aging Resilience Evaluation (CARE), a prospective registry of patient...
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Introduction: Growing research suggests that aerobic high-intensity interval training (HIIT) improves cardiovascular function and physical performance compared with moderate intensity continuous training (MICT). However relatively few animal models of HIIT are available to inform about the benefits of this exercise—particularly among older animals....
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While neurodegenerative diseases can strike at any age, the majority of afflicted individuals are diagnosed at older ages. Due to the important impact of age in disease diagnosis, the field of neuroscience could greatly benefit from the many of the theories and ideas from the biology of aging – now commonly referred as geroscience. As discussed in...
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Neuroscience has a rich history of studies focusing on neurobiology of aging. However, much of the aging studies in neuroscience occur outside of the gerosciences. The goal of this primer is twofold: First, to briefly highlight some of the history of aging neurobiology, and second, to introduce to geroscientists the broad spectrum of methodological...
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The UAB Nathan Shock Center focuses on comparative energetics and aging. Energetics, as defined for this purpose, encompasses the causes, mechanisms, and consequences of the acquisition, storage, and use of metabolizable energy. Comparative energetics is the study of metabolic processes at multiple scales and across multiple species as it relates t...
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Background: Intestinal (i.e., "gut") permeability may be related to cardiovascular disease (CVD) risk, but biomarkers for gut permeability are limited and associations with CVD risk are unknown-particularly among older adults. Aims: This cross-sectional study aimed to determine if serum biomarkers related to gut permeability [intestinal fatty ac...
Article
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Aging is by far the most prominent risk factor for Alzheimer’s disease (AD), and both aging and AD are associated with apparent metabolic alterations. As developing effective therapeutic interventions to treat AD is clearly in urgent need, the impact of modulating whole-body and intracellular metabolism in preclinical models and in human patients,...
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Skeletal muscle is the most abundant tissue in healthy individuals and it has important roles in health beyond voluntary movement. The overall mass and energy requirements of skeletal muscle require it to be metabolically active and flexible to multiple energy substrates. The tissue has evolved to be largely load dependent and it readily adapts in...
Article
Chronic low back pain (cLBP) can interfere with daily activities and be a major contributor of worse long-term disability and overall well-being. It disproportionally impacts non-Hispanic Black (NHB) and people of lower socioeconomic status. Additionally, optimism is a trait that has been linked to reduced symptom severity, including pain and pain...
Article
Chronic low back pain (cLBP) prevalence increases with advancing age and is a leading contributor to mobility disability among older adults. Opioids are commonly prescribed treatments to reduce pain related symptoms. The rise in opioid use and misuse can enhance a variety of issues in the adult population; such as, lack of mobility and decrease in...
Article
Chronic low back pain (cLBP) is a leading cause of morbidity and health care utilization in the US. Ample evidence suggests sociodemographic variables (i.e., gender, age, income, and race) influence pain. However, a framework informing associations of multiple sociodemographic factors with provider and intervention utilization, specifically in cLBP...
Article
Full-text available
Increasing life expectancies are unfortunately accompanied by increased prevalence of Alzheimer's disease (AD). Regrettably, there are no current therapeutic options capable of preventing or treating AD. We review here data indicating that AD is accompanied by gut dysbiosis and impaired renin angiotensin system (RAS) function. Therefore, we propose...
Article
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Aging is associated with gut dysbiosis – a condition linked with altered central nervous system function (“gut-brain axis”). Age-related health benefits have been ascribed to the renin-angiotensin system, mediated partially via the angiotensin(1-7) axis. Research has shown exercise altering gut microbiota composition and function. This study explor...
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Declining health and cognition are hallmarks of advanced age that reduce both the quality and length of the lifespan. While caloric restriction has been highlighted as a strategy for increasing healthspan, time-restricted feeding and changes in dietary macronutrient composition may be more feasible alternatives with similar health outcomes. Further...
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Mitochondrial dysfunction and iron (Fe) dyshomeostasis are invoked among the mechanisms contributing to muscle aging, possibly via a detrimental mitochondrial-iron feed-forward loop. We quantified the labile Fe pool, Fe isotopes, and the expression of mitochondrial Fe handling proteins in muscle biopsies obtained from young and older adults. The ex...
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Disruption of the skeletal muscle circadian clock leads to a preferential shift towards lipid oxidation, while reducing carbohydrate oxidation. These effects are apparent at the whole-body level, including glucose intolerance, increased energy expenditure, and fasting hyperglycemia. We hypothesize that exercise counters these metabolic disturbances...
Article
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Purpose To evaluate the safety and feasibility of combining exercise (EX) and resveratrol to treat older adults with physical function limitations. Methods Three-arm, two-site pilot randomized, controlled trial (RCT) for community-dwelling adults (N = 60), 71.8 ± 6.3 years of age with functional limitations. Participants were randomized to receive...
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Exercise provides a robust physiological stimulus that evokes cross-talk among multiple tissues that when repeated regularly (i.e., training) improves physiological capacity, benefits numerous organ systems, and decreases the risk for premature mortality. However, a gap remains in identifying the detailed molecular signals induced by exercise that...
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To (1) investigate the efficacy of multiple doses of an orally delivered probiotic bacteria Lactobacillus paracasei (LP) modified to express angiotensin (1–7) (LP-A) in altering physiologic parameters relevant to the gut-brain axis in older rats and to (2) compare this strategy with subcutaneous delivery of synthetic Ang(1–7) peptide on circulating...
Article
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Cognitive frailty is a geriatric condition defined by the coexistence of cognitive impairment and physical frailty. This “composite” aging phenotype is associated with a higher risk of several adverse health-related outcomes, including dementia. In the last decade, cognitive frailty has gained increased attention from the scientific community that...
Article
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Aging is a multifactorial process characterized by progressive changes in gut physiology and the intestinal mucosal immune system. These changes, along with alterations in life style, diet, nutrition, inflammation and immune function alter both composition and stability of the gut microbiota. Given the impact of environmental influences on the gut...
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Despite its potential to improve metabolic health outcomes, longitudinal physical activity (PA) patterns and their association with cardiometabolic disease among people living with HIV (PLWH) have not been well characterized. We investigated this relationship among PLWH in the Centers for AIDS Research Network of Integrated Clinical Systems with at...
Article
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Prior evidence suggests that the choice of antihypertensive medication may influence functional status among older adults with hypertension, particularly in conjunction with exercise. In particular, angiotensin converting enzyme (ACE) inhibitors have shown potential to positively influence function. However, randomized, controlled trials are needed...
Article
Declining cognitive functions in older individuals have enormous emotional, clinical, and public health consequences. Thus, therapeutics for preserving function and keeping older adults living independently are imperative. Aging is associated dysbiosis, defined as a loss of number and diversity in gut microbiota, which has been linked with various...
Article
Full-text available
Declining cognitive functions in older individuals have enormous emotional, clinical and public health consequences. Thus therapeutics for preserving function and keeping older adults living independently are imperative. Aging is associated dysbiosis, defined as a loss of number and diversity in gut microbiota, which has been linked with various as...
Article
Full-text available
Hypertension has been linked with peripheral and central reductions in vascular density, and with devastating effects on brain function. However, the underlying mechanisms in the relationship between blood pressure and cognitive impairment have yet to be fully elucidated. Here, we review compelling evidence from two lines of inquiry: one that links...
Article
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Whether disruption of iron metabolism is implicated in human muscle aging is presently unclear. We explored the relationship among iron metabolism, muscle mitochondrial homeostasis, inflammation, and physical function in older adults and young controls. Eleven young and 23 older men and women were included. Older adults were classified into high–fu...
Article
Full-text available
Aging is associated with gut dysbiosis – a condition linked with altered central nervous system function (i.e the “gut-brain axis”). Age-related health benefits have been ascribed to the renin-angiotensin system (RAS), mediated partially via the angiotensin (1-7) or Ang(1-7) axis. This pre-clinical study explored dosing of a genetically modified pr...
Article
Full-text available
Intestinal (i.e. “gut”) permeability may be related to cardiovascular disease (CVD) risk, but biomarkers for gut permeability are limited and associations with CVD risk are unknown – particularly among older adults. This cross-sectional study aimed to determine if serum biomarkers related to gut permeability [intestinal fatty acid-binding protein (...
Article
Full-text available
The human intestinal tract (i.e., “gut”) is inhabited by over 100 trillion microorganisms; including over 1000 species of known bacteria. These organisms have co-evolved with humans over millennia to live together for mutual benefit. Though long overlooked in considerations of human health and disease treatment, gut microorganisms are highly involv...
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Objectives: Hospital-associated disability (HAD), defined as loss of independence in activities of daily living (ADL) following acute hospitalization, is observed among older adults. The study objective is to determine overall prevalence of HAD among older adults hospitalized in acute care, and to assess the impact of study initiation year in mode...
Article
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In recent years a number of beneficial health effects have been ascribed to the renin-angiotensin system (RAS) that extend beyond lowering blood pressure, primarily mediated via the angiotensin converting enzyme-2 (ACE2)/angiotensin (1-7) or Ang(1-7)/MAS receptor axis. Moreover, once thought as merely a systemic effector, RAS components exist withi...
Article
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Background: Physical exercise is associated with decreased cardiovascular disease (CVD) risk, but recent large-scale trials suggest that exercise alone is insufficient to reduce CVD events in high-risk older adults. Purpose: This pilot randomized clinical trial aimed to collect critical data on feasibility, safety, and protocol integrity necessa...
Poster
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Activity tracking positively influences daily step counts and systolic blood pressure in older adults with high risk of CVD
Article
Background Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) may protect against aging-related decline. This study directly compared ACEis and ARBs on associations with risk of mobility disability in older adults when combined with a physical activity intervention. Methods This was a secondary analysis of the...
Article
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Multisite pain, or pain that occurs simultaneously at >1 anatomical site, is more prevalent than single-site pain. While multisite pain affects over half of older adults, it remains an understudied pain entity that may have important functional implications in an aging population. Greater understanding of this complex pain entity from a biopsychoso...
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In a pilot randomized clinical trial, participants aged ≥60 years (n = 35) with physical limitations and symptomatic knee osteoarthritis (OA) were randomized to 12 weeks of lower-body low-load resistance training with blood-flow restriction (BFR) or moderate-intensity resistance training (MIRT) to evaluate changes in muscle strength, pain, and phys...
Article
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This pilot randomized controlled trial (RCT) was designed to provide the preliminary data necessary to conduct a full-scale trial to compare the efficacy of differing first-line antihypertensive medications in improving functional status in older adults, when combined with exercise. The primary objectives were to assess study feasibility, safety, a...
Preprint
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The gastrointestinal tract contains trillions of microbes (collectively known as the gut microbiota) that play essential roles in host physiology and health. Studies from our group and others have demonstrated that exercise independently alters the composition and functional capacity of the gut microbiota. Here, we review what is known about the gu...
Article
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Exercise is widely recognized as a critical component of a healthy lifestyle by multiple scientific and regulatory bodies. Yet only 35% of adults in the United States even report engaging in regular physical activity. In response to this challenge, the Exercise is Medicine (EIM) initiative encourages clinicians in all settings to regularly assess a...
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Background: We provide the first examination of mitochondrial DNA (mtDNA) variants and pulmonary function in older persons. Methods: Cross-sectional associations between mtDNA variants and pulmonary function were evaluated as a combined p-values meta-analysis, using data from two independent cohorts of older persons. The latter included white an...
Article
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Over the last few decades, considerable evidence shows that greater levels of aerobic exercise and cardiovascular fitness benefit cognitive performance. However, the degree to which free-living activity in community settings is related to cognitive performance remains unclear, particularly in older adults vulnerable to disability. Also, it is unkno...
Article
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Declines in walking speed are associated with a variety of poor health outcomes including disability, comorbidity, and mortality. While genetic factors are putative contributors to variability in walking, few genetic loci have been identified for this trait. We examined the role of mitochondrial genomic variation on walking speed by sequencing the...
Article
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Background Age‐related changes in blood pressure are associated with a variety of poor health outcomes. Genetic factors are proposed contributors to age‐related increases in blood pressure, but few genetic loci have been identified. We examined the role of mitochondrial genomic variation in blood pressure by sequencing the mitochondrial genome. Met...
Data
Appendix S1. Research investigators for the LIFE (Lifestyle Interventions and Independence for Elders) study. Table S1. Blood Pressure Characteristics of Study Cohorts
Article
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Background Cardiorespiratory fitness (CRF) is the only major risk factor that is not routinely assessed in the clinical setting, for preventive medicine. A valid and practical CRF test is needed for use in the clinics. The objective of this study is to demonstrate the validity of a 3-minute squat test to assess CRF in primary care. Methods A cross...
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Human circadian rhythmicity is driven by a circadian clock comprised of two distinct components: the central clock, located in the suprachiasmatic nucleus (SCN) within the hypothalamus, and the peripheral clocks, located in almost all tissues and organ systems in the body. Entrainment, or alignment, of circadian rhythmicity is dependent upon time o...
Article
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Advanced age has been associated with alterations to the microbiome within the intestinal tract as well as intestinal permeability (i.e., “leaky gut”). Prior studies suggest that intestinal permeability may contribute to increases in systemic inflammation—an aging hallmark—possibly via microorganisms entering the circulation. Yet, no studies exist...
Article
Full-text available
Background: Data are sparse regarding the value of physical activity (PA) surveillance among older adults-particularly among those with mobility limitations. The objective of this study was to examine longitudinal associations between objectively measured daily PA and the incidence of cardiovascular events among older adults in the LIFE (Lifestyle...