Oliver J. Wilson’s research while affiliated with Leeds Beckett University and other places

Background Acute sarcopenia is sarcopenia lasting less than 6 months, typically following acute illness or injury. It may impact patient recovery and quality of life, advancing to chronic sarcopenia. However, its development and assessment remain poorly understood, particularly during hospitalisation. This systematic review aimed to elucidate the incidence of acute sarcopenia and examine changes in muscle parameters during hospitalisation. Methods Eighty‐eight papers were included in the narrative synthesis; 33 provided data for meta‐analyses on the effects of hospitalisation on handgrip strength (HGS), rectus femoris cross‐sectional area (RFCSA) and various muscle function tests. Meta‐regressions were performed for length of hospital stay (LoS) and age for all meta‐analyses; sex was also considered for HGS. Results Acute sarcopenia development was assessed in four studies with a pooled incidence of 18% during hospitalisation. Incidence was highest among trauma patients in intensive care (59%), whereas it was lower among medical and surgical patients (15%–20%). Time of development ranged from 4 to 44 days. HGS remained stable during hospitalisation (SMD = 0.05, 95% CI = −0.18:0.28, p = 0.67) as did knee extensor strength. LoS affected HGS performance (θ = 0.04, 95% CI = 0.001:0.09, p = 0.045) but age (p = 0.903) and sex (p = 0.434) did not. RFCSA, reduced by 16.5% over 3–21 days (SMD = −0.67, 95% CI = −0.92:−0.43, p < 0.001); LoS or time between scans did significantly predict the reduction (θ = −0.04, 95% CI = −0.077:−0.011, p = 0.012). Indices of muscle quality also reduced. Muscle function improved when assessed by the short physical performance battery (SMD = 0.86, 95% CI = 0.03:1.69, p = 0.046); there was no change in 6‐min walk (p = 0.22), timed up‐and‐go (p = 0.46) or gait speed tests (p = 0.98). The only significant predictor of timed up‐and‐go performance was age (θ = −0.11, 95% CI = −0.018:−0.005, p = 0.009). Conclusions Assessment and understanding of acute sarcopenia in clinical settings are limited. Incidence varies between clinical conditions, and muscle parameters are affected differently. HGS and muscle function tests may not be sensitive enough to identify acute changes during hospitalisation. Currently, muscle health deterioration may be underdiagnosed impacting recovery, quality of life and overall health following hospitalisation. Further evaluation is necessary to determine the suitability of existing diagnostic criteria of acute sarcopenia. Muscle mass and quality indices might need to become the primary determinants for muscle health assessment in hospitalised populations.

To establish the criterion‐assessed energy and fluid requirements of female netball players, 13 adult players from a senior Netball Super League squad were assessed over 14 days in a cross‐sectional design, representing a two‐ and one‐match microcycle, respectively. Total energy expenditure (TEE) and water turnover (WT) were measured by doubly labeled water. Resting and activity energy expenditure were measured by indirect calorimetry and Actiheart, respectively. Mean 14‐day TEE was 13.46 ± 1.20 MJ day⁻¹ (95% CI, 12.63–14.39 MJ day⁻¹). Resting energy expenditure was 6.53 ± 0.60 MJ day⁻¹ (95% CI, 6.17–6.89 MJ day⁻¹). Physical activity level was 2.07 ± 0.19 arbitrary units (AU) (95% CI, 1.95–2.18 AU). Mean WT was 4.1 ± 0.9 L day⁻¹ (95% CI, 3.6–4.7 L day⁻¹). Match days led to significantly greater TEE than training (+2.85 ± 0.70 MJ day⁻¹; 95% CI, +1.00– +4.70 MJ day⁻¹; p = 0.002) and rest (+4.85 ± 0.70 MJ day⁻¹; 95% CI, +3.13–+6.56 MJ day⁻¹; p < 0.001) days. Matches led to significantly greater energy expenditure (+1.85 ± 1.27 MJ; 95% CI, +0.95–+2.76 MJ day⁻¹; p = 0.001) than court‐based training sessions. There was no significant difference in TEE (+0.03 ± 0.35 MJ day⁻¹; 95% CI, −0.74–+0.80 MJ day⁻¹; p = 0.936) across weeks. Calibrated Actiheart 5 monitors underestimated TEE (−1.92 ± 1.21 MJ day⁻¹). Energy and fluid turnover were greatest on match days, followed by training and rest days, with no difference across weeks. This study provides criterion‐assessed energy and fluid requirements to inform dietary guidance for female netball players.

Fatty acids are stored within the muscle as intramyocellular lipids (IMCL). Some, but not all, studies indicate that following a high-fat diet (HFD), IMCL may accumulate and affect insulin sensitivity. This systematic review and meta-analysis aimed to quantify the effects of an HFD on IMCL. It also explored the potential modifying effects of HFD fat content and duration, IMCL measurement technique, physical activity status, and the associations of IMCL with insulin sensitivity. Five databases were systematically searched for studies that examined the effect of ≥3 d of HFD (>35% daily energy intake from fat) on IMCL content in healthy individuals. Meta-regressions were used to investigate associations of the HFD total fat content, duration, physical activity status, IMCL measurement technique, and insulin sensitivity with IMCL responses. Changes in IMCL content and insulin sensitivity (assessed by hyperinsulinemic-euglycemic clamp) are presented as standardized mean difference (SMD) using a random effects model with 95% confidence intervals (95% CIs). Nineteen studies were included in the systematic review and 16 in the meta-analysis. IMCL content increased following HFD (SMD = 0.63; 95% CI: 0.31, 0.94, P = 0.001). IMCL accumulation was not influenced by total fat content (P = 0.832) or duration (P = 0.844) of HFD, physical activity status (P = 0.192), or by the IMCL measurement technique (P > 0.05). Insulin sensitivity decreased following HFD (SMD = –0.34; 95% CI: –0.52, –0.16; P = 0.003), but this was not related to the increase in IMCL content following HFD (P = 0.233). Consumption of an HFD (>35% daily energy intake from fat) for ≥3 d significantly increases IMCL content in healthy individuals regardless of HFD total fat content and duration of physical activity status. All IMCL measurement techniques detected the increased IMCL content following HFD. The dissociation between changes in IMCL and insulin sensitivity suggests that other factors may drive HFD-induced impairments in insulin sensitivity in healthy individuals. This trial was registered at PROSPERO as CRD42021257984.

Simple Summary This article explores the relationship between sarcopenia, cardiovascular disease and metabolic diseases. The authors suggest non-drug treatments such as exercise, dietary modifications and behavioural interventions as potential strategies to help older adults manage these conditions. This review highlights the importance of combining strength and aerobic training and adopting comprehensive nutritional strategies. Additionally, the authors propose integrating behavioural science to help people adopt these lifestyle changes. Further research is needed to determine the most effective treatments and ways to make these changes easier for people to adopt. Overall, a comprehensive approach is required to address sarcopenia in older adults with cardiovascular and metabolic diseases. Abstract This narrative review examines the mechanisms underlying the development of cardiovascular disease (CVD) and metabolic diseases (MDs), along with their association with sarcopenia. Furthermore, non-pharmacological interventions to address sarcopenia in patients with these conditions are suggested. The significance of combined training in managing metabolic disease and secondary sarcopenia in type II diabetes mellitus is emphasized. Additionally, the potential benefits of resistance and aerobic training are explored. This review emphasises the role of nutrition in addressing sarcopenia in patients with CVD or MDs, focusing on strategies such as optimising protein intake, promoting plant-based protein sources, incorporating antioxidant-rich foods and omega-3 fatty acids and ensuring sufficient vitamin D levels. Moreover, the potential benefits of targeting gut microbiota through probiotics and prebiotic fibres in sarcopenic individuals are considered. Multidisciplinary approaches that integrate behavioural science are explored to enhance the uptake and sustainability of behaviour-based sarcopenia interventions. Future research should prioritise high-quality randomized controlled trials to refine exercise and nutritional interventions and investigate the incorporation of behavioural science into routine practices. Ultimately, a comprehensive and multifaceted approach is essential to improve health outcomes, well-being and quality of life in older adults with sarcopenia and coexisting cardiovascular and metabolic diseases.

MicroRNAs (miRNAs) are endogenously generated single-stranded RNAs that play crucial roles in numerous biological processes, such as cell development, proliferation, differentiation, metabolism and apoptosis. They negatively regulate target gene expression by repressing translation of messenger RNA into a functional protein. Several miRNAs have been implicated in the development and progression of RA. They are involved in inflammatory and immune processes and are associated with susceptibility to RA and disease activity. They are also considered to be potential markers of disease activity or even therapeutic targets. Likewise, several miRNAs are affected acutely by exercise and regulate exercise-related adaptations in the skeletal muscle and cardiovascular system and aerobic fitness. Interestingly, some miRNAs affected by exercise are also important in the context of RA. Investigating these might increase our understanding of the effects of exercise in RA and improve exercise prescription and, potentially, disease management. In this review, we focus on the miRNAs that are associated with both RA and exercise and discuss their roles in (and potential interactions between) RA and exercise-induced adaptations.

Background Exercise is advocated in the treatment of rheumatoid arthritis (RA). However, uncertainty around the acute effects of exercise on pain and inflammation may be stopping people with RA from exercising more regularly. Objectives To determine the acute effects of exercise on pain symptoms, clinical inflammatory markers, and inflammatory cytokines in RA. Design A systematic review of the literature. Data sources and methods Five databases were searched (PubMed, Cochrane Library, CINAHL, Scopus and SPORTDiscus); inclusion criteria were studies with acute exercise, a definite diagnosis of RA and disease characteristics assessed by clinical function (i.e., disease activity score, health assessment questionnaire and self-reported pain), clinical markers associated with inflammation (i.e., c-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)), and inflammatory cytokines (i.e., interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-α)). Results From a total of 1544 articles, initial screening and full text assessment left 11 studies meeting the inclusion criteria. A total of 274 people were included in the studies (RA = 186; control = 88). Acute bouts of aerobic, resistance, and combined aerobic and resistance exercise did not appear to exacerbate pain symptoms in people with RA. Conclusion Post-exercise responses for pain, clinical inflammatory markers and inflammatory cytokines were not different between people with or without RA. Exercise prescription was variable between studies, which limited between-study comparisons. Therefore, future investigations in people with RA are warranted, which combine different exercise modes and intensities to examine acute effects on pain symptoms and inflammatory markers. Registration The PROSPERO international prospective register of systematic reviews – CRD42018091155.

The COVID-19 pandemic and social distancing restrictions have significantly reduced population-wide physical activity (PA) levels. However, the impact of the pandemic and relevant restrictions on PA participation, and any potential barriers to it, in people with rheumatoid arthritis (RA) are not clear. Furthermore, we are unsure if any such PA changes have affected their body weight, mental wellbeing, and/or quality of life (QoL). Thus, the aim of this study was to examine the impact of the lockdown on PA participation in people with RA, versus people without RA. Participants ( n = 128; RA = 27, non-RA = 101) completed a self-administered online survey, which included questions on PA, body weight, mental wellbeing and QoL. PA participation during lockdown was significantly lower among RA versus non-RA participants ( p < 0.001). Additionally, a similar profile of results was found where more RA participants vs non-RA participants reported reduced habitual PA (59% vs 33%) and increased body weight (59% vs 35%). Mental wellbeing scores were similarly low in both groups during lockdown (RA: 20.8 ± 4.2; non-RA: 22.2 ± 3.4, p = 0.080). Matched group comparisons identified similar trends to full sample analyses. In the first months of the lockdown, more people with RA reported decreased PA participation and increased body weight than their non-RA counterparts. Access to exercise equipment and facilities appears to be the main cause for these results. Looking beyond COVID-19, specific PA promotion for people with RA will be required to prevent a pandemic of inactivity.

Purpose: Beneficial effects of carbohydrate (CHO) ingestion on exogenous CHO oxidation and endurance performance require a well-functioning gastrointestinal (GI) tract. However, GI complaints are common during endurance running. This study investigated the effect of a CHO solution-containing sodium alginate and pectin (hydrogel) on endurance running performance, exogenous and endogenous CHO oxidation and GI symptoms. Methods: Eleven trained male runners, using a randomised, double-blind design, completed three 120-minute steady state runs at 68% V[Combining Dot Above]O2max, followed by a 5-km time-trial. Participants ingested 90 g·h-1 of 2:1 glucose:fructose (13C enriched) either as a CHO hydrogel, a standard CHO solution (non-hydrogel), or a CHO-free placebo during the 120 minutes. Fat oxidation, total and exogenous CHO oxidation, plasma glucose oxidation and endogenous glucose oxidation from liver and muscle glycogen were calculated using indirect calorimetry and isotope ratio mass spectrometry. GI symptoms were recorded throughout the trial.RESULTS: Time-trial performance was 7.6% and 5.6% faster after hydrogel ([minutes:seconds]19:29 ± 2:24; p < 0.001) and non-hydrogel (19:54 ± 2:23, p = 0.002), respectively, versus placebo (21:05 ± 2:34). Time-trial performance after hydrogel was 2.1% faster (p = 0.033) than non-hydrogel. Absolute and relative exogenous CHO oxidation was greater with hydrogel (68.6 ± 10.8 g, 31.9 ± 2.7%; p = 0.01) versus non-hydrogel (63.4 ± 8.1 g, 29.3 ± 2.0%; p = 0.003). Absolute and relative endogenous CHO oxidation were lower in both CHO conditions compared with placebo (p < 0.001), with no difference between CHO conditions. Absolute and relative liver glucose and muscle glycogen oxidation were not different between CHO conditions. Total GI symptoms were not different between hydrogel and placebo, but GI symptoms was higher in non-hydrogel compared with placebo and hydrogel (p < 0.001). Conclusion: Ingestion of glucose and fructose in hydrogel form during running benefited endurance performance, exogenous CHO oxidation and GI symptoms, compared with a standard CHO solution.

Purpose This study examined the influence of dynamic apnoea training on splenic volume and haematological responses in non-breath-hold divers (BHD). Methods Eight non-BHD performed ten maximal dynamic apnoeas, four times a week for six weeks. Splenic volumes were assessed ultrasonically, and blood samples were drawn for full blood count analysis, erythropoietin, iron, ferritin, albumin, protein and osmolality at baseline, 24 h post the completion of each week’s training sessions and seven days post the completion of the training programme. Additionally, blood samples were drawn for haematology at 30, 90, and 180 min post session one, twelve and twenty-four. Results Erythropoietin was only higher than baseline (6.62 ± 3.03 mlU/mL) post session one, at 90 (9.20 ± 1.88 mlU/mL, p = 0.048) and 180 min (9.04 ± 2.35 mlU/mL, p = 0.046). Iron increased from baseline (18 ± 3 µmol/L) post week five (23 ± 2 µmol/L, p = 0.033) and six (21 ± 6 µmol/L; p = 0.041), whereas ferritin was observed to be lower than baseline (111 ± 82 µg/L) post week five (95 ± 75 µg/L; p = 0.016), six (84 ± 74 µg/L; p = 0.012) and one week post-training (81 ± 63 µg/L; p = 0.008). Reticulocytes increased from baseline (57 ± 12 × 10⁹/L) post week one (72 ± 17 × 10⁹/L, p = 0.037) and six (71 ± 17 × 10⁹/L, p = 0.021) while no changes were recorded in erythrocytes (p = 0.336), haemoglobin (p = 0.124) and splenic volumes (p = 0.357). Conclusions Six weeks of dynamic apnoeic training increase reticulocytes without altering mature erythrocyte concentration and splenic volume.

Abstract: Splenic contractions occur in response to apnoea-induced hypoxia with and without facial water immersion. However, the splenic responses to a series of static or dynamic apnoeas with whole body water immersion in non-divers (ND) and elite breath-hold divers (EBHD) are unknown. Methods EBHD (n = 8), ND (n = 10) and control (n = 8) participants were recruited. EBHD and ND performed a series of five maximal DYN or STA apnoeas on separate occasions. Control performed a static eupnoeic (STE) protocol to control against any effects of water immersion and diurnal variation on splenic volume and haematology. Heart rate (HR) and peripheral oxygen saturation (SpO2 ) were monitored within 30s after each apnoea. Pre and post-apnoeic splenic volumes were quantified ultrasonically, and blood samples were drawn for haematology. Results EBHD and ND end-apnoeic HR was higher (p < 0.001) and SpO2 was lower in DYN (p = 0.024) versus STA. EBHD attained lower end-apnoeic SpO2 during DYN and STA than ND (p < 0.001). Splenic contractions occurred following DYN (EBHD,-47 ± 6%;ND,-37 ± 4%,p < 0.001) and STA (EBHD,-26 ± 4%;ND,-26 ± 8%,p < 0.01). DYN-associated splenic contractions were greater than STA in EBHD only (p = 0.042). Haemoglobin was greater following DYN only (EBHD,+5 ± 8 g/L,+4 ± 2%;ND,+8 ± 3 g/L,+4.9 ± 3%,p = 0.019). Haematocrit remained unchanged after each protocol. There were no between group differences in post-apnoeic splenic volume or haematology. Conclusions In both groups, splenic contractions occurred in response to STA and DYN when combined with whole body immersion. DYN apnoeas were effective at increasing haemoglobin concentration but not STA apnoeas. Thus, the magnitude of the splenic response relates to the hypoxemic stress encountered during apnoeic epochs. This article is protected by copyright. All rights reserved.