High consumption of carbohydrates is linked to metabolic syndrome, possibly via the endogenous formation of advanced glycated end-products. Many Dutch elementary school children have a carbohydrate intake of >130g/day, the estimated minimum requirement. In this observational study, 126 Dutch elementary school children (5-12y of age) from two schools differing in frequency of gym lessons (2 or 5 times a week) were included. In all participants, height, weight, waist circumference, autofluorescence of skin glycated end-products (AGE-score), sports activity and carbohydrate consumption were recorded once. Sports activities in leisure time differentiated participants in ‘sportsmen’ and ‘non-sportsmen’. Carbohydrate intake and AGE score were positively associated in non-sportsmen (p<0.003), but negatively in sportsmen (p<0.002). In sportsmen, but not in non-sportsmen (p>0.50), a positive association was found (p<0.002) between carbohydrate intake and subject age. The intake of total carbohydrate and carbohydrates from juices and soft drinks was lower (p<0.001) at the Wassenberg School relative to the Alexander School. Based on waist to height ratio, >95% of the children had normal fat mass. No correlations were found between waist to height ratio or BMI and carbohydrate intake. Waist to height ratio was positively associated with BMI (p<0.001)) and subject age (p<0.001). Of all principal parameters, AGE score is most affected by being sportsmen or not (p<0.001). This study indicates that an increased intake of carbohydrates can be counteracted by sufficient physical activity (>2.5 hours per week). This implies that skin autofluorescence is a fast and non-invasive method to screen children for life style.
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Aim: To investigate the effects of exercise on salivary concentrations of inflammatory markers by analyzing a panel of 25 inflammatory markers in subjects who had participated in bicycle ergometer tests varying in workload and hydration status. Methods: Fifteen healthy young men (20-35 years) had performed 4 different exercise protocols of 1 hour duration in a randomly assigned cross-over design, preceded by a rest protocol. Individual workloads depended on participant's pre-assessed individual maximum workload (Wmax): rest (protocol 1), 70% Wmax in hydrated (protocol 2) and dehydrated (protocol 3) state, 50% Wmax (protocol 4) and intermittent 85%/55% Wmax in 2 min blocks (protocol 5). Saliva samples were collected before (T0) and immediately after exercise (T1), and at several time points after exercise (2 hours (T3), 3 hours (T4), 6 hours (T5) and 24 hours (T6)). Secretory Leukocyte Protease Inhibitor (SLPI), Matrix Metallopeptidase-9 (MMP-9) and lactoferrin was analyzed using a commercial ELISA kit, a panel of 22 cytokines and chemokines were analyzed using a commercial multiplex immunoassay. Data was analyzed using a multilevel mixed linear model, with multiple test correction. Results: Among a panel of 25 inflammatory markers, SLPI concentrations were significantly elevated immediately after exercise in all protocols compared to rest and higher concentrations reflected the intensity of exercise and hydration status. MMP-9 showed a significant increase in the 70% Wmax dehydrated, 50% Wmax and intermittent protocols. Conclusions: Salivary concentrations of SLPI and MMP-9 seem associated with exercise intensity and hydration status and may offer non-invasive biomarkers to study (local) inflammatory responses to different exercise intensities in human studies. sa
Introduction Radical cystectomy (RC) is the standard treatment for patients with non-metastatic muscle-invasive bladder cancer, as well as for patients with therapy refractory high-risk non-muscle invasive bladder cancer. However, 50–65% of patients undergoing RC experience perioperative complications. The risk, severity and impact of these complications is associated with a patient’s preoperative cardiorespiratory fitness, nutritional and smoking status and presence of anxiety and depression. There is emerging evidence supporting multimodal prehabilitation as a strategy to reduce the risk of complications and improve functional recovery after major cancer surgery. However, for bladder cancer the evidence is still limited. The aim of this study is to investigate the superiority of a multimodal prehabilitation programme versus standard-of-care in terms of reducing perioperative complications in patients with bladder cancer undergoing RC.Methods and analysis This multicentre, open label, prospective, randomised controlled trial, will include 154 patients with bladder cancer undergoing RC. Patients are recruited from eight hospitals in The Netherlands and will be randomly (1:1) allocated to the intervention group receiving a structured multimodal prehabilitation programme of approximately 3–6 weeks, or to the control group receiving standard-of-care. The primary outcome is the proportion of patients who develop one or more grade ≥2 complications (according to the Clavien-Dindo classification) within 90 days of surgery. Secondary outcomes include cardiorespiratory fitness, length of hospital stay, health-related quality of life, tumour tissue biomarkers of hypoxia, immune cell infiltration and cost-effectiveness. Data collection will take place at baseline, before surgery and 4 and 12 weeks after surgery.Ethics and dissemination Ethical approval for this study was granted by the Medical Ethics Committee NedMec (Amsterdam, The Netherlands) under reference number 22–595/NL78792.031.22. Results of the study will be published in international peer-reviewed journals.Trial registration number NCT05480735.
