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Exercise, aging and disease Flashcards

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1
Q

What can obesity lead to?

A

Chronic diseases

  • Diabetes type II
  • CVD
  • Cancer

Obesity is increasing in the last 40 years

Can also induce Osteoarthritis and Osteoporosis

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2
Q

What year will British people be the fattest in Europe?

A

2025

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3
Q

What number is physical inactivity to death worldwide?

A

Physical inactivity is the 4th major contributor to death worldwide

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4
Q

What are the figures for deaths from non-communicable diseases attributed to physical inactivity?

A
  • 6-10% for all causes

- 30% for ischaemic heart disease (coronary artery atherosclerosis)

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5
Q

What is SeDS?

A

Sedentary death syndrome

Death due to lack of regular physical activity

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6
Q

How does the body maintain constant weight?

A

The body has an homoeostatic mechanism

An increase of food intake = increase of energy expenditure

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7
Q

What is adaptive thermogenesis?

A

Signals from blood nutrients and leptin from adipocytes controlled by hypothalamus

Activates the sympathetic NS and Brown adipose tissue (rodents/infants)

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8
Q

What is leptin?

A

Leptinis one of the hormones directly connected to body fat and obesity.

Leptin, a hormone released from the fat cells located in adipose tissues, sends signals to the hypothalamus in the brain

Produced by white adipose tissue

Activates the sympathetic nervous system

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9
Q

How is energy utilised in the body?

A

Obligatory energy expenditure (required for cellular and organ function) - 50%

Physical activity (variable) - 30%

Adaptive thermogenesis (variable, regulated by hypothalamus and responds to diet and temperature) - 20%

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10
Q

Where does leptin act upon in the hypothalamus?

A

Acts on Ob-Rb receptors

Hypothalamus will encourage the endocrine system

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11
Q

What occurs if there is a mutation in the gene encoding leptin (ob/ob mouse)?

A

Type 2 diabetes develops

Extremely obese (results in overeating) hyperphagia + decrease in energy expenditure

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12
Q

What is leptin resistance in obesity?

A

As people gain weight, they develop leptin resistance

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13
Q

How are carbohydrates, lipids and protein ABSORBED as?

A

Carbohydrate - Mainly glucose

Lipids - Mainly fatty acids + Cholesterol + Phospholipids

Protein - Amino acids

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14
Q

How are carbohydrates, lipids and protein STORED as?

A

Carbohydrates - Glycogen

Lipids - Mainly triglyercides

Protein - Protein

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15
Q

What are carbohydrates, lipids and protein STORAGE SITES?

A

Carbohydrates - Liver (100g), Muscle (400g)

Lipids - Liver (limited), Adipose tissue (large quantities), Other cells (limited)

Protein - Very limited in all cells

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16
Q

What is the FATE OF EXCESS of carbohydrates, lipids and protein?

A

Carbohydrates - Converted to lipid

Lipids - Stored in unlimited quantities as triglyceride

Proteins - Deaminated then converted to CHO (& fat)

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17
Q

What is the normal blood glucose before a meal?

A

4.0 - 5.9 mM

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18
Q

What is the blood glucose after a meal?

A

7.8 mM 90+ after a meal

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19
Q

What happens to the brain if glucose levels dip below normal levels?

A

It leads to a hypoglycemic condition and coma

Type 1 diabetics are at risk of this due to loss of main hormone that controls regulation of diabetes

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20
Q

Where does the body detect glucose?

A

In the pancreas

B-cells of islets of Langerhans

Glucose is taken up through these cells and promotes the generation of ATP

More glucose = More ATP, inhibits the potassium channel, depolarises the cell and depolaristion of the cell activates the voltage dependent calcium channel resulting in calcium influx and release of insulin

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21
Q

What is insulin?

A

It promotes glucose uptake

It does this by promoting the muscle to take up glucose

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22
Q

What is the % of glucose load stored after a meal?

A

70% of glucose load is stored in muscle

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23
Q

What does the liver do?

A

It converts glucose to glycogen

Inhibits gluconeogenesis

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24
Q

What does adipose tissue do to insulin?

A

Converts to triglyceride

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25
What does the insulin receptor do?
- Particularly abundant in muscle and adipocytes - Low insulin: most GLUT4 in vesicles - Insulin binding causes rapid insertion of GLUT4 into surface membrane
26
What pathway leads to the insertion of GLUT4 into the Glucose plasma membrane?
PI-3K signalling pathway Happens quickly
27
What does the increase of triglyceride storage do in insulin receptors?
It increases the circulating fatty acids (Non-esterified-fatty acids or free-fatty acids) Reduces insulin sensitivity There are several proposed targets: - Glucose transporter - Early signalling events - Transfer of GLUT4 transporters from vesicles into the membrane
28
Is insulin resistance reversible?
Yes, for patients that are becoming insulin resistant, controlling their diet and doing exercise is an important intervention that can reverse pre-diabetic situation to full diabetes
29
What are the reasons for variations in physical activity?
Reasons for differences in sedimentary behaviour between individuals (same sex twin studies): - 69% due to environmental factors - 31% have genetic basis (polygenic basis/multiple genes)
30
What is pre-diabetes (impaired glucose tolerance)?
Elevated blood glucose but not as high as in Type 2 diabetes (eg before a meal of 5.6 to 7.0 mmol/L)
31
How much 150 minutes of exercise/week lowers risk?
- Coronary heart disease = 40% - High blood pressure = 50% - Stroke = 27% - Type 2 diabetes = 50% - Colon cancer = 60% - Breast cancer = 20% - 50% - Alzheimer's disease = 33% (Daniel Lieberman 2011)
32
What is the outcome of the reduced level of obesity?
Reduced obesity --> Reduced NEFA --> Reduced insulin resistance --> Improved glucose control --> Reduced stress of pancreatic beta cells and less chance of progressing to insulin dependent diabetes
33
How much energy is in the food we eat?
53 g mars bar for 70KG person - 40 min jogging - 50 min leisurely cycling - 100 min leisurely walking - 3 hours typing Takes a long time to burn off the calories
34
What is the mechanism of the ability of regular exercise to reduce chronic disease?
1. Trained muscle INCREASED muscle mass, insulin sensitivity and ability to use lipid as energy source will lead to DECREASED conversion glucose to fat, circulating fats and storage of fat. 2. INCREASED physical fitness and brain health can lead to resisting effects of pathogens/disease/stress 3. DECREASE of inflammation (anti-inflammatory cytokines released from muscle = myokines) as many chronic diseases have an inflammatory basis 4. Specific anti-disease reduction by myokines 5. Acute activation of body stress responses
35
How does atherosclerosis develop?
- Underlying cause of the majority of CVD - A chronic inflammatory disease of medium-large arteries - Deposition of lipids in blood vessel wall and will result in endothelial activation. As a result immune cell (lymphocutes, monocytes, macrocytes) will be recruited underneath the endothelium. The cells will activated themselves and they will generate pro-inflammatory cytokines. Foam cells form and will acquire lipid into the cytoplasm END PRODUCT = IT WILL RUPTURE
36
What is important for the progression of atherosclerosis?
The balance between pro-inflammatory and anti-inflammatory cytokines
37
What are 2 anti-inflammatory cytokines?
- TGF-B | - Interleukin-5,10
38
What are 3 proinflamminatroy cytokines?
- Tumour necrosis factor-a - Interferon-Y - Interleukin-9
39
What do muscles secrete?
Myokines that include anti-inflammatory cytokines
40
What is epidural anaesthesia?
Blocks the nerves going down the spine making the legs useless
41
What does contracting skeletal muscle do?
It will release humoral factors known as myokines and it is now known to interact with various organs - adipose tissue - liver - brain - cardiovascular system
42
What are myokines?
- Cytokines or other peptides released from contracting skeletal muscle - endocrine, paracrine and autocrine functions - Many are produced upon contraction; thus can mediate effects of physical activity - A key interaction is by the myokines going to adipose tissue limiting and releasing adipokines - Has a general effect of reducing diabetes type 2, atherosclerosis, cancer etc.
43
Name 5 myokines?
Myostatin - Regulates skeletal muscle hypertrophy Brain-derived neutrophic factor (BDNF) - Neural growth and activity IL-6: (100 fold in circulation) - cross-talk with adipose tissue; releases cortisol from adrenal cortex and increases sensitivity IGF-1 and FGF-2: osteogeneisis; muscle nerve innervation remodelling Unidentified - anti-tumour, altered pancreatic function
44
WHat does BDNF do?
More exercise = More BDNF released Through higher amounts of BDNF, we get; - Increased serotonin - Increased dopamine BDNF increases brain plasticity (new connections between cells in a wide array of important cortical areas of the brain) Suggested to be better than anti-depressants for overcoming mild-moderate depression Proven therapy for neurodegenerative diseases
45
How do we improve multiple cognitive tasks?
By doing submaximal aerobic exercise performed of periods around 60 mins
46
What are the roles of the body's physiological stress response systems?
- Stress responses (flight or fight) - Co-ordination of cardiovascular, muscloskeletal and nervous systems - To be able to meet the demands and restore body homoeostatis and restore the status quo - Chronic activation (always on) which gives dysregulation of multiple body systems, weakened stress responses and immune suppression - Autonomic nervous system + hypothalmus:pituary:adrenal axis + immune system
47
What is stress reduced activation of the sympathetic nervous system?
Stress gets picked up by the amygdala influenced the hypothalamus The hypothalmus activates the sympathetic nerve output of the nervous system This generates sympathetic nerves that go to the organs (heart) Nervous output is supplemented by adrenaline by adrenal medulla and adds to direct nervous output
48
What happens when the sympathetic nervous system releases sympathetic nerve outputs to various organs?
- Increases heart rate - Increases mobilise energy stores - Increases breathing rate - Increase the amount of blood available - Sympathetic innovation to smooth muscle to divert blood from gut to skeletal muscle to brain to be more alert in fight or flight response
49
What is the hypothalamic:pituitary:adrenal axis?
Longer term than the sympathetic output Slower than sympathetic output to various organs Hypothalamus becomes alert to stress and releases corticotrophin (CRH) via hypophyseal stalk portal blood system Anterior releases andrenocorticotrohic hormone (ACTH) via the blood Adrenal cortex releases cortisol
50
What does the adrenal cortex do?
It mobilises energy stores and immune cells to fight infection
51
What are the consequences of chronic activation of the physiological stress response?
Long term stress
52
What are the problems with long term stress?
Constant cortisol will: - increase appetite and that will increase fat storage - Cortisol resistance - Weakened immune system Repeated adrenaline surges will: - increase blood pressure which can lead to endothelial injury which can risk of development of atherosclerosis
53
What does the brain release as a "pleasure reward"?
- Endocannabinoids - Endorphins - Dopamine (INCREASED) - Serotonin (INCREASED)
54
What is responsible for a runners high?
Endorphins They are not very permeable across the blood brain barrier
55
In the brain, what does BDNF cause an increase in after exercise?
- Dopamine | - Serotonin
56
What can inhibit long term stress?
Relaxation that comes from the 4 pleasure reward systems - Endocannabinoids - Endorphins - Dopamine (INCREASED by BDNF) - Serotonin (INCREASED by BDNF)
57
When does loss of functional capacity occur?
After the age of 30
58
Where does loss of functional capacity normally occur?
Mostly in skeletal muscle mass
59
What is sarcopenia?
Age-associated loss of muscle mass
60
What happens in sarcopenia?
- Number of muscle fibres decrease (hypoplasia) | - Decrease in the area of each muscle fibre (atrophy)
61
What is accompanied by sarcopenia?
- Increase of fat and connective tissue infiltrating in the muscle - Fat deposition is called Myosteatosis
62
How is sarcopenia and myosteatosis accelerated?
By doing too little exercise and allowing fat to increase
63
What is the mechanism responsible for sarcopenia?
1. Neuropathic processes 2. Axonal sprouting from remaining motorneurones 3. Decrease in growth factors with age 4. Nutritional changes 5. Increase of infiltration myosteatosis and connective tissue with age
64
What are neuropathic processes?
a) loss of a-motorneuones which leads to muscle denervation and loss of motor May result inability of nerves to recover from oxidative stress Changes in mitochondrial capacity with age b) loss of nerve innervation leads to denervation muscle atrophy: irreversible reduction in number of muscle fibres
65
What is axonal sprouting from remaining motorneuones?
Reinneravtion of some denervated muscles --> giant motor units Leads to decrease of fine control of motor unit recruitment when regulating force
66
What are the principles of loss of growth factors with age?
- Insulin like growth factor decreases - Decrease in pituitary function - Shift from lowering anabolic to increasing catabolic influence
67
What are the nutritional changes as a result of sarcopenia?
- Loss of apetite as food intake goes down
68
What happens during the infiltration of fat and connective tissue?
- Fat cells and fat droplets will enter the cytoplasm | - Myosteatosis will increase a load on specific muscle
69
What does the introduction of myosteasosis do on the load of the specific muscle?
It increases the insert load which increases pro-inflammatory adipokines which promotes sarcopenia Increases inflammation which increases insulin resistance
70
How do we limit sarcopenia?
- Exercise is the only known treatment for sarcopenia and myosteatosis Primary treatment is resistance training using weights or resistance bands Fast twitch type II fibres tend to atrophy more than type I with age
71
What can endurance training do?
Can limit normal loss of aerobic power & VO2 max

Exercise Phys (4 decks)

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