Background/Objectives: Approximately 53.4 million U.S. adults aged 50 or older have low bone mass, yet male bone health remains under-researched. This study evaluated the effects of one year of prune supplementation on bone health in older men susceptible to, or with, osteopenia. Methods: A total of 59 men (aged 55-80 years) were randomly assigned to one of three groups: 100 g prunes, 50 g prunes, or 0 g prunes (control; multivitamin only) daily, with each group also receiving 450 mg elemental calcium and 800 IU vitamin D3 via a multivitamin. Dual-energy X-ray absorptiometry (Lunar model DXA; GE Healthcare, CA, USA) scans and blood samples were collected at baseline, 3 months, 6 months, and 12 months. Results: No significant changes were observed in total bone mineral density (BMD) or lumbar spine BMD over one year. There were no significant changes in C-reactive protein (CRP). Osteoprotegerin (OPG) decreased significantly in all groups; however, the decrease was significantly greater in the control group compared to the levels in both prune groups. Sclerostin (SOST) significantly increased over time within all groups. Tartrate-resistant acid phosphatase-5b (TRAP5b) increased in all groups, albeit in the control group, it increased significantly more over time compared to the increase in the 100 g group. Conclusions: Overall, prune supplementation, regardless of dosing, did not increase total or lumbar BMD or aid in maintaining bone density beyond the levels achieved by Ca++ and vitamin D3 supplementation in older men susceptible to, or with, osteopenia (with a negative T-score down to -2.5 standard deviations (SD) below the mean). Although between-group differences were observed in select secondary biomarkers (OPG, TRAP5b), these did not correspond to detectable changes in BMD and should therefore be considered exploratory rather than directly indicative of clinical bone benefit. Additional research is needed to fully understand the effects of prunes on bone metabolism in men.

Background/Objectives: Approximately 53.4 million U.S. adults aged 50 or older have low bone mass, yet male bone loss remains under-researched. This study evaluated the effects of one year of prune supplementation on bone health in osteopenic men. Methods: Fifty-nine men (55–80 years) were randomly assigned to one of three groups: 0 g prune (control), 50 g prune, or 100 g prune daily, along with 450 mg elemental calcium and 800 IU vitamin D₃. Dual-energy X-ray absorptiometry (DXA) scans and blood samples were collected at baseline, 3, 6, and 12 months. Results: No significant changes were observed in total bone mineral density (BMD) over one year. C-reactive protein (CRP) was significantly higher in the control group compared to the 50 g group at all time points. Osteo-protegerin (OPG) decreased significantly in all groups, however, the decrease was significantly greater in the control compared to both prune groups. Sclerostin (SOST) significantly increased over time in all groups, albeit to a greater degree in the control group. Tartrate-resistant acid phosphatase-5b (TRAP5b) increased in the 50 g and control group but remained stable in the 100 g group. Conclusions: Overall, prune supplementation did not improve BMD beyond that of the calcium and vitamin D₃ supplementation however, there was a modest effect on biomarkers of inflammation and bone metabolism.

BACKGROUND:Diet and exercise are the cornerstone of obesity prevention and treatment. However, a substantial number of individuals are non-responsive to existing weight-loss interventions and obesity rates continue to rise. Daily exposure to low-oxygen conditions may aid in current weight-loss strategies by increasing resting metabolic rate and decreasing appetite. Whether in-home, overnight, normobaric hypoxic exposure promotes body weight loss in adults with obesity remains unknown. METHODS:Fifty adults with obesity (BMI: 30-39.9 kg/m2) will complete this double-blind, parallel-arm, randomized, controlled-feeding clinical trial. Participants will be provided with a weight maintenance diet for 2 weeks while undergoing baseline measurements. Following the weight maintenance phase, an energy restricted diet (500 kcal/day below weight maintenance needs) will be provided in combination with either overnight exposure to normobaric hypoxia (8 h/night, 15% oxygen, elevation ∼2,640 m) or normoxia (8 h/night, 21% oxygen, elevation ∼60 m), using a commercially available, in-home tent system, for 8 weeks. The primary outcome is the difference in body weight change between interventions. Secondary outcomes include measures of body composition, total and resting energy expenditure, energy intake from an ad libitum meal, insulin sensitivity and glycemic control, sympathetic tone, iron absorption and indicators of iron status, stool microbial diversity and composition, appetite, psychosocial factors, and sleep quantity and quality. DISCUSSION:Chronic, overnight, low oxygen exposure may provide a novel intervention to supplement current weight-loss strategies, inform new strategies to accelerate weight loss, and aid long-term weight management efforts in adults with obesity. CLINICAL TRIAL REGISTRATION:Clinicaltrials.govNCT05289310.

White potatoes are a major contributor to energy and nutrient intake in the USA, which supports investigating their relationship with cardiometabolic health. This cross-sectional analysis assessed relationships of total white potato intake and dietary patterns containing white potatoes prepared by various methods with markers of cardiometabolic health in adults categorised by diabetes status. The dietary intake assessment component of the National Health and Nutrition Examination Survey (2001-2018), What We Eat in America (WWEIA), was linked with the Food and Nutrient Database for Dietary Studies and Food Patterns Equivalents Database to rank the consumption of white potato-containing foods. Dietary patterns were determined by percent calories from white potatoes and main food groups in WWEIA using cluster analysis. Regression analysis assessed trends in individuals with (n 5467) and without (n 38 159) diagnosed diabetes. P < 0·01 was significant. The most consumed white potato-containing foods were French fries, potato chips and home fries. In adults without diagnosed diabetes, total white potato intake was positively associated with glucose, insulin, Homeostatic Model Assessment for Insulin Resistance and waist circumference. Glycated Hb was lower in those who primarily consumed dietary patterns with baked/boiled potatoes, and waist circumference was higher in those who primarily consumed dietary patterns with chips, fried potatoes or mashed potatoes compared with adults with no white potato intake. In adults without diagnosed diabetes, total white potato intake was associated with greater cardiometabolic risk, which may be due, in part, to frying as the predominate preparation method of white potatoes in the USA.

Background Postmenopausal females have an elevated cardiovascular disease (CVD) risk, induced partly by reduced skeletal muscle microvascular blood flow (SMBF), elevated reactive oxygen (ROS), and impaired meal metabolism (glycerol, glucose, lactate). Evidence suggests that creatine monohydrate (CrM), holds promise for reducing CVD risk via improvements in blood flow and ROS reductions; however, data are limited. The current pilot study investigated the impact of CrM on SMBF, ROS concentrations, and markers of meal metabolism at rest and following the consumption of a high carbohydrate (HC) meal (a potent stimulator of ROS), in postmenopausal females. Methods Six postmenopausal females (66 +/- 7 yrs, 30.9 +/- 3.59 kg/m(2)) were enrolled in this randomized, double-blind, crossover study. Participants completed two randomized study arms: CrM (20g/day) and placebo (PL, maltodextrin, 20g/day), each for five days, separated by a four-week washout period. At PRE- and POST-supplementation visits, a microdialysis probe was inserted into the gastrocnemius muscle to measure SMBF (ethanol outflow/inflow ratio (o:i)), [H2O2] (an index of ROS), and dialysate contents. Following a 45min equilibrium period, participants rested for one hour and then consumed a HC meal (35% of daily energy requirements; similar to 80% carbohydrates). Dialysate samples were collected every 20 minutes and data is combined (1hr basal + 4hr post-prandial). ClinicalTrials.gov ID #NCT06018480. Results Five days of CrM increased SMBF (mean +/- SD; PRE CrM:0.71 +/- 0.11o:i, POST CrM: 0.61 +/- 0.10o:i; Visit*Treatment p<0.0001) compared to five days of PL (PRE PL: 0.65 +/- 0.19o:i, POST PL: 0.63 +/- 0.14o:i; Visit*Treatment p=0.44). CrM had no effect on [H2O2] (PRE CrM:1.24 +/- 0.73 mu M, POST CrM: 1.21 +/- 0.19 mu M; Visit*Treatment p=0.99). CrM increased dialysate glycerol (0.67 +/- 0.32 mu mol/L, 0.75 +/- 0.25 mu mol/L; Visit*Treatment p=0.04), with no change in dialysate glucose (Visit*Treatment p=0.49), and a non-significant decrease in dialysate lactate (Visit*Treatment p=0.06). Conclusions Five days of CrM increased SMBF and dialysate glycerol, suggesting enhanced blood flow and lipid mobilization that may support a reduction in CVD risk in postmenopausal females.

Impaired blood flow and elevated reactive oxygen species (ROS) concentrations, generated primarily from NADPH oxidase (NOX), indicate risk for cardiovascular disease (CVD). Creatine monohydrate (CM) may reduce CVD risk by lowering ROS concentrations and increasing skeletal muscle microvascular blood flow (SMBF). To determine if NOX-derived ROS impairs SMBF and whether five days of CM supplementation reduces in-vivo ROS concentrations and improves SMBF. Seven individuals had two microdialysis probes placed (control (CON) and apocynin (APO): NOX inhibitor) in skeletal muscle to measure in-vivo ROS (Hydrogen Peroxide (H2O2)) concentrations and SMBF (ethanol outflow/inflow ratio, inversely related to blood flow) at rest and four hours post-meal consumption. Procedures were performed before (PRE) and after (POST) five days of CM supplementation (20 g/day). Dialysate H2O2 concentrations were lower in the APO probe compared to CON from 120–140 min (APO: 1.19 ± 0.39 µM; CON: 2.04 ± 0.95 µM, p = 0.039), 140–160 min (APO: 1.17 ± 0.37 µM; CON: 2.06 ± 0.98 µM, p = 0.034) and 160–180 min post meal ingestion (p ≤ 0.05). APO perfusion increased SMBF at 20–40 min, 120–140 min (APO: 0.61 ± 0.13; CON: 0.75 ± 0.09 µM, p = 0.048), 140–160 min (APO: 0.61 ± 0.12 µM; CON: 0.76 ± 0.14 µM, p = 0.046), 160–180 min, and 180–200 min post meal (p ≤ 0.05). Ethanol outflow/inflow ratio was lower (higher SMBF) POST CM supplementation compared to PRE CM supplementation at 0–20 min (p = 0.036) and 20–40 min (p = 0.049) following HC/HF meal consumption. Inhibition of NOX-derived ROS increased SMBF, suggesting that NOX activity may impair blood flow regulation over the duration of baseline and post-prandial time points. Further, CM supplementation could be an effective strategy for enhancing postprandial blood flow.

Background: Prediabetes is on the rise and can progress to type 2 diabetes and related cardiometabolic complications if left untreated. Nutrition plays a critical role in blood glucose regulation, and evaluating the effects of whole foods on indices of glycemic control and body composition within individuals with prediabetes is important. This study examined whether consuming one average fresh mango daily for 24 weeks could improve the blood glucose indices and body composition in individuals with prediabetes. Methods: The participants were randomly assigned to either a treatment group (~300 g mango daily for 24 weeks) or a control group (an isocaloric granola bar daily for 24 weeks). Laboratory visits were conducted at baseline and at weeks 6, 12, and 24 to distribute the study regimen and collect anthropometric measurements, body composition data, and blood samples. Results: Twenty-three participants completed this study (treatment: n = 11; control: n = 12). At week 24, the treatment group had lower fasting blood glucose (p < 0.02) and improved insulin sensitivity (QUICKI, p = 0.02), and indicated a trend toward lower insulin resistance (HOMA-IR, p = 0.05) compared with the control. The mean HbA1c remained stable in the treatment group but increased in the control group (p = 0.02). In the treatment group, the body fat percentage showed a borderline decrease (p = 0.05), while the fat-free mass increased (p < 0.03); no significant changes were observed in the control group. Conclusions: The daily consumption of mango for 24 weeks improved the glycemic control, insulin sensitivity, and body composition in adults with prediabetes, which supports the potential of mango as a practical dietary intervention for metabolic health.

Background: The objective of this study was to compare the effects of daily consumption of white potatoes compared with white rice on cardiometabolic health in individuals with type-2 diabetes (T2D). Objective: To determine the effects of white potato consumption compared to white rice (a commonly consumed refined grain) on indices of glycemic control and cardiovascular health in individuals with overweight or obesity and T2D. Methods: In this randomized crossover study, comparative control trial, 24 adults with T2D [45–80 y, body mass index (kg/m2) 25–40] consumed baked white potatoes (100 g) or calorie-matched white rice (75 g) daily for 12 wk, separated by a 2-wk washout, with assessments of glycemic control, lipids, inflammation, blood pressure, endothelial function, and body composition at baseline (only 1 baseline visit included as a covariate in statistical analyses), 6 wk, and 12 wk. A linear mixed model was used to assess treatment (potato or rice), time (6 wk or 12 wk), and the treatment-by-time interaction for all outcome variables. Results: There were no significant (P ≤ 0.05) treatment-by-time interactions for any outcome. There was a main effect of treatment (i.e., independent of time) with the potato regimen resulting in lower waist circumference (P < 0.0001; 4.5 ± 1.0 cm), percent fat mass (P = 0.01; 1.7 ± 0.7%), waist-to-hip ratio (P = 0.002; 0.025 ± 0.013), heart rate (P = 0.01; 3.1 ± 1.2 bpm), as well as higher percent fat-free mass (P = 0.05; 1.4 ± 0.7%) and maximum brachial artery dilation (P = 0.05; 0.074 ± 0.037 mm) when compared to the rice regimen. There were significant timepoint effects (i.e., independent of treatment) for increased homeostatic model assessment of β-cell function (P = 0.02; 34.3 ± 14.5) and decreased high sensitivity C-reactive protein (P = 0.02; 0.08 ± 0.05 μg/mL) and flow-mediated dilation/shear (P = 0.03; 4.3 × 10–5 ± 3.79 × 10–5) during the study. Conclusions: White potatoes did not negatively affect glycemic indices, vascular health, lipids, or blood pressure compared to white rice and modestly improved body composition and vascular measures. In both groups, over time, there were reductions in flow-mediated dilation/shear stress, β cell function, and high-sensitivity C-reactive protein. Our preliminary results support white potatoes as a substitute for white rice in T2D.

Binge and chronic alcohol intake impair skeletal muscle and liver circadian clocks. Scheduled exercise is suggested to protect against circadian misalignment, like that induced by alcohol. It was tested whether scheduled, voluntary daily wheel running would protect the gastrocnemius and liver clocks against alcohol-induced perturbations. Female C57BL6/Hsd mice were assigned to 1 of 4 groups: control-sedentary (CON SED, n = 26), control-exercise (CON EX, n = 28), alcohol-sedentary (ETOH SED, n = 27), or alcohol-exercise (ETOH EX, n = 25). Exercise mice were granted access to running wheels for 2 h/day (ZT13-15) while ETOH mice consumed alcohol-containing liquid diet for 6 weeks. Tissues were collected every 4 h starting at ZT12 from 4-5 mice/group and were used for RNA/cDNA/RT-PCR (gastrocnemius and liver) and Western blotting (gastrocnemius). A second cohort of mice were weaned off alcohol, given regular chow, and continued daily exercise (2 h/day) for ~2 weeks. Then, all mice (EX and SED) were given 24-h wheel access for 1 week to assess cyclic running behaviors during abstinence. While alcohol differentially disrupted muscle and liver clocks in sedentary mice, differences between exercised groups were minimized. BMAL1 protein expression increased in the nuclear-enriched fraction in the gastrocnemius of both exercise groups compared to both sedentary groups. In the second cohort, wheel running was increased in ETOH EX compared to ETOH SED in the dark cycle. In the light cycle, ETOH mice ran less than CON mice, and EX mice ran less than SED mice despite all mice receiving chow diet and no EtOH. Overall, scheduled wheel running partially offset the alcohol-induced perturbations in the muscle and liver clock while ETOH and EX both influenced the timing of subsequent activity after the dietary intervention ended.

Objective To assess nutritive blood flow, lactate, and glucose within active and latent trigger points (TrPs) compared with non-TrP muscle. Design Case-controlled observational study. Setting A university-based clinical and translational research center. Participants Active TrPs were identified through palpation of the upper trapezius muscle of individuals with episodic or chronic tension-type headache (TTH). Latent TrPs and muscle without TrPs were identified in age- and sex-matched subjects without a history of headache. A total of 64 individuals participated in the study. Interventions Not applicable. Main Outcome Measures Nutritive blood flow, and interstitial lactate and glucose concentrations were determined at 12-20 minutes intervals over 160 minutes through microdialysis sampling of interstitial fluid. Results Subjects were 33.8±10.8 years, 64.1% women, and 73.4% white, with no statistical differences between active, latent, and no TrP groups on demographic or baseline variables (P>.05). Subjects with TTH reported a median of 4 headaches/mo and had experienced headaches for a median of 120 months. Active TrPs exhibit higher nutritive blood flow than anatomically matched no TrP muscle (P=.026) but were not different from latent TrPs (P=.554). There were no global differences between the 3 groups for lactate (P=.329) or glucose (P=.231). Conclusions This study provides in vivo evidence of higher nutritive blood flow in active TrPs from individuals with TTH but no difference in lactate and glucose compared with non-TrP muscle. Our data do not support the TrP as a tightly contracted, ischemic region within skeletal muscle. Interventions designed to relax muscle contraction or increase blood flow may have limited benefits in alleviating active trigger points.

There is mounting evidence suggesting that reactive oxygen species (ROS) generated by NADPH oxidase (NOX) regulate physiological processes, as NOX has been shown to promote increases in lipolysis in cultured adipocytes. PURPOSE: To determine the mechanisms by which NOX stimulates adipose tissue lipolysis. METHODS: Young healthy females (n = 17; mean ± SD; age: 21.7 ± 5 years; body mass index: 22.2 ± 3.8 kg/m2) participated in this study. Participants underwent microdialysis and hyperinsulinemic-euglycemic clamp (clamp) procedures. Three microdialysis probes were inserted into subcutaneous abdominal adipose tissue to monitor local adipose tissue ROS (H2O2) production and lipolysis (as indicated by dialysate glycerol). To determine whether NOX stimulates lipolysis via distinct signaling pathways, microdialysis probes were perfused with either isoproterenol (Iso; β-adrenergic agonist to stimulate canonical lipolysis signaling) or atrial natriuretic peptide (ANP to stimulate non-canonical lipolysis signaling), then perfused with a local NOX inhibitor (apocynin). A control probe was perfused with apocynin but without any agonists of lipolysis. The microdialysis procedures were then repeated under hyperinsulinemic conditions during the same study visit. RESULTS: In the fasted state, dialysate H2O2 concentrations were lower in the control and Iso probes upon apocynin perfusion (control probe without apocynin: 1.06 ± 0.5 μM, with apocynin: 0.62 ± 0.2 μM; p = 0.005; Iso probe without apocynin: 1.01 ± 0.4 μM, with apocynin: 0.66 ± 0.2 μM; p = 0.003). Apocynin perfusion did not alter dialysate H2O2 concentrations in the ANP probe under the fasted state (p = 0.11). Dialysate glycerol concentrations did not change upon apocynin perfusion under any of the microdialysis probe conditions in the fasted state (p > 0.05). During the clamp, apocynin perfusion resulted in lower dialysate H2O2 concentrations in the three conditions (control probe without apocynin: 1.22 ± 0.6 μM, with apocynin: 0.75 ± 0.3 μM; p = 0.03; Iso probe without apocynin: 1.55 ± 0.8 μM, with apocynin: 0.79 ± 0.3 μM; p = 0.01; ANP probe without apocynin: 1.55 ± 0.6 μM, with apocynin: 0.92 ± 0.3 μM; p = 0.03). Dialysate glycerol concentrations were lower in the Iso probe upon apocynin perfusion during the clamp (Iso probe without apocynin: 124.7 ± 38 μM, with apocynin: 90.9 ± 25 μM; p = 0.003). CONCLUSIONS: This study presents adipose tissue NOX as a source of in vivo ROS production in human participants. In addition, we reveal a novel mechanism of NOX in adipose tissue function whereby NOX exerts increases in β-adrenergic-mediated lipolysis during hyperinsulinemia. Our findings highlight the roles of ROS as signaling mediators and suggest that an imbalance between NOX activity and insulin action on adipose tissue could negatively affect systemic fatty acid metabolism. Porter Pre-doctoral Fellowship from the American Physiological Society and an NIH National Research Service Award (F31HL154642). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Background/Objectives: A pilot study was conducted to investigate the effect of four weeks of creatine monohydrate (CrM) on vascular endothelial function in older adults. Methods: In a double-blind, randomized crossover trial, twelve sedentary, healthy older adults were allocated to either the CrM or placebo (PL) group for four weeks, at a dose of 4 × 5 g/day for 5 days, followed by 1 × 5 g/day for 23 days. Macrovascular function (flow-mediated dilation [FMD%], normalized FMD%, brachial-ankle pulse wave velocity [baPWV], pulse wave analysis [PWA]), microvascular function (microvascular reperfusion rate [% StO2/sec]), and biomarkers of vascular function (tetrahydrobiopterin [BH4], malondialdehyde [MDA], oxidized low-density lipoprotein [oxLDL], glucose, lipids) were assessed pre- and post-supplementation with a four-week washout period. Results: CrM significantly increased FMD% (pre-CrM, 7.68 ± 2.25%; post-CrM, 8.9 ± 1.99%; p < 0.005), and normalized FMD% (pre-CrM, 2.57 × 10−4 ± 1.03 × 10−4%/AUCSR; post-CrM, 3.42 × 10−4 ± 1.69 × 10−4%/AUCSR; p < 0.05), compared to PL. Microvascular reperfusion rates increased following CrM (pre-CrM, 2.29 ± 1.42%/sec; post-CrM, 3.71 ± 1.44%/sec; p < 0.05), with no change following PL. A significant reduction in fasting glucose (pre-CrM, 103.64 ± 6.28; post-CrM, 99 ± 4.9 mg/dL; p < 0.05) and triglycerides (pre-CrM, 99.82 ± 35.35; post-CrM, 83.82 ± 37.65 mg/dL; p < 0.05) was observed following CrM. No significant differences were observed for any other outcome. Conclusions: These pilot data indicate that four weeks of CrM supplementation resulted in favorable effects on several indices of vascular function in older adults.

Increased reactive oxygen species (ROS) generation and microvascular endothelial disruptions occur with natural ageing, but often transpire before the detection of cardiometabolic conditions including hypertension. Age-related increases in blood pressure are driven by complex systemic changes with poorly understood integrated mechanisms. The deconditioning experienced by ageing skeletal muscle from mid-life is associated with reduced microvascular blood flow and increased peripheral resistance, suggesting that vasodilatory decrements in the muscle may precede the age-related increases in blood pressure. Structural and functional changes within the vascular and skeletal muscle systems with advancing age can influence redox homeostasis, and vice versa, further compounding microvascular endothelial dysfunction. Therefore, comparisons between the microvascular environments of healthy and hypertensive cohorts can provide insights into the changes that occur during significant periods of functional decline. This comprehensive study protocol describes a microdialysis technique to assess the interactions of microvascular health and functional changes in the muscle, which currently cannot be otherwise addressed. Here, we detail an experimental protocol to simultaneously detect skeletal muscle ROS (H2O2 and indirect O2 -), determine nutritive blood flow and assess microvascular endothelial function in response to acetylcholine stimulation. We expect that healthy middle-aged individuals should not have increased ROS generation in the muscle at rest, compared to their hypertensive or older counterparts, but may exhibit perturbed microvascular function. The described technique allows for intricate exploration of microvascular physiology that will provide a critically novel insight into benchmarking potential age-related mechanisms involved in the development of age-related hypertension, and aid in early identification and prevention. KEY POINTS: Increased reactive oxygen species (ROS) production and microvascular endothelial dysfunction precede the onset of age-related cardiometabolic and vascular conditions such as hypertension. The profound structural and functional changes that occur within the vasculature and in skeletal muscle from middle age prompt a need to mechanistically explore the microvascular environment in healthy and hypertensive individuals. Using a novel microdialysis technique, we detail an experimental protocol to simultaneously detect skeletal muscle ROS (H2O2 and indirect O2 -), determine nutritive blood flow and assess microvascular endothelial function in response to acetylcholine stimulation. With this technique and study protocol, we can reveal functional insights into potential perturbations in ROS generation at rest and the microvascular endothelium, which play important roles in the development of age-related hypertension.

In 2005 and 2008 two studies by Shah et al were published shedding light on the internal milieu of myofascial trigger points (TrP). 1 Shah JP Phillips TM Danoff JV Gerber LH. An in vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle. J Appl Physiol. 2005; 99: 1977-1984 Crossref PubMed Scopus (505) Google Scholar ,2 Shah JP Danoff JV Desai MJ et al. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil. 2008; 89: 16-23 Abstract Full Text Full Text PDF PubMed Scopus (491) Google Scholar These studies served as a critical inflection in our understanding of the biochemicals associated with TrPs and myofascial pain and are supportive of the popular Integrated Hypothesis proposed by Simons. 3 Simons DG Travell JG Simons LS. Travell & Simons' myofascial pain and dysfunction: the trigger point manual. 2nd ed. Williams & Wilkins, Baltimore1999 Google Scholar As determined through Google Scholar, the two studies have garnered nearly 1700 scientific citations. However, upon close review problematic technical errors and results improbabilities exist that question the validity of the findings. Response to Letter to the Editor on “Biochemicals Associated With Pain and Inflammation are Elevated in Sites Near to and Remote From Active Myofascial Trigger Points”Archives of Physical Medicine and RehabilitationPreviewWe thank the Archives of PM&R for the opportunity to respond to the letter to the editor. Full-Text PDF

OBJECTIVES:To investigate the biochemical milieu of the upper trapezius muscle in subjects with active, latent, or absent myofascial trigger points (MTPs) and to contrast this with that of the noninvolved gastrocnemius muscle.DESIGN:We used a microanalytic technique, including needle insertions at standardized locations in subjects identified as active (having neck pain and MTP), latent (no neck pain but with MTP), or normal (no neck pain, no MTP). We followed a predetermined sampling schedule; first in the trapezius muscle and then in normal gastrocnemius muscle, to measure pH, bradykinin, substance P, calcitonin gene-related peptide, tumor necrosis factor alpha, interleukin 1beta (IL-1beta), IL-6, IL-8, serotonin, and norepinephrine, using immunocapillary electrophoresis and capillary electrochromatography. Pressure algometry was obtained. We compared analyte concentrations among groups with 2-way repeated-measures analysis of variance.SETTING:A biomedical research facility.PARTICIPANTS:Nine healthy volunteer subjects.INTERVENTIONS:Not applicable.MAIN OUTCOME MEASURES:Preselected analyte concentrations.RESULTS:Within the trapezius muscle, concentrations for all analytes were higher in active subjects than in latent or normal subjects (P<.002); pH was lower (P<.03). At needle insertion, analyte concentrations in the trapezius for the active group were always higher (pH not different) than concentrations in the gastrocnemius muscle. At all times within the gastrocnemius, the active group had higher concentrations of all analytes than did subjects in the latent and normal groups (P<.05); pH was lower (P<.01).CONCLUSIONS:We have shown the feasibility of continuous, in vivo recovery of small molecules from soft tissue without harmful effects. Subjects with active MTPs in the trapezius muscle have a biochemical milieu of selected inflammatory mediators, neuropeptides, cytokines, and catecholamines different from subjects with latent or absent MTPs in their trapezius. These concentrations also differ quantitatively from a remote, uninvolved site in the gastrocnemius muscle. The milieu of the gastrocnemius in subjects with active MTPs in the trapezius differs from subjects without active MTPs.

Introduction Chronic pain affects 19% of adults in the United States, with increasing prevalence in active and aging populations. Pain can limit physical activity and activities of daily living (ADLs), resulting in declined mental and social health. Nutritional interventions for pain currently target inflammation or joint health, but few influence both. Collagen, the most abundant protein in the human body and constituent of the extra cellular matrix, is such a nutraceutical. While there have been reports of reductions in pain with short-term collagen peptide (CP) supplementation, there are no long-term studies specifically in healthy middle-aged active adults. Purpose To determine the effects of daily CP consumption over 3, 6, and 9 months on survey measures of pain, function, and physical and mental health using The Knee Injury & Osteoarthritis Outcomes Score (KOOS) and Veterans Rand 12 (VR-12) in middle-aged active adults. Methods This study was a double-blind randomized control trial with three treatment groups (Placebo, 10 g/d CP, and 20 g/d CP). Results Improvements in ADLs (p = .031, & eta;(p) (2) = .096) and pain (p = .037, & eta;(p) (2) = .164) were observed with 10 g/d CP over 6 months, although pain only improved in high frequency exercisers (>180 min/week). Additionally, VR-12 mental component scores (MCS) improved with 10 g/d of CP over 3-9 months (p = .017, & eta;(p) (2) = .309), while physical component scores (PCS) improved with 20 g/d of CP over 3-9 months, but only in females (p = .013, & eta;(p) (2)= .582). Conclusion These findings suggest 10 to 20 g/d of CP supplementation over 6 to 9 months may improve ADLs, pain, MCS, and PCS in middle-aged active adults.

Glucocorticoid myopathy is the most common, toxic, noninflammatory myopathy. Our work shows that high-force contractions increase protein synthesis in skeletal muscle following short-term glucocorticoid treatment. However, longer duration glucocorticoid treatment results in anabolic resistance to high-force contractions despite activation of the mechanistic target of rapamycin in complex 1 (mTORC1) signaling pathway. This work defines potential limits for high-force contractions to activate the processes that would restore lost muscle mass in glucocorticoid myopathic patients.