Blood flow restriction (BFR) exercise may be an alternative form of resistance training; however, a side of effect of BFR resistance exercise is acute muscle pain. Typically, BFR exercise studies restrict blood flow with a cuff continuously during the exercise bout, including rest periods. However, others have used intermittent BFR where the cuff is inflated only during sets. We performed two studies to compare intermittent and continuous BFR exercise. In study one, eleven subjects randomly proceeded through three treatments of unilateral leg extensions to failure: (i) continuous BFR, (ii) intermittent BFR and (iii) control (exercise without BFR). Pain measurements were taken immediately after each set. In study two, subjects (n = 32) underwent a 5-week resistance training programme after random assignment to one of the three conditions. Lean mass and strength were assessed at baseline and after training. Continuous BFR resulted in significantly greater pain than intermittent BFR or control. Both BFR conditions resulted in significantly fewer repetitions to failure than control. This suggests that an acute bout of intermittent BFR exercise may produce as much muscle fatigue as an acute bout of continuous BFR exercise, but with less pain. With training, maximal knee extension (P = 0·033) and maximum knee flexion (P = 0·007) strength increased among all groups. There were no significant differences between groups in strength or lean mass. These results suggest that short-term low-load resistance training increases muscle strength to a similar extent as low-load resistance training without BFR.

The purpose of this study was to evaluate the effects of oral supplementation with pomegranate extract on cardiovascular risk, physical function, oxidative stress, and inflammation in hemodialysis (HD) patients. Thirty-three HD subjects were randomized to the pomegranate (POM) or placebo (CON) group. Patients in POM ingested a 1000 mg capsule of a purified pomegranate polyphenol extract 7 days/week for 6 months. Individuals in CON ingested a noncaloric placebo capsule using the same protocol. Measurements were conducted at baseline and repeated 6 months following the start of the intervention. Brachial blood pressure (BP) was obtained using an automatic digital BP monitor. Cardiovascular risk was assessed using ultrasound and arterial tonometry. Blood samples were collected for the measurements of circulating markers of inflammation, oxidative stress, and antioxidant capacity. Muscle strength and physical function were assessed by isokinetic dynamometry, a validated shuttle walk test, and a battery of tests to assess functional fitness. Systolic blood pressure and diastolic blood pressure were reduced by 24 ± 13.7 and 10 ± 5.3 mmHg, respectively, in POM (P < .05). However, the BP differences in POM were no longer significant after controlling for baseline BP. The paraoxonase-1 activity increased by 26.6% (P < .05) in POM, compared to no significant change in CON. However, pomegranate supplementation had no effect on other markers of cardiovascular disease risk, inflammation and oxidative stress, or measures of physical function and muscle strength. While pomegranate extract supplementation may reduce BP and increase the antioxidant activity in HD patients, it does not improve other markers of cardiovascular risk, physical function, or muscle strength.

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These results do not support the efficacy of HMB to attenuate co-morbid conditions in MHD patients. Moreover, this highlights the need for future interventions targeted at reducing pill burden and improving pill compliance in this population.

Traditional aerobic exercise decreases the risk of developing inflammatory diseases in both obese and normal weight individuals. The magnitude of the anti‐inflammatory immune response following traditional exercise is reduced and the time‐course is shorter in obese compared to normal weight individuals. Although obesity may affect the ability to engage in traditional exercise, whole body vibration (WBV) has emerged as a more tolerated alternative. The impact of WBV on immune‐mediated inflammation in obesity, however, is unknown. PURPOSE To determine if WBV elicits a differential magnitude and time‐course of immune‐mediated inflammation between obese and normal weight individuals. METHODS 11 obese (OB) (BMI: 35.9 ± 8.8 kg/m2, Age: 33 ± 4 y, percent body fat (%BF): 39.1 ± 2.4%) and 12 normal weight (NW) (BMI: 21.3 ± 2.2 kg/m2, Age: 29 ± 7 y, %BF: 17.4 ± 2.1%) men and women participated in this study. Following IV insertion and a resting (PRE) blood draw, each participant performed the WBV protocol, which consisted of 10 cycles of 1 minute of WBV in a static squat position followed by 30 seconds of rest. Following completion of the WBV protocol, blood samples were obtained immediately (POST), 1 hour (1h), 3 hours (3h), and 24 hours (24h) post‐WBV. Blood was analyzed for leukocyte composition (immune‐mediated inflammation) and IL‐6 (muscle activation). RESULTS PRE leukocyte composition was not different between groups. In NW, the percentage of neutrophils decreased (1h: 62 ± 3% vs. 24h: 54 ± 3%, p=0.009) and the percentage of lymphocytes increased (1h: 28 ± 3% vs. 24h: 35 ± 2%, p=0.011). In contrast, there were no changes in leukocyte composition in OB. An association was observed between %BF and the percentage of monocytes at POST (r= −0.67, p=0.023) and 1h (r= −0.65, p=0.03) in OB, whereas in NW %BF was only correlated with percentage of monocytes at PRE (r= −0.61, p=0.045). Although IL‐6 was higher in OB compared with NW at each time point (all p<0.05), a similar percent change from baseline was observed between groups for all post‐WBV time points. IL‐6 at PRE was correlated with percent change at 3h (r= −0.61, p=0.048) only in OB. CONCLUSION WBV elicited favorable alterations in leukocyte composition over time in NW, while no change in leukocytes were detected in OB. In addition, adiposity appears to impact the timing of the leukocyte response to WBV. Although WBV provoked similar IL‐6 changes in both groups, higher concentrations of IL‐6 at PRE appeared to be related to smaller changes at 3h in OB. Taken together, these data suggest a differential inflammatory immune response to WBV exercise between obese and normal weight individuals. Support or Funding Information Supported by Medical College of Georgia TUPP award This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

These results indicate that IDEX does not exacerbate hemodynamic instability during HD, regardless of a patient's hydration status or the timing of exercise.

Elevated nocturnal blood pressure (BP) and nocturnal non‐dipping are frequently observed in patients with chronic kidney disease (CKD) and are stronger predictors of cardiovascular complications and CKD progression than standard office BP. The sympathetic nervous system (SNS) is thought to modulate diurnal hemodynamic changes and the vascular endothelium plays a fundamental role in BP regulation. We hypothesized that SNS overactivity and endothelial dysfunction in CKD are linked to elevated nocturnal BP and non‐dipping. In 32 CKD patients with hypertension (56 ± 7 years), office BP, 24‐hr ambulatory BP, muscle sympathetic nerve activity (MSNA) and endothelial function via flow‐mediated dilation (FMD) were measured. Participants were subsequently divided into dippers (nighttime average BP > 10% lower than the daytime average BP, n = 8) and non‐dippers ( n = 24). Non‐dippers had higher nighttime BP ( p < .05), but not office and daytime BP, compared to dippers. MSNA burst incidence (81 ± 13 versus 67 ± 13 bursts/100 HR, p = .019) was higher and brachial artery FMD (1.7 ± 1.5 versus 4.7 ± 1.9%, p < .001) was lower in non‐dippers compared to dippers. MSNA and FMD each predicted nighttime systolic (β = 0.48,‐0.46, p = .02, 0.07, respectively) and diastolic BP (β = 0.38,‐0.47, p = .04, 0.03, respectively) in multivariate‐adjusted analyses. Our novel findings demonstrate that unfavorable nocturnal BP profiles are associated with elevated SNS activity and endothelial dysfunction in CKD. Specifically, CKD patients with higher nighttime BP and the non‐dipping pattern have higher MSNA and lower FMD. These support our hypothesis that SNS overactivation and endothelial dysfunction are linked to the dysregulation of nighttime BP as well as the magnitude of BP lowering at nighttime in CKD.