Objective To investigate the effects of a 16-week concurrent exercise regimen [resistance exercise (RE) + functional exercise (FE)] in combination with, or without, a leucine-enriched whey protein isolate supplement on muscle strength, physical functioning, aerobic capacity, and cardiometabolic health in older adults (≥60 years). Physical activity levels were also evaluated 6 months post-cessation of the intervention. Methods Forty-six, community-dwelling, previously untrained males, and females [age: 68 ± 5 years (mean ± SD); BMI: 27.8 ± 6.2 kg/m 2 ] who completed the trial were initially randomized to one of two independent arms [Exercise n = 24 (E); Exercise+Protein n = 22 (EP)]. Both arms completed 16 weeks of RE (performed to fatigue) (2 times/week) with FE (1 time/week) on non-consecutive days. Additionally, EP were administered a leucine-enriched whey protein supplement (3 times/day) for 16 weeks based on individual body-weight (1.5 g/kg/day). Results As a result of dietary supplementation, protein intake increased in EP (∼1.2 ± 0.4 to 1.5 ± 0.7 g/kg/day) during the intervention. Maximal strength (1RM) values for leg press (E: +39 ± 7 kg, p = 0.006; EP: +63 ± 7 kg, p < 0.001), chest press (E: +22 ± 4 kg, p < 0.001; EP: +21 ± 6 kg, p < 0.001), and bicep curl (E: +7 ± 0 kg, p = 0.002; EP: +6 ± 1 kg, p = 0.008) significantly increased in E and EP respectively, with no differences between arms ( p > 0.05). Physical functioning in the obstacle course (E: -5.1 ± 6.8 s, p < 0.001; EP: -2.8 ± 0.8 s, p < 0.001) and short-physical performance battery scores (E: +0.5 ± 0.5, p = <0.001; EP: +0.4 ± 0.5, p = 0.038), and aerobic capacity in the 6-min walk test (E: +37 ± 24 m, p = 0.014; EP: +36 ± 3 m, p = 0.005) improved in E and EP respectively, with no differences between arms ( p > 0.05). No significant change was observed for markers of cardiometabolic health (glycaemic control or blood pressure) ( p > 0.05). At follow-up, 86% of older adults reported to performing physical activity ≥1 per week. Of those, 61% were still participating in strength- and cardiovascular- based exercise. Conclusion Concurrent exercise (RE + FE) offers a potent method to combat age-related muscle weakness, and our results suggest a high proportion of older adults may continue to exercise unsupervised. However, leucine-enriched whey protein isolate supplementation did not confer any additional benefit in those already consuming ample amounts of dietary protein a...

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Background Increasing protein intake (above the Recommended Dietary Amount) alone or with resistance-based exercise is suggested to improve cardiometabolic health; however, randomized controlled trials (RCTs) are needed to confirm this. Methods The Liverpool Hope University-Sarcopenia Aging Trial (LHU-SAT) was a 16 week RCT (ClinicalTrials.gov Identifier: NCT02912130) of 100 community-dwelling older adults [mean age: 68.73 ± 5.80 years, body mass index: 27.06 ± 5.18 kg/m 2 (52% women)] who were randomized to four independent groups [Control (C), Exercise (E), Exercise + Protein (EP), Protein (P)]. E and EP completed supervised and progressive resistance-based exercise (resistance exercise: two times per week, functional circuit exercise: once per week), while EP and P were supplemented with a leucine-enriched whey protein drink (three times per day) based on individual body weight (0.50 g/kg/meal, 1.50 g/kg/day). Outcome measures including arterial stiffness (pulse wave velocity), fasting plasma/serum biomarkers [glucose/glycated haemoglobin, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein, insulin, resistin, leptin, adiponectin, C-reactive protein, tumour necrosis factor-alpha, interleukin-6, cystatin-C, & ferritin], insulin resistance (HOMA-IR), and kidney function (eGFR) were measured before and after intervention. Results Total protein intake (habitual diet plus supplementation) increased to 1.55 ± 0.69 g/kg/day in EP and to 1.93 ± 0.72 g/kg/day in P, and remained significantly lower (P < 0.001) in unsupplemented groups (E: 1.08 ± 0.33 g/kg/day, C: 1.00 ± 0.26 g/kg/day). At 16 weeks, there was a group-by-time interaction whereby absolute changes in LDL-cholesterol were lower in EP [mean difference: À0.

Background A screening test evaluates a functional movement by assessing an athlete's functional limitations, weaknesses, or impairments that may increase the risk of injury for the athlete. Objective To assess the inter-rater reliability and subject variability of the Functional Movement Screen (FMS) and to analyze the use of video scoring as opposed to live scoring. Design A reliability study. Each athlete was tested and retested, 1 week apart by the same rater, who also scored the athlete's fi rst session from a video recording. These video recordings were then scored by fi ve other raters. Setting Human Performance Lab using two standard video cameras (sagittal and frontal views) and SiliconCoach video capture software. Participants 21 female (19.6±1.5 years, 64.4±5.1 kg, 1.7±0.1 m) and 19 male (19.7± 1.0 years, 80.1 ±9.9 kg, 1.9±0.1 m) Varsity athletes from swimming, soccer, volleyball, crosscountry and gymnastics volunteered to participate, along with six raters. Assessment The FMS consists of seven tasks that focus on mobility and stability. Each task is rated out of 3, with pain being an automatic zero, for a total score out of 21. Raters (6) looked for malalignment and asymmetry. Main outcome measurement The Krippendorff alpha (Kalpha) was used to assess the reliability of each of the three tests: inter-rater, test-retest, live versus video. Results The Kalpha for the inter-rater, the test-retest, and the live/video was 0.3806, 0.6161, and 0.9096, respectively. Conclusion Inter-rater reliability results show that clinicians should avoid comparison across multiple raters. It is possible that with more training this value may increase. Fortunately, if a single rater is used, clinicians can be confi dent that a change in the FMS score is due to a change in the athlete as the testretest produced good reliability. This study also demonstrates that streamlining the FMS process with the use of video capture is appropriate.

Provides a review and synthesis of the finance literature regarding foreign investment and the real estate literature dealing with foreign investment in US real estate. Addresses the motivations for investing in US real estate, including the potential for increased returns as well as the potential for risk reduction. Proposes an investment decision making model indicating factors that foreign investors need to consider when investing in US real estate.