BACKGROUNDThe purpose of this study was to determine the efficacy of a clinician referral and exercise program in improving exercise levels and quality of life for men with prostate cancer.METHODSThis was a multicenter cluster randomized controlled trial in Melbourne, Australia comprising 15 clinicians: 8 clinicians were randomized to refer eligible participants (n = 54) to a 12-week exercise program comprising 2 supervised gym sessions and 1 home-based session per week, and 7 clinicians were randomized to follow usual care (n = 93). The primary outcome was self-reported physical activity; the secondary outcomes were quality of life, anxiety, and symptoms of depression.RESULTSA significant intervention effect was observed for vigorous-intensity exercise (effect size: Cohen's d, 0.46; 95% confidence interval [CI], 0.09-0.82; P = .010) but not for combined moderate and vigorous exercise levels (effect size: d, 0.08; 95% CI, −0.28 to 0.45; P = .48). Significant intervention effects were also observed for meeting exercise guidelines (≥150 min/wk; odds ratio, 3.9; 95% CI, 1.9-7.8; P = .002); positive intervention effects were observed in the intervention group for cognitive functioning (effect size: d, 0.34; 95% CI, −0.02 to 0.70; P = .06) and depression symptoms (effect size: d, −0.35; 95% CI, −0.71 to 0.02; P = .06). Eighty percent of participants reported that the clinician's referral influenced their decision to participate in the exercise program.CONCLUSIONSThe clinician referral and 12-week exercise program significantly improved vigorous exercise levels and had a positive impact on mental health outcomes for men living with prostate cancer. Further research is needed to determine the sustainability of the exercise program and its generalizability to other cancer populations. Cancer 2015;121:2646–2654. © 2015 American Cancer Society.

VT reduces muscle soreness and IL6. It may stimulate lymphocyte and neutrophil responses and may be a useful modality in treating muscle inflammation.

Interval training (IT) may induce physiological adaptations superior to those achieved with conventional moderate-intensity continuous training (MCT) in patients with coronary artery disease (CAD). Our objectives were (1) to systematically review studies which have prescribed IT in CAD, (2) to summarize the findings of this research including the safety and physiological benefits of IT, and (3) to identify areas for further investigation. A systematic review of the literature using computerized databases was performed. The search yielded two controlled trials and five randomized controlled trials (RCTs) enrolling 213 participants. IT prescribed in isolation or in combination with resistance training was shown to induce significant and clinically important physiological adaptations in cardiac patients. IT was also shown to improve cardiorespiratory fitness (e.g. VO(2max), VO(2AT)), endothelial function, left ventricle morphology and function (e.g. ejection fraction) to a significantly greater extent when compared with conventional MCT. No adverse cardiac or other life-threatening events occurred secondary to exercise participation in these studies. However, these findings must be interpreted with caution, as methodological limitations were present in all trials reviewed. In conclusion, robustly designed RCTs with thorough and standardized reporting are required to determine the risk and benefits of IT in the broader cardiac patient population. Further research is required to determine optimal IT protocols for the use in cardiac rehabilitation programmes, potentially contributing to novel exercise prescription guidelines for this patient population.

Rowlands DS, Thorburn MS, Thorp RM, Broadbent S, Shi X. Effect of graded fructose coingestion with maltodextrin on exogenous 14 C-fructose and 13 C-glucose oxidation efficiency and high-intensity cycling performance. J Appl Physiol 104: 1709-1719, 2008. First published March 27, 2008 doi:10.1152/japplphysiol.00878.2007.-The ingestion of solutions containing carbohydrates with different intestinal transport mechanisms (e.g., fructose and glucose) produce greater carbohydrate and water absorption compared with singlecarbohydrate solutions. However, the fructose-ingestion rate that results in the most efficient use of exogenous carbohydrate when glucose is ingested below absorption-oxidation saturation rates is unknown. Ten cyclists rode 2 h at 50% of peak power then performed 10 maximal sprints while ingesting solutions containing 13 C-maltodextrin at 0.6 g/min combined with 14 C-fructose at 0.0 (No-Fructose), 0.3 (Low-Fructose), 0.5 (Medium-Fructose), or 0.7 (High-Fructose) g/min, giving fructose:maltodextrin ratios of 0.5, 0. 8, and 1.2. Mean (percent coefficient of variation) exogenous-fructose oxidation rates during the 2-h rides were 0.18 (19), 0.27 (27), 0.36 (27) g/min in Low-Fructose, Medium-Fructose, and High-Fructose, respectively, with oxidation efficiencies (ϭoxidation/ingestion rate) of 62-52%. Exogenous-glucose oxidation was highest in Medium-Fructose at 0.57 (28) g/min (98% efficiency) compared with 0.54 (28), 0.48 (29), and 0.49 (19) in Low-Fructose, High-Fructose, No-Fructose, respectively; relative to No-Fructose, only the substantial 16% increase (95% confidence limits Ϯ16%) in Medium-Fructose was clear. Total exogenous-carbohydrate oxidation was highest in Medium-Fructose at 0.84 (26) g/min. Although the effect of fructose quantity on overall sprint power was unclear, the metabolic responses were associated with lower perceptions of muscle tiredness and physical exertion, and attenuated fatigue (power slope) in the Medium-Fructose and HighFructose conditions. With the present solutions, low-medium fructose-ingestion rates produced the most efficient use of exogenous carbohydrate, but fatigue and the perception of exercise stress and nausea are reduced with moderate-high fructose doses. dose response; dual-tracer method; substrate metabolism; gastrointestinal distress; fatigue IT IS NOW WIDELY ACCEPTED that ingestion of carbohydrate solutions can delay fatigue and improve endurance performance during high-intensity exercise of ϳ60 min or longer (reviewed in Ref. 25). The proposed mechanisms for performance enhancement are related to the prevention of hypoglycemia and the maintenance of high carbohydrate-oxidation rates during the later stages of exercise, when endogenous muscle and liver carbohydrate stores may become depleted (8). For these reasons and for reasons relating to hydration, there is interest from industry, scientists, and athletes in finding the formulation that will best optimize performance.During exercise, ingested glucose is rapidly absorbed into the circulation and oxidized b...

PurposeAlthough evidence is building on the positive effects of physical activity for prostate cancer survivors, less is known about the possible independent effects of sedentary behavior on quality of life and psychological well-being in this population. We determined the extent to which objectively measured moderate-to-vigorous physical activity (MVPA) and sedentary behavior were independently associated with quality of life, anxiety, and depressive symptoms in prostate cancer survivors.MethodsAn exploratory cross-sectional analysis was undertaken on baseline data from a multicenter, cluster randomized controlled trial on the efficacy of a clinician referral and 12-week exercise program for men who had completed active treatment for prostate cancer. Multiple regression analyses were performed using data from 98 prostate cancer survivors who wore hip-mounted accelerometers (time spent sedentary defined as <100 counts per minute [CPM]; MVPA defined as >1,951 CPM) and completed self-report instruments on their quality of life, anxiety, and depressive symptoms. Results were compared with minimal clinically important differences for the quality of life scales.ResultsIndependent of sedentary behavior, increases in MVPA of between 15 and 33 min/day were associated with clinically important (but not statistically significant) improvements in three quality of life scales (insomnia, diarrhea, and financial difficulties). Independent of MVPA, decreases in sedentary behavior of 119 and 107 min/day were associated with clinically important (but not statistically significant) improvements in physical functioning and role functioning, respectively.ConclusionWithin our exploratory study, modest increases in MVPA and more substantive decreases in sedentary behavior were independently associated with clinically important improvements in several quality of life scales. Further research, including prospective studies, is required to understand sedentary behavior across larger and more representative samples (in terms of their physical, psychological, and social functioning and their engagement in physical activity) of prostate cancer survivors.Trial registrationAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12610000609055