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Papers by Beth Taylor

Research paper thumbnail of Coming of Age: Considerations in the Prescription of Exercise for Older Adults

Methodist DeBakey cardiovascular journal

Older adults represent the fastest-growing age demographic of the population. Physiological chang... more Older adults represent the fastest-growing age demographic of the population. Physiological changes associated with primary aging and concurrent chronic disease adversely impact functional capacity, health outcomes, and quality of life. For these reasons, there is a national emphasis for healthcare providers to improve the health, function, and quality of life of older adults to preserve independent living and psychological well-being. The benefits of regular physical activity or exercise with regard to aging and disease are indisputable, yet many clinicians do not prescribe exercise to older adults. This reluctance may be attributable to a lack of knowledge regarding appropriate exercise prescription for older adults in light of the potential risks and benefits of various doses and types of exercise. In addition, clinicians and patients may have concerns about potential health considerations relevant to older adults such as comprehensive pre-exercise screening and exercise-drug int...

Research paper thumbnail of Comparison of the Clinical Determinants of the Blood Pressure Response Following Two Different Exercise Modalities

Medicine & Science in Sports & Exercise, 2015

Research paper thumbnail of Efficacy and Safety of an Insulin Infusion Protocol in a Surgical ICU

Data Revues 10727515 V202i1 S107275150501519x, Sep 8, 2011

Research paper thumbnail of Resting Blood Pressure and Muscle Strength in Healthy Men and Women: 916 Board #232 June 1, 2: 00 PM - 3: 30 PM

Medicine and science in sports and exercise, 2016

Research paper thumbnail of Deep-Targeted Exon Sequencing Reveals Angiotensinogen (AGT) loci on Chr 1q42.2 Associate with Postexercise Hypotension among Caucasians: 3657 Board #96 June 4, 9: 30 AM - 11: 00 AM

Medicine and science in sports and exercise, 2016

Research paper thumbnail of Urban Community Schools: Educator Perceptions of the Effects of Children's Health and Wellness on Learning

Current Issues in Education, Jan 27, 2014

Findings from a participatory action-research project that brought together 11 individuals from f... more Findings from a participatory action-research project that brought together 11 individuals from five of Hartford's seven community schools to engage in a focus group discussion about the effects of children's health and wellness on learning are presented. The researchers and key personnel from Hartford Public Schools and Achieve Hartford! coconstructed the inquiry. Issues identified as interfering with student learning clustered into themes that include students' and family members' mental, behavioral, nutritional, and domestic/neighborhood health. The results are being used to create a call for translational research proposals for University researchers to address these questions and disseminate findings to Hartford Public Schools and related community partners.

Research paper thumbnail of The Influence of ABO Blood Type on Hemostatic Activation Following A Marathon: 1400 Board #53 June 2, 8: 00 AM - 9: 30 AM

Medicine and science in sports and exercise, 2016

Research paper thumbnail of Single Low-Density Lipoprotein Apheresis Does Not Improve Vascular Endothelial Function in Chronically Treated Hypercholesterolemic Patients

International Journal of Vascular Medicine, 2016

Objective. To investigate vascular endothelial function (VEF) responses to a single low-density l... more Objective. To investigate vascular endothelial function (VEF) responses to a single low-density lipoprotein (LDL) apheresis session in hypercholesterolemic patients undergoing chronic treatment. Methods. We measured brachial artery flow-mediated dilation (FMD), plasma lipids, vitamin E (α- and γ-tocopherol), markers of oxidative/nitrative stress (malondialdehyde (MDA) and nitro-γ-tocopherol (NGT)), and regulators of NO metabolism (arginine (ARG) and asymmetric dimethylarginine (ADMA)) prior to (Pre) and immediately following (Post) LDL apheresis and at 1, 3, 7, and 14 d Post in 5 hypercholesterolemic patients (52 ± 11 y). Results. Relative to Pre, total cholesterol (7.8 ± 1.5 mmol/L) and LDL-cholesterol (6.2 ± 1.2 mmol/L) were 61% and 70% lower (P < 0.01), respectively, at Post and returned to Pre levels at 14 d. Brachial FMD responses (6.9 ± 3.6%) and plasma MDA, ARG, and ADMA concentrations were unaffected by LDL apheresis. Plasma α-tocopherol, γ-tocopherol, and NGT concentrations were 52-69% lower at Post (P < 0.01), and α-tocopherol remained 36% lower at 1 d whereas NGT remained 41% lower at d 3. Conclusions. Acute cholesterol reduction by LDL apheresis does not alter VEF, oxidative stress, or NO homeostasis in patients treated chronically for hypercholesterolemia.

Research paper thumbnail of The blood pressure response to acute and chronic exercise in chronic kidney disease

Nephrology (Carlton, Vic.), Jan 20, 2016

The current study was designed to determine if a relationship exists between acute and chronic bl... more The current study was designed to determine if a relationship exists between acute and chronic blood pressure responses to aerobic exercise in pre-dialysis patients. Pre-dialysis kidney patients attended 4 sessions before being randomized to the treatment (n=25) or control group ( n=21). In session 1, resting blood pressure was recorded and these measurements were repeated during the second visit when peak oxygen uptake (VO 2peak ) was assessed. In the third and fourth sessions blood pressures were taken prior to a 40-min walk or period of seated rest. After the 40-min walk or seated rest, blood pressures were monitored for 60 min in the laboratory and for the subsequent 24 hours. After session 4, subjects in the treatment group trained aerobically at a moderate intensity, three times per week for 16 weeks. Control subjects were asked to be sedentary. All measurements were repeated after 16 weeks of training or sedentary living. Training increased VO 2peak (ml/kg/min) in the treatme...

Research paper thumbnail of Short-term cessation of statin therapy does not alter aerobic exercise performance in physically active middle-aged adults

The Physician and sportsmedicine, Jan 7, 2016

Physically active adults may be especially vulnerable to the adverse muscular side effects of sta... more Physically active adults may be especially vulnerable to the adverse muscular side effects of statins. We determined if short-term cessation of statin therapy would improve aerobic exercise performance in middle-aged adults engaged in regular aerobic exercise training. Physically active middle-aged adults on statin therapy ≥6 mo (n = 16; 58 ± 10 y) or not taking lipid-lowering medications (controls) (n = 19; 51 ± 9 y) completed a peak oxygen consumption (VO2peak) and time to exhaustion test on a cycle ergometer 2-7 d apart. Tests were repeated following 1 mo of statin cessation or a 1 mo period for controls. Questionnaires were administered to assess exercise history and muscle complaints. Statin users reported little or no muscle complaints and participation in aerobic exercise was similar between groups (p≥0.13). The lower VO2peak (37.3 ± 9.0 vs. 43.1 ± 4.9 ml/kg/min; p = 0.02) and time to exhaustion (21.9 ± 4.4 vs. 26.0 ± 6.3 min; p = 0.04) in statin users versus controls did not...

Research paper thumbnail of High-Dose versus Low-Dose Vitamin D Supplementation and Arterial Stiffness among Individuals with Prehypertension and Vitamin D Deficiency

Disease markers, 2015

Introduction. Vitamin D deficiency is associated with the onset and progression of hypertension a... more Introduction. Vitamin D deficiency is associated with the onset and progression of hypertension and cardiovascular disease (CVD). However, mechanisms underlying vitamin D deficiency-mediated increased risk of CVD remain unknown. We sought to examine the differential effect of high-dose versus low-dose vitamin D supplementation on markers of arterial stiffness among ~40 vitamin D deficient adults with prehypertension. Methods. Participants were randomized to high-dose (4000 IU/d) versus low-dose (400 IU/d) oral vitamin D3 for 6 months. 24 hr ambulatory blood pressure (BP), carotid-femoral pulse wave velocity, and pulse wave analyses were obtained at baseline and after 6 months of vitamin D supplementation. Results. There were no changes in resting BP or pulse wave velocity over 6 mo regardless of vitamin D dose (all p…

Research paper thumbnail of Relationships between physical activity and muscular strength among healthy adults across the lifespan

SpringerPlus, 2015

The purpose of this study was to examine relationships between objective and self-report measures... more The purpose of this study was to examine relationships between objective and self-report measures of physical activity and muscle strength among healthy adults ranging in age from 20 to 91 years. Participants (n = 412) were mostly Caucasian men (48 %) and women (52 %) 43.9 ± 16.1 year of age with a body mass index (BMI) of 26.4 ± 4.8 kg/m(2). Physical activity was measured objectively with an accelerometer and by self-report with the Paffenbarger Physical Activity Questionnaire. Upper and lower body muscle strength were measured with an isokinetic dynamometer and handgrip strength with a static dynamometer. Multivariate regression assessed relationships between physical activity and muscle strength. The strongest correlates of upper body strength including handgrip strength were gender (r = -0.861 to -0.716), age (r = -0.445 to -0.241), BMI (r = 0.134-0.397), and physical activity (r = 0.093-0.186). The strongest correlates of lower body strength were gender (r = -0.772 to -0.634), age (r = -0.663 to -0.445), BMI (r = 0.160-0.266), and physical activity (r = -0.139 to 0.151). The strongest correlates of muscle strength were gender (explaining 40-74 % of the variance), age (6-44 %), and BMI (2-16 %), while physical activity correlations were weaker (1-3 %). Conflict surrounding the influence of a physically active lifestyle on muscle strength with age may be due to the stronger influences of other factors that supersede those of physical activity whether measured objectively or by self-report methods.

Research paper thumbnail of Effect of Simvastatin on Arterial Stiffness in Patients with Statin Myalgia

Advances in preventive medicine, 2015

Statins reduce arterial stiffness but are also associated with mild muscle complaints. It is uncl... more Statins reduce arterial stiffness but are also associated with mild muscle complaints. It is unclear whether individuals with muscle symptoms experience the same vascular benefit or whether statins affect striated and smooth muscle cells differently. We examined the effect of simvastatin treatment on arterial stiffness in patients who did versus those who did not exhibit muscle symptoms. Patients with a history of statin-related muscle complaints (n = 115) completed an 8 wk randomized, double-blind, cross-over trial of daily simvastatin 20 mg and placebo. Serum lipids and pulse wave velocity (PWV) were assessed before and after each treatment. Muscle symptoms with daily simvastatin treatment were reported by 38 patients (33%). Compared to baseline, central PWV decreased (P = 0.01) following simvastatin treatment but not placebo (drug ∗ time interaction: P = 0.047). Changes in central PWV with simvastatin treatment were not influenced by myalgia status or time on simvastatin (P ≥ 0.1...

Research paper thumbnail of The effect of compression socks worn during a marathon on hemostatic balance

The Physician and sportsmedicine, Jan 25, 2015

Marathon running evokes parallel increases in markers of coagulation and fibrinolysis (i.e. hemos... more Marathon running evokes parallel increases in markers of coagulation and fibrinolysis (i.e. hemostatic activation) immediately following strenuous, endurance exercise such that hemostatic balance is maintained. However, other factors incident to marathon running (i.e. dehydration, travel) may disproportionately activate the coagulatory system, increasing blood clot risk after an endurance event in otherwise healthy individuals. We investigated the effect of compression socks on exercise-induced hemostatic activation and balance in endurance athletes running the 2013 Hartford Marathon. Adults (n = 20) were divided into compression sock (SOCK; n = 10) and control (CONTROL; n = 10) groups. Age, anthropometrics, vital signs, training mileage and finishing time were collected. Venous blood samples were collected 1 day before, immediately after and 1 day following the marathon for analysis of coagulatory (i.e. thrombin-antithrombin complex [TAT] and D-dimer) and fibrinolytic (i.e. tissue ...

Research paper thumbnail of Atorvastatin Treatment Does Not Alter Pulse Wave Velocity in Healthy Adults

International Scholarly Research Notices, 2014

Introduction. Both statins and regular physical activity (PA) reduce arterial stiffness. The pres... more Introduction. Both statins and regular physical activity (PA) reduce arterial stiffness. The present post hoc analysis examined if arterial stiffness was improved with high-dose atorvastatin treatment in healthy adults and whether PA levels magnified this response. We utilized data from a double-blind, random-assignment clinical trial investigating the effects of atorvastatin 80 mg/d for 6 mo on skeletal muscle symptoms. Methods. Central and peripheral arterial pulse wave velocity (PWV) were measured and PA levels assessed at baseline and 6 mo in subjects randomized to atorvastatin ( = 21, 9 men) or placebo ( = 29, 16 men). Results. Baseline participant characteristics, PWV, and PA levels were not different between treatments. Central (means ± SD; 8.7 ± 2.6 to 9.0 ± 2.5 m/sec) and peripheral PWV (9.9 ± 1.3 to 9.8 ± 1.6 m/sec) were unchanged from baseline following atorvastatin treatment (time × drug interaction: ≥ 0.13). Similarly, PA levels were unaffected by time or treatment. In sex and age adjusted models, baseline levels of PA were not related to changes in PWV with atorvastatin treatment. Conclusion. These data indicate that highdose atorvastatin treatment for 6 mo does not influence arterial stiffness in healthy adults. Participation in habitual PA did not magnify the vascular effects of statin therapy. This study was registered with ClinicalTrials.gov NCT00609063.

Research paper thumbnail of Does endometrial injury improve implantation of frozen–thawed embryos?

Archives of Gynecology and Obstetrics, 2014

To investigate whether endometrial injury (EI) increases pregnancy rates in subjects undergoing f... more To investigate whether endometrial injury (EI) increases pregnancy rates in subjects undergoing frozen-thawed embryo transfer (FET) cycles. We conducted a prospective study of 80 consecutive subjects at a private fertility center. All women were undergoing frozen embryo transfer after one or more unsuccessful in vitro fertilization and embryo transfer cycle(s). Subjects in the experimental group underwent endometrial biopsy in the luteal phase of the cycle preceding the frozen embryo transfer cycle. The primary outcomes were chemical and clinical pregnancy rates. The 40 subjects who underwent EI in the cycle preceding their FET cycle were compared with 40 controls. There were differences in the groups' baseline characteristics; the average age was slightly higher and the duration of infertility was longer in the EI group. Chemical pregnancy rates between the two groups were similar, 27 % (range 17-40 %) in the injury group and 26 % (16-40 %) in the control group (OR for chemical pregnancy = 1.05, 95 % CI 0.42-2.12). The difference in clinical pregnancy rate was not statistically significant: 40 % (25-57 %) in the injury group versus 33 % (19-49 %) in the control group (OR for clinical pregnancy = 1.38, 95 % CI 0.55-3.46). Based on the results of this pilot study, EI in the luteal phase of the cycle preceding the frozen embryo transfer cycle does not appear to significantly improve implantation or clinical pregnancy rates.

Research paper thumbnail of Changes in Muscle Strength in Patients With Statin Myalgia

The American Journal of Cardiology, 2014

Statins can produce myalgia or muscle pain, which may affect medication adherence. We measured th... more Statins can produce myalgia or muscle pain, which may affect medication adherence. We measured the effects of statins on muscle strength in patients with previous statin myalgia. Leg isokinetic extension average power at 60° per second (-8.8 ± 10.5N-M, p = 0.02) and average peak torque at 60° per second (-14.0 ± 19.7N-M, p = 0.04) decreased slightly with statin use, but 8 of 10 other variables for leg strength did not change (all p >0.13). Handgrip, muscle pain, respiratory exchange ratio, and daily activity also did not change (all p >0.09). In conclusion, statin myalgia is not associated with reduced muscle strength or muscle performance.

Research paper thumbnail of Greater γ-tocopherol status during acute smoking abstinence with nicotine replacement therapy improved vascular endothelial function by decreasing 8-iso-15(S)-prostaglandin F2α

Experimental biology and medicine (Maywood, N.J.), Jan 30, 2014

Nicotine replacement therapy (NRT) improves the long-term success rate of smoking cessation, but ... more Nicotine replacement therapy (NRT) improves the long-term success rate of smoking cessation, but induces oxidative stress and inflammatory responses that may delay the restoration of vascular endothelial function (VEF). No studies have examined co-therapy of NRT-assisted smoking abstinence with γ-tocopherol (γ-T), a vitamin E form with antioxidant and anti-inflammatory activities, on improvements in VEF. In a randomized, double-blind, placebo-controlled study, healthy smokers (25 ± 1 y old; mean ± SEM) received NRT and abstained from smoking for 24 h with placebo (n = 12) or oral administration of γ-T-rich mixture of tocopherols (γ-TmT; n = 11) that provided 500 mg γ-T. Brachial artery flow-mediated dilation (FMD), and biomarkers of nitric oxide metabolism, antioxidant status, inflammation, and lipid peroxidation [8-iso-prostaglandin F2α stereoisomers (8-iso-15(R)-PGF2α and 8-iso-15(S)-PGF2α)] were measured prior to and after 24 h of smoking abstinence. Smoking abstinence with NRT r...

Research paper thumbnail of American Society for Parenteral and Enteral Nutrition and Academy of Nutrition and Dietetics: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in nutrition support

Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 2014

This 2014 revision of the Standards of Practice (SOP) and Standards of Professional Performance (... more This 2014 revision of the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for Registered Dietitians Nutritionists (RDNs) in Nutrition Support represents an update of the 2007 Standards composed by content experts of the American Society for Parenteral and Enteral Nutrition and the Academy of Nutrition and Dietetics. The revision is based upon the Revised 2012 SOP in Nutrition Care and SOPP for RDs, which incorporates the Nutrition Care Process and the six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. These SOP and SOPP are designed to promote the provision of safe, effective, and efficient nutrition support services, facilitate evidence-based practice, and serve as a professional evaluation resource for RDNs who specialize or wish to specialize in nutrition support therapy. These standa...

Research paper thumbnail of Serum PCSK9 Levels Distinguish Individuals Who Do Not Respond to High-Dose Statin Therapy with the Expected Reduction in LDL-C

Journal of lipids, 2014

The purpose of the present report was to examine whether proprotein convertase subtilisin/kexin t... more The purpose of the present report was to examine whether proprotein convertase subtilisin/kexin type 9 (PCSK9) levels differ in individuals who do not exhibit expected reductions in low density lipoprotein cholesterol (LDL-C) with statin therapy. Eighteen nonresponder subjects treated with 80 mg atorvastatin treatment for 6 months without substantial reductions in LDL-C (ΔLDL-C: 2.6 ± 11.4%) were compared to age- and gender-matched atorvastatin responders (ΔLDL-C: 50.7 ± 8.5%) and placebo-treated subjects (ΔLDL-C: 9.9 ± 21.5%). Free PCSK9 was marginally higher in nonresponders at baseline (P = 0.07) and significantly higher in atorvastatin responders after 6 months of treatment (P = 0.04). The change in free PCSK9 over 6 months with statin treatment was higher (P < 0.01) in atorvastatin responders (134.2 ± 131.5 ng/mL post- versus prestudy) than in either the nonresponders (39.9 ± 87.8 ng/mL) or placebo subjects (27.8 ± 97.6 ng/mL). Drug compliance was not lower in the nonrespond...

Research paper thumbnail of Coming of Age: Considerations in the Prescription of Exercise for Older Adults

Methodist DeBakey cardiovascular journal

Older adults represent the fastest-growing age demographic of the population. Physiological chang... more Older adults represent the fastest-growing age demographic of the population. Physiological changes associated with primary aging and concurrent chronic disease adversely impact functional capacity, health outcomes, and quality of life. For these reasons, there is a national emphasis for healthcare providers to improve the health, function, and quality of life of older adults to preserve independent living and psychological well-being. The benefits of regular physical activity or exercise with regard to aging and disease are indisputable, yet many clinicians do not prescribe exercise to older adults. This reluctance may be attributable to a lack of knowledge regarding appropriate exercise prescription for older adults in light of the potential risks and benefits of various doses and types of exercise. In addition, clinicians and patients may have concerns about potential health considerations relevant to older adults such as comprehensive pre-exercise screening and exercise-drug int...

Research paper thumbnail of Comparison of the Clinical Determinants of the Blood Pressure Response Following Two Different Exercise Modalities

Medicine & Science in Sports & Exercise, 2015

Research paper thumbnail of Efficacy and Safety of an Insulin Infusion Protocol in a Surgical ICU

Data Revues 10727515 V202i1 S107275150501519x, Sep 8, 2011

Research paper thumbnail of Resting Blood Pressure and Muscle Strength in Healthy Men and Women: 916 Board #232 June 1, 2: 00 PM - 3: 30 PM

Medicine and science in sports and exercise, 2016

Research paper thumbnail of Deep-Targeted Exon Sequencing Reveals Angiotensinogen (AGT) loci on Chr 1q42.2 Associate with Postexercise Hypotension among Caucasians: 3657 Board #96 June 4, 9: 30 AM - 11: 00 AM

Medicine and science in sports and exercise, 2016

Research paper thumbnail of Urban Community Schools: Educator Perceptions of the Effects of Children's Health and Wellness on Learning

Current Issues in Education, Jan 27, 2014

Findings from a participatory action-research project that brought together 11 individuals from f... more Findings from a participatory action-research project that brought together 11 individuals from five of Hartford's seven community schools to engage in a focus group discussion about the effects of children's health and wellness on learning are presented. The researchers and key personnel from Hartford Public Schools and Achieve Hartford! coconstructed the inquiry. Issues identified as interfering with student learning clustered into themes that include students' and family members' mental, behavioral, nutritional, and domestic/neighborhood health. The results are being used to create a call for translational research proposals for University researchers to address these questions and disseminate findings to Hartford Public Schools and related community partners.

Research paper thumbnail of The Influence of ABO Blood Type on Hemostatic Activation Following A Marathon: 1400 Board #53 June 2, 8: 00 AM - 9: 30 AM

Medicine and science in sports and exercise, 2016

Research paper thumbnail of Single Low-Density Lipoprotein Apheresis Does Not Improve Vascular Endothelial Function in Chronically Treated Hypercholesterolemic Patients

International Journal of Vascular Medicine, 2016

Objective. To investigate vascular endothelial function (VEF) responses to a single low-density l... more Objective. To investigate vascular endothelial function (VEF) responses to a single low-density lipoprotein (LDL) apheresis session in hypercholesterolemic patients undergoing chronic treatment. Methods. We measured brachial artery flow-mediated dilation (FMD), plasma lipids, vitamin E (α- and γ-tocopherol), markers of oxidative/nitrative stress (malondialdehyde (MDA) and nitro-γ-tocopherol (NGT)), and regulators of NO metabolism (arginine (ARG) and asymmetric dimethylarginine (ADMA)) prior to (Pre) and immediately following (Post) LDL apheresis and at 1, 3, 7, and 14 d Post in 5 hypercholesterolemic patients (52 ± 11 y). Results. Relative to Pre, total cholesterol (7.8 ± 1.5 mmol/L) and LDL-cholesterol (6.2 ± 1.2 mmol/L) were 61% and 70% lower (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01), respectively, at Post and returned to Pre levels at 14 d. Brachial FMD responses (6.9 ± 3.6%) and plasma MDA, ARG, and ADMA concentrations were unaffected by LDL apheresis. Plasma α-tocopherol, γ-tocopherol, and NGT concentrations were 52-69% lower at Post (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01), and α-tocopherol remained 36% lower at 1 d whereas NGT remained 41% lower at d 3. Conclusions. Acute cholesterol reduction by LDL apheresis does not alter VEF, oxidative stress, or NO homeostasis in patients treated chronically for hypercholesterolemia.

Research paper thumbnail of The blood pressure response to acute and chronic exercise in chronic kidney disease

Nephrology (Carlton, Vic.), Jan 20, 2016

The current study was designed to determine if a relationship exists between acute and chronic bl... more The current study was designed to determine if a relationship exists between acute and chronic blood pressure responses to aerobic exercise in pre-dialysis patients. Pre-dialysis kidney patients attended 4 sessions before being randomized to the treatment (n=25) or control group ( n=21). In session 1, resting blood pressure was recorded and these measurements were repeated during the second visit when peak oxygen uptake (VO 2peak ) was assessed. In the third and fourth sessions blood pressures were taken prior to a 40-min walk or period of seated rest. After the 40-min walk or seated rest, blood pressures were monitored for 60 min in the laboratory and for the subsequent 24 hours. After session 4, subjects in the treatment group trained aerobically at a moderate intensity, three times per week for 16 weeks. Control subjects were asked to be sedentary. All measurements were repeated after 16 weeks of training or sedentary living. Training increased VO 2peak (ml/kg/min) in the treatme...

Research paper thumbnail of Short-term cessation of statin therapy does not alter aerobic exercise performance in physically active middle-aged adults

The Physician and sportsmedicine, Jan 7, 2016

Physically active adults may be especially vulnerable to the adverse muscular side effects of sta... more Physically active adults may be especially vulnerable to the adverse muscular side effects of statins. We determined if short-term cessation of statin therapy would improve aerobic exercise performance in middle-aged adults engaged in regular aerobic exercise training. Physically active middle-aged adults on statin therapy ≥6 mo (n = 16; 58 ± 10 y) or not taking lipid-lowering medications (controls) (n = 19; 51 ± 9 y) completed a peak oxygen consumption (VO2peak) and time to exhaustion test on a cycle ergometer 2-7 d apart. Tests were repeated following 1 mo of statin cessation or a 1 mo period for controls. Questionnaires were administered to assess exercise history and muscle complaints. Statin users reported little or no muscle complaints and participation in aerobic exercise was similar between groups (p≥0.13). The lower VO2peak (37.3 ± 9.0 vs. 43.1 ± 4.9 ml/kg/min; p = 0.02) and time to exhaustion (21.9 ± 4.4 vs. 26.0 ± 6.3 min; p = 0.04) in statin users versus controls did not...

Research paper thumbnail of High-Dose versus Low-Dose Vitamin D Supplementation and Arterial Stiffness among Individuals with Prehypertension and Vitamin D Deficiency

Disease markers, 2015

Introduction. Vitamin D deficiency is associated with the onset and progression of hypertension a... more Introduction. Vitamin D deficiency is associated with the onset and progression of hypertension and cardiovascular disease (CVD). However, mechanisms underlying vitamin D deficiency-mediated increased risk of CVD remain unknown. We sought to examine the differential effect of high-dose versus low-dose vitamin D supplementation on markers of arterial stiffness among ~40 vitamin D deficient adults with prehypertension. Methods. Participants were randomized to high-dose (4000 IU/d) versus low-dose (400 IU/d) oral vitamin D3 for 6 months. 24 hr ambulatory blood pressure (BP), carotid-femoral pulse wave velocity, and pulse wave analyses were obtained at baseline and after 6 months of vitamin D supplementation. Results. There were no changes in resting BP or pulse wave velocity over 6 mo regardless of vitamin D dose (all p…

Research paper thumbnail of Relationships between physical activity and muscular strength among healthy adults across the lifespan

SpringerPlus, 2015

The purpose of this study was to examine relationships between objective and self-report measures... more The purpose of this study was to examine relationships between objective and self-report measures of physical activity and muscle strength among healthy adults ranging in age from 20 to 91 years. Participants (n = 412) were mostly Caucasian men (48 %) and women (52 %) 43.9 ± 16.1 year of age with a body mass index (BMI) of 26.4 ± 4.8 kg/m(2). Physical activity was measured objectively with an accelerometer and by self-report with the Paffenbarger Physical Activity Questionnaire. Upper and lower body muscle strength were measured with an isokinetic dynamometer and handgrip strength with a static dynamometer. Multivariate regression assessed relationships between physical activity and muscle strength. The strongest correlates of upper body strength including handgrip strength were gender (r = -0.861 to -0.716), age (r = -0.445 to -0.241), BMI (r = 0.134-0.397), and physical activity (r = 0.093-0.186). The strongest correlates of lower body strength were gender (r = -0.772 to -0.634), age (r = -0.663 to -0.445), BMI (r = 0.160-0.266), and physical activity (r = -0.139 to 0.151). The strongest correlates of muscle strength were gender (explaining 40-74 % of the variance), age (6-44 %), and BMI (2-16 %), while physical activity correlations were weaker (1-3 %). Conflict surrounding the influence of a physically active lifestyle on muscle strength with age may be due to the stronger influences of other factors that supersede those of physical activity whether measured objectively or by self-report methods.

Research paper thumbnail of Effect of Simvastatin on Arterial Stiffness in Patients with Statin Myalgia

Advances in preventive medicine, 2015

Statins reduce arterial stiffness but are also associated with mild muscle complaints. It is uncl... more Statins reduce arterial stiffness but are also associated with mild muscle complaints. It is unclear whether individuals with muscle symptoms experience the same vascular benefit or whether statins affect striated and smooth muscle cells differently. We examined the effect of simvastatin treatment on arterial stiffness in patients who did versus those who did not exhibit muscle symptoms. Patients with a history of statin-related muscle complaints (n = 115) completed an 8 wk randomized, double-blind, cross-over trial of daily simvastatin 20 mg and placebo. Serum lipids and pulse wave velocity (PWV) were assessed before and after each treatment. Muscle symptoms with daily simvastatin treatment were reported by 38 patients (33%). Compared to baseline, central PWV decreased (P = 0.01) following simvastatin treatment but not placebo (drug ∗ time interaction: P = 0.047). Changes in central PWV with simvastatin treatment were not influenced by myalgia status or time on simvastatin (P ≥ 0.1...

Research paper thumbnail of The effect of compression socks worn during a marathon on hemostatic balance

The Physician and sportsmedicine, Jan 25, 2015

Marathon running evokes parallel increases in markers of coagulation and fibrinolysis (i.e. hemos... more Marathon running evokes parallel increases in markers of coagulation and fibrinolysis (i.e. hemostatic activation) immediately following strenuous, endurance exercise such that hemostatic balance is maintained. However, other factors incident to marathon running (i.e. dehydration, travel) may disproportionately activate the coagulatory system, increasing blood clot risk after an endurance event in otherwise healthy individuals. We investigated the effect of compression socks on exercise-induced hemostatic activation and balance in endurance athletes running the 2013 Hartford Marathon. Adults (n = 20) were divided into compression sock (SOCK; n = 10) and control (CONTROL; n = 10) groups. Age, anthropometrics, vital signs, training mileage and finishing time were collected. Venous blood samples were collected 1 day before, immediately after and 1 day following the marathon for analysis of coagulatory (i.e. thrombin-antithrombin complex [TAT] and D-dimer) and fibrinolytic (i.e. tissue ...

Research paper thumbnail of Atorvastatin Treatment Does Not Alter Pulse Wave Velocity in Healthy Adults

International Scholarly Research Notices, 2014

Introduction. Both statins and regular physical activity (PA) reduce arterial stiffness. The pres... more Introduction. Both statins and regular physical activity (PA) reduce arterial stiffness. The present post hoc analysis examined if arterial stiffness was improved with high-dose atorvastatin treatment in healthy adults and whether PA levels magnified this response. We utilized data from a double-blind, random-assignment clinical trial investigating the effects of atorvastatin 80 mg/d for 6 mo on skeletal muscle symptoms. Methods. Central and peripheral arterial pulse wave velocity (PWV) were measured and PA levels assessed at baseline and 6 mo in subjects randomized to atorvastatin ( = 21, 9 men) or placebo ( = 29, 16 men). Results. Baseline participant characteristics, PWV, and PA levels were not different between treatments. Central (means ± SD; 8.7 ± 2.6 to 9.0 ± 2.5 m/sec) and peripheral PWV (9.9 ± 1.3 to 9.8 ± 1.6 m/sec) were unchanged from baseline following atorvastatin treatment (time × drug interaction: ≥ 0.13). Similarly, PA levels were unaffected by time or treatment. In sex and age adjusted models, baseline levels of PA were not related to changes in PWV with atorvastatin treatment. Conclusion. These data indicate that highdose atorvastatin treatment for 6 mo does not influence arterial stiffness in healthy adults. Participation in habitual PA did not magnify the vascular effects of statin therapy. This study was registered with ClinicalTrials.gov NCT00609063.

Research paper thumbnail of Does endometrial injury improve implantation of frozen–thawed embryos?

Archives of Gynecology and Obstetrics, 2014

To investigate whether endometrial injury (EI) increases pregnancy rates in subjects undergoing f... more To investigate whether endometrial injury (EI) increases pregnancy rates in subjects undergoing frozen-thawed embryo transfer (FET) cycles. We conducted a prospective study of 80 consecutive subjects at a private fertility center. All women were undergoing frozen embryo transfer after one or more unsuccessful in vitro fertilization and embryo transfer cycle(s). Subjects in the experimental group underwent endometrial biopsy in the luteal phase of the cycle preceding the frozen embryo transfer cycle. The primary outcomes were chemical and clinical pregnancy rates. The 40 subjects who underwent EI in the cycle preceding their FET cycle were compared with 40 controls. There were differences in the groups&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; baseline characteristics; the average age was slightly higher and the duration of infertility was longer in the EI group. Chemical pregnancy rates between the two groups were similar, 27 % (range 17-40 %) in the injury group and 26 % (16-40 %) in the control group (OR for chemical pregnancy = 1.05, 95 % CI 0.42-2.12). The difference in clinical pregnancy rate was not statistically significant: 40 % (25-57 %) in the injury group versus 33 % (19-49 %) in the control group (OR for clinical pregnancy = 1.38, 95 % CI 0.55-3.46). Based on the results of this pilot study, EI in the luteal phase of the cycle preceding the frozen embryo transfer cycle does not appear to significantly improve implantation or clinical pregnancy rates.

Research paper thumbnail of Changes in Muscle Strength in Patients With Statin Myalgia

The American Journal of Cardiology, 2014

Statins can produce myalgia or muscle pain, which may affect medication adherence. We measured th... more Statins can produce myalgia or muscle pain, which may affect medication adherence. We measured the effects of statins on muscle strength in patients with previous statin myalgia. Leg isokinetic extension average power at 60° per second (-8.8 ± 10.5N-M, p = 0.02) and average peak torque at 60° per second (-14.0 ± 19.7N-M, p = 0.04) decreased slightly with statin use, but 8 of 10 other variables for leg strength did not change (all p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.13). Handgrip, muscle pain, respiratory exchange ratio, and daily activity also did not change (all p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.09). In conclusion, statin myalgia is not associated with reduced muscle strength or muscle performance.

Research paper thumbnail of Greater γ-tocopherol status during acute smoking abstinence with nicotine replacement therapy improved vascular endothelial function by decreasing 8-iso-15(S)-prostaglandin F2α

Experimental biology and medicine (Maywood, N.J.), Jan 30, 2014

Nicotine replacement therapy (NRT) improves the long-term success rate of smoking cessation, but ... more Nicotine replacement therapy (NRT) improves the long-term success rate of smoking cessation, but induces oxidative stress and inflammatory responses that may delay the restoration of vascular endothelial function (VEF). No studies have examined co-therapy of NRT-assisted smoking abstinence with γ-tocopherol (γ-T), a vitamin E form with antioxidant and anti-inflammatory activities, on improvements in VEF. In a randomized, double-blind, placebo-controlled study, healthy smokers (25 ± 1 y old; mean ± SEM) received NRT and abstained from smoking for 24 h with placebo (n = 12) or oral administration of γ-T-rich mixture of tocopherols (γ-TmT; n = 11) that provided 500 mg γ-T. Brachial artery flow-mediated dilation (FMD), and biomarkers of nitric oxide metabolism, antioxidant status, inflammation, and lipid peroxidation [8-iso-prostaglandin F2α stereoisomers (8-iso-15(R)-PGF2α and 8-iso-15(S)-PGF2α)] were measured prior to and after 24 h of smoking abstinence. Smoking abstinence with NRT r...

Research paper thumbnail of American Society for Parenteral and Enteral Nutrition and Academy of Nutrition and Dietetics: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in nutrition support

Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 2014

This 2014 revision of the Standards of Practice (SOP) and Standards of Professional Performance (... more This 2014 revision of the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for Registered Dietitians Nutritionists (RDNs) in Nutrition Support represents an update of the 2007 Standards composed by content experts of the American Society for Parenteral and Enteral Nutrition and the Academy of Nutrition and Dietetics. The revision is based upon the Revised 2012 SOP in Nutrition Care and SOPP for RDs, which incorporates the Nutrition Care Process and the six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. These SOP and SOPP are designed to promote the provision of safe, effective, and efficient nutrition support services, facilitate evidence-based practice, and serve as a professional evaluation resource for RDNs who specialize or wish to specialize in nutrition support therapy. These standa...

Research paper thumbnail of Serum PCSK9 Levels Distinguish Individuals Who Do Not Respond to High-Dose Statin Therapy with the Expected Reduction in LDL-C

Journal of lipids, 2014

The purpose of the present report was to examine whether proprotein convertase subtilisin/kexin t... more The purpose of the present report was to examine whether proprotein convertase subtilisin/kexin type 9 (PCSK9) levels differ in individuals who do not exhibit expected reductions in low density lipoprotein cholesterol (LDL-C) with statin therapy. Eighteen nonresponder subjects treated with 80 mg atorvastatin treatment for 6 months without substantial reductions in LDL-C (ΔLDL-C: 2.6 ± 11.4%) were compared to age- and gender-matched atorvastatin responders (ΔLDL-C: 50.7 ± 8.5%) and placebo-treated subjects (ΔLDL-C: 9.9 ± 21.5%). Free PCSK9 was marginally higher in nonresponders at baseline (P = 0.07) and significantly higher in atorvastatin responders after 6 months of treatment (P = 0.04). The change in free PCSK9 over 6 months with statin treatment was higher (P < 0.01) in atorvastatin responders (134.2 ± 131.5 ng/mL post- versus prestudy) than in either the nonresponders (39.9 ± 87.8 ng/mL) or placebo subjects (27.8 ± 97.6 ng/mL). Drug compliance was not lower in the nonrespond...