Perceptions, expectations, and informal supports influence exercise activity in frail older adults

This study aims to explore frail older adults’ perceptions of what influences their exercise behaviors. A qualitative descriptive design was used. Semi-structured, open-ended interviews were conducted with 29 frail older adults. Thematic content analysis established the findings. Frail older adults perceive exercise as a by-product of other purposeful activities such as manual work or social activities. Progression into frailty appears to be associated with a decline in non-family support, changing traditional roles within family support networks, and lower baseline activity levels. Frail older adults perceive exercise as incidental to more purposeful activities rather than an endpoint in itself. Therefore, exercise programs concentrating on functional outcomes may be more relevant for this population. Strategies that educate and promote social support networks may also benefit frail older adults.

Functional application of lactic acid bacteria exopolysaccharide in complex food systems

Lactic acid bacteria expolysaccharides (LAB-EPS), in particular those formed from sucrose have the potential to improve food and beverage rheology and enhance their sensory properties potentially replacing or reducing expensive hydrocolloids currently used as improvers in food and beverage industries. Addition of sucrose not only enables EPS formation but also affects organic acid formation, thus influencing the sensory properties of the resulting food/beverage products. The first part of the study the organoleptic modulation of barley malt derived wort fermented using in situ produced bacterial polysaccharides has been investigated. Weisella cibaria MG1 was capable to produce exopolysaccharides during sucrosesupplemented barley malt derived wort fermentation. Even though the strain dominated the (sucrose-supplemented) wort fermentation, it was found to produce EPS (14.4 g l-1) with lower efficiency than in SucMRS (34.6 g l-1). Higher maltose concentration in wort led to the increased formation of oligosaccharide (OS) at the expense of EPS. Additionally, small amounts of organic acids were formed and ethanol remained below 0.5% (v/v). W. cibaria MG1 fermented worts supplemented with 5 or 10% sucrose displayed a shear-thinning behaviour indicating the formation of polymers. This report showed how novel and nutritious LAB fermented wort-base beverage with prospects for further advancements can be formulated using tailored microbial cultures. In the next step, the impact of exopolysaccharide-producing Weissella cibaria MG1 on the ability to improve rheological properties of fermented plant-based milk substitute plant based soy and quinoa grain was evaluated. W. cibaria MG1 grew well in soy milk, exceeding a cell count of log 8 cfu/g within 6 h of fermentation. The presence of W. cibaria MG1 led to a decrease in gelation and fermentation time. EPS isolated from soy yoghurts supplemented with sucrose were higher in molecular weight (1.1 x 108 g/mol vs 6.6 x 107 g/mol), and resulted in reduced gel stiffness (190 ± 2.89 Pa vs 244 ± 15.9 Pa). Soy yoghurts showed typical biopolymer gels structure and the network structure changed to larger pores and less cross-linking in the presence of sucrose and increasing molecular weight of the EPS. In situ investigation of Weissella cibaria MG1 producing EPS on quinoa-based milk was performed. The production of quinoa milk, starting from wholemeal quinoa flour, was optimised to maximise EPS production. On doing that, enzymatic destructuration of protein and carbohydrate components of quinoa milk was successfully achieved applying alpha-amylase and proteases treatments. Fermented wholemeal quinoa milk using Weissella cibaria MG1 showed high viable cell counts (>109 cfu/mL), a pH of 5.16, and significantly higher water holding capacity (WHC, 100 %), viscosity (> 0. 5 Pa s) and exopolysaccharide (EPS) amount (40 mg/L) than the chemically acidified control. High EPS (dextran) concentration in quinoa milk caused earlier aggregation because more EPS occupy more space, and the chenopodin were forced to interact with each other. Direct observation of microstructure in fermented quinoa milk indicated that the network structures of EPS-protein could improve the texture of fermented quinoa milk. Overall, Weissella cibaria MG1 showed favorable technology properties and great potential for further possible application in the development of high viscosity fermented quinoa milk. The last part of the study investigate the ex-situ LAB-EPS (dextran) application compared to other hydrocolloids as a novel food ingredient to compensate for low protein in biscuit and wholemeal wheat flour. Three hydrocolloids, xanthan gum, dextran and hydroxypropyl methylcellulose, were incorporated into bread recipes based on high-protein flours, low-protein flours and coarse wholemeal flour. Hydrocolloid levels of 0–5 % (flour basis) were used in bread recipes to test the water absorption. The quality parameters of dough (farinograph, extensograph, rheofermentometre) and bread (specific volume, crumb structure and staling profile) were determined. Results showed that xanthan had negative impact on the dough and bread quality characteristics. HPMC and dextran generally improved dough and bread quality and showed dosage dependence. Volume of low-protein flour breads were significantly improved by incorporation of 0.5 % of the latter two hydrocolloids. However, dextran outperformed HPMC regarding initial bread hardness and staling shelf life regardless the flour applied in the formulation.

A study protocol of a randomised controlled trial to measure the effects of an augmented prescribed exercise programme (APEP) for frail older medical patients in the acute setting

Background: Older adults experience functional decline in hospital leading to increased healthcare burden and morbidity. The benefits of augmented exercise in hospital remain uncertain. The aim of this trial is to measure the short and longer-term effects of augmented exercise for older medical in-patients on their physical performance, quality of life and health care utilisation. Design and Methods: Two hundred and twenty older medical patients will be blindly randomly allocated to the intervention or sham groups. Both groups will receive usual care (including routine physiotherapy care) augmented by two daily exercise sessions. The sham group will receive stretching and relaxation exercises while the intervention group will receive tailored strengthening and balance exercises. Differences between groups will be measured at baseline, discharge, and three months. The primary outcome measure will be length of stay. The secondary outcome measures will be healthcare utilisation, activity (accelerometry), physical performance (Short Physical Performance Battery), falls history in hospital and quality of life (EQ-5D-5 L). Discussion: This simple intervention has the potential to transform the outcomes of the older patient in the acute setting.

Impact of exercise on innate immunity in multiple sclerosis progression and symptomatology

Multiple Sclerosis (MS), an idiopathic progressive immune-mediated neurological disorder of the central nervous system (CNS), is characterized by recurrent episodes of inflammatory demyelination and consequent axonal deterioration. It accounts for functional deterioration and lasting disability among young adults. A body of literature demonstrates that physical activity counteracts fatigue and depression and may improve overall quality of life in MS patients. Furthermore, much data indicates that exercise ameliorates chronic neuroinflammation and its related pathologies by tipping cytokine profiles toward an anti-inflammatory signature. Recent data has focused on the direct impact of exercise training on the innate immune system by targeting toll-like receptors (TLRs), signaling pattern recognition receptors that govern the innate immune response, shedding light on the physiological role of TLRs in health and disease. Indeed, TLRs continue to emerge as players in the neuroinflammatory processes underpinning MS. This review will highlight evidence that physical activity and exercise are potential immunomodulatory therapies, targeting innate signaling mechanism(s) to modulate MS symptom development and progression.