Journal of Exercise & Organ Cross Talk

Abstract This study investigated the effects of intense endurance training (HIET) combined with egg white and wheat germ supplementation on immune, respiratory, and cardiopulmonary function in endurance runners. In this quasi-experimental study, 24 male endurance runners from Saqqez City were randomly assigned to either a training + supplement group (n=12) or a training + placebo group (n=12). Both groups underwent 8 weeks of HIET (3 sessions/week, 60 min/session, 70-90% heart rate reserve). The supplement group consumed 15g egg white powder (75 kcal) and 17.5g wheat germ powder (78 kcal) daily, approximately 2 hours before training. The placebo group received starch powder. Cardiopulmonary function (VO2max, FEV1), cardiac biomarkers (NT-proBNP, left ventricular stroke volume - LVSV), and inflammatory markers (IL-6) were assessed pre- and post-intervention. Data were analyzed using ANCOVA (SPSS v26, α=0.05), controlling for baseline values. Significant improvements were observed in the supplement group compared to the placebo group for VO2max (F(1,21)=29.482, p<0.001, η²=0.510) and FEV1 (F(1,21)=60.308, p<0.001, η²=0.742). IL-6 levels decreased significantly in the supplement group relative to the placebo group, which showed an increase (F(1,21)=7.848, p=0.011, η²=0.272). No significant between-group differences were found for NT-proBNP (F(1,21)=3.627, p=0.071, η²=0.147) or LVSV (F(1,21)=0.061, p=0.807, η²=0.003). Eight weeks of HIET combined with egg white and wheat germ supplementation significantly enhanced maximal oxygen consumption and expiratory function while attenuating exercise-induced inflammation in endurance runners, compared to HIET alone. These findings suggest potential benefits of this supplement combination for improving cardiopulmonary performance and modulating immune responses during intense endurance training.

Abstract NAFLD, a general term that describes several diseases caused by hepatic fat deposition such as hepatic steatosis (HS) and nonalcoholic steatohepatitis (NASH), includes the many conditions that are related to fat accumulation in the liver. Indeed, NAFLD is treated with a treatment plan consisting of weight loss, nutritional supplementation, and physical activity. Despite the lack of scientific research on diet and physical exercise, there is a paucity of evidence on NAFLD. The DASH and Mediterranean diets have been frequently used for treating cardiovascular metabolic risk factors, such as insulin resistance and type 2 diabetes mellitus (T2DM). In this study, an in-depth assessment of existing dietary and physical activity methods, involving Brazilian and other country-specific recommendations was conducted to determine their effect on the risk of nonalcoholic fatty liver disease (NAFLD).

Abstract Dear Editor-in-Chief
Overweight and obesity are considered as the most important lifestyle-related diseases today such that they are known as the fifth leading causes of death worldwide according to the published statistics. Moreover, as previous studies have shown, low-grade chronic inflammation is among the symptoms of these diseases and plays a key role in the pathogenesis of various physical problems and chronic diseases, such as cancer, diabetes, metabolic syndrome, cardiovascular, and neurodegenerative diseases (Safaei et al., 2021).
Meanwhile, new evidence suggests that leucine-rich α 2-glycoprotein 1 (LRG1) proinflammatory factor, an important upstream signaling pathway of transforming growth factor_⁃β (TGF_⁃β), will cause several pathological processes (Zou et al., 2022). In other words, it can be stated that LRG1, alone or in combination with other known factors, is considered as a potential biomarker for inflammation and obesity. There is a positive relationship between high levels of LRG1 and obesity, while low levels of plasma LRG1 predict weight loss in surgery for obesity and metabolic diseases (Pek et al., 2018). Investigation of the importance and the relationship of this issue in a broad study on 2,058 patients with type 2 diabetes showed that higher plasma LRG1 levels in women than men have a significant relationship with several risk factors for cardiovascular disease, namely arterial stiffness, endothelial dysfunction, systolic blood pressure, obesity, kidney disease, and high-sensitivity C-reactive protein (Pek et al., 2018; Zou et al., 2022). A recent 8-year longitudinal study also found that pigment epithelial-derived factor and plasma LRG1 mediated the inverse relationship between skeletal muscle mass and chronic kidney disease progression in patients with type 2 diabetes (Low et al., 2021). In other words, there is a positive correlation between high LRG1 levels in blood serum and adipose stores and high levels of body-mass-index (BMI), visceral adipose tissue, and waist circumference of obese people. According to these results and laboratory observations, LRG1 has been assumed to increase fat accumulation via suppression of fatty acids catabolism and inducing lipid biosynthesis through sterol regulatory element-binding transcription factor 1 activation or may enable hyperglycemia by decreasing expression of insulin receptor substrates (IRS1 and IRS2) (He et al., 2021).
On the other hand, consistent with the findings of studies showing the high serum levels of LRG1, it is possible that LRG1 binds preferentially to liver cells. With this assumption, LRG1 is considered a new adipokine that can play a role in obesity conditions by regulating an almost unique cross-talk between adipose tissue and the liver. More broad research is required to know whether LRG1 also exerts metabolic functions in physiological circumstances or not. However, the results of a study on LRG1 knockout mice with a high-fat diet revealed weight loss, smaller fat cell size, and preservation of brown adipose tissue in this type of mice. In other words, an increase in LRG1 gene expression during the process of fat lipogenesis can play an important role in regulating energy homeostasis (He et al., 2021; MacCannell et al., 2021). However, changing lifestyle by performing regular physical activity and a balanced diet have been introduced as a useful solution to prevent obesity. In this regard, a recent study on the elderly with an average BMI of 34 ± 1 kg / m2 showed that exercise combined with diet resulted in an 8-10 % weight loss in these individuals, indicating the possibility that molecular changes in peroxisome proliferator-activated receptor γ (PPARγ) coactivator 1α (PGC-1α) pathway can help transport fat and oxidize it in the skeletal muscles of older and obese people and in some ways regulate insulin resistance (Mulya et al., 2017).
Previous research studies have referred to the key role of PGC-1α in regulating mitochondrial function and helping regulate cellular energy status by enabling cellular energy in conditions 
when the body needs energy, such as fasting, performing exercise activities, or inhibiting it when the body has enough energy available. However, the evidence obtained regarding the role of PGC-1α and its relationship with LRG1 gene expression in obesity therapy showed that LRG1 expression in white adipose tissue reduced in mice model of insulin - resistant type II diabetes and obesity following treatment with PPARγ agonists (Muise et al., 2008). Moreover, evidence regarding the positive effects of exercise activity and the role of PGC-1α showed that probably five proteins, including interleukin 15 (IL-15), fibronectin type III domain- containing protein 5 (FNDC5), vascular endothelial growth factor B (VEGF-B), LRG1, and tissue inhibitor of metalloproteinase 4 (TIMP4), secreted in skeletal muscles, increase following endurance exercise activity and contribute to longevity as well (Boström et al., 2012).
Considering the evidence presented, LRG1 seems to play a key role in the pathogenesis of obesity. However, more broad research is required to better understand its relationship with other transcription factors, vital signaling pathways in this process, as well as the important effect of type, intensity, and duration of exercise activity, and type of diet in regulating its expression and its regulatory role in cross-talk with other organs to prevent obesity (Yang et al., 2021). 

Abstract Sarcopenia, an age-associated phenomenon, is characterized by the reduced skeletal muscle mass and function. Research studies indicate that a wide range of factors can play a key role in the onset of muscle atrophy and its progression, especially during old age. However, the pathophysiology of this event is not well understood and there are many unresolved issues yet. Performing different training methods (aerobic, resistance, and concurrent) is among the strategies that may be beneficial for the prevention and improvement of sarcopenia by affecting the signaling pathways of muscle cells. On the other hand, the way in which this type of training affects the signaling pathways involved in sarcopenia has not been well understood. Even the previous research has been incapable of well introducing an effective training method for the elderly at risk for sarcopenia. Generally, in this review article, we investigate and summarize the important and key mechanisms that may contribute to sarcopenia. In the following, we have examined the effect of regular physical activity on cellular signaling pathways involved in sarcopenia, as well as the usefulness of aerobic, resistance, and concurrent activities in adaptation and prevention of the pathology of sarcopenia in the elderly.

Abstract The COVID-19 epidemic has caused lifestyle changes in people from all walks of life and has become a global threat to the health and well-being of all countries of the world. Considering changes caused by the prevalence of the disease and quarantine conditions, the increased likelihood of the prevalence of overweight and obesity in people is among these threats. On the other hand, patients with overweight and obesity, and consequently, non-alcoholic fatty liver disease (NAFLD) have a weaker immune system than other people with ideal weight, and as a result, are more likely to develop COVID-19. As there is currently no definitive treatment for COVID-19 and NAFLD, and because people with NAFLD are more likely to develop COVID-19 based on the research in this area, paying attention to this important issue is thus necessary. Considering a regular physical activity program and having a balanced diet are among the essential strategies and may help prevent NAFLD, and consequently, COVID-19. However, given the novelty of COVID-19 pathogen and the ambiguity of the exact cause of why people get NAFLD, further research is needed to be done on the type of effective diet, as well as the type, intensity, and volume of exercise for these people. This study aimed to summarize the available evidence on the pathology and epidemiology of NAFLDs and COVID-19, as well as the effect of NAFLD on COVID-19 in people. Given the existing risks, the nutrition and exercise strategies were investigated in this regard.