Journal of Exercise & Organ Cross Talk

Abstract Western diet (WD) consumption promotes oxidative stress and inflammation and plays a central role in the development of fatty liver disease. This study investigated the effects of high-intensity interval training (HIIT), ketone ester supplementation, and their combination on hepatic Keap1, Nrf2, and NF-κB protein levels in WD-fed mice. Thirty male C57BL/6J mice were randomly assigned to five groups (n=6): normal diet (ND), WD, WD plus ketone ester (WD+KE), WD plus HIIT (WD+HIIT), and WD plus HIIT combined with ketone ester supplementation (WD+HIIT+KE). Except for the ND group, all animals consumed a WD for eight weeks. HIIT was performed for four weeks (three sessions/week), and ketone ester was administered daily by oral gavage. Hepatic protein levels of Keap1, Nrf2, and NF-κB were determined using Western blotting. WD feeding significantly increased hepatic Keap1 and NF-κB protein levels and reduced Nrf2 levels compared with the ND group. HIIT and ketone ester, both independently and in combination, significantly decreased NF-κB and increased Nrf2 protein levels compared with the WD group. In addition, HIIT alone and in combination with ketone ester supplementation significantly reduced hepatic Keap1 levels (p<0.05). Overall, both interventions alleviated WD-induced alterations in hepatic oxidative stress and inflammatory signaling. The combined intervention elicited the most pronounced molecular responses, suggesting potential synergistic effects of HIIT and ketone ester supplementation in attenuating Western diet-induced oxidative stress and inflammation.

Abstract This study aimed to investigate the effects of two different resistance training protocols on TNF-α and adiponectin in young overweight men. Sixty healthy overweight men (BMI ≥ 25 kg/m², age 20–30 years) were randomly assigned to three groups: Experimental Group 1 (EG1), Experimental Group 2 (EG2), and Control Group (CG). EG1 performed the DeLorme-Watkins protocol, consisting of 3 sets of 10 repetitions at 50%, 75%, and 100% of 10RM, while EG2 performed HIPT, consisting of 3 sets (set 1: 6 repetitions at 70% of 1RM; set 2: 4 repetitions at 80% of 1RM; set 3: 2 repetitions at 90% of 1RM). Training lasted 8 weeks. TNF-α and adiponectin levels were measured pre- and post-intervention. One-way ANOVA with Tukey post hoc tests and paired-samples t-tests were used to analyze inter- and intra-group differences (α≤0.05). TNF-α significantly decreased in EG1 (P = 0.04), while adiponectin levels significantly increased in both EG1 (P = 0.02) and EG2 (P = 0.03) at post-test compared to pre-test. Additionally, TNF-α levels were significantly lower in EG1 than in CG at post-test (P = 0.01). Both resistance training protocols exerted beneficial effects on inflammatory and anti-inflammatory markers, potentially contributing to cardiovascular disease prevention. However, the DeLorme-Watkins protocol resulted in a significantly greater reduction in TNF-α levels compared to HIPT, whereas no significant between-group difference was observed for adiponectin.

Abstract Type 2 diabetes in older adults is characterized by chronic low-grade inflammation and oxidative stress, with elevated interleukin-1β (IL-1β) and reduced superoxide dismutase (SOD) activity playing central roles in disease progression.  This study aimed to investigate the independent and combined effects of eight weeks of moderate-intensity aerobic exercise and NBS superfood supplementation on serum IL-1β and SOD levels in elderly men with type 2 diabetes. Forty older men (aged 60–75 years) with type 2 diabetes were randomly allocated using stratified block randomization to four groups (n=10 each): control, exercise-only (TR), supplement-only (SUP), and exercise + supplement (TR+SUP). The exercise groups performed supervised cycling at 60–70% Wmax, 30 min/session, 3 sessions/week for 8 weeks. The supplementation groups received 10 g/day NBS superfood. Fasting serum IL-1β and SOD were measured before and 48 hours after the intervention using ELISA. Two-way repeated-measures ANOVA revealed significant time × group interactions for both IL-1β (p<0.001, η²p=0.372) and SOD (p<0.001, η²p=0.892). Post-hoc tests showed the greatest reductions in IL-1β and largest increases in SOD occurred in the TR+SUP group compared to all other groups (p<0.001), indicating a synergistic effect. Eight weeks of moderate-intensity aerobic exercise combined with NBS superfood supplementation exerts potent synergistic anti-inflammatory and antioxidant effects in older men with type 2 diabetes, suggesting a promising non-pharmacological strategy for managing chronic inflammation and oxidative stress.

Abstract Obesity is a major risk factor for metabolic diseases. Subfatin, an adipokine with potential metabolic benefits, is of increasing interest. This study investigated the effects of eight weeks of Moderate-Intensity Interval Training (MIIT) on plasma subfatin levels and body composition in sedentary, obese, middle-aged women. Thirty sedentary women (aged 50-60 years; BMI >30 kg/m²) were purposively selected and randomly assigned to an experimental (n=15) or a control (n=15) group. The experimental group performed an eight-week MIIT program (three sessions/week) at an intensity of 50-75% of heart rate reserve, following the principle of progressive overload. The control group maintained their usual sedentary routine. Fasting plasma subfatin levels were measured via enzyme-linked immunosorbent assay (ELISA), and body composition indices (BMI, body fat percentage [BFP], waist-to-hip ratio [WHR]) were assessed pre- and post-intervention. The MIIT group exhibited a significant increase in plasma subfatin levels (p=0.016) and a significant decrease in BFP (p=0.01) compared to the control group. While positive trends were observed, no significant inter-group differences were found for BMI (p>0.05) or WHR (p=0.095). An eight-week MIIT program effectively elevated plasma subfatin concentration and reduced body fat percentage in sedentary, obese, middle-aged women. These results suggest that MIIT may be a valuable exercise strategy for improving adipokine profile and body composition in this population.

 
 


 

Abstract High blood pressure or hypertension has become the most common cardiovascular and renal risk factor among people around the world and is mainly associated with an inactive lifestyle and unhealthy diet. The aim of the present study was to investigate the effect of eight weeks of moderate-intensity interval training on plasma levels of FoxN1 and blood pressure indices in middle-aged men with hypertension. In the present quasi-experimental study, 32 middle-aged men with an age range of 50-60 years and with high blood pressure were purposefully selected and then randomly assigned to two control (n = 15) and experimental (n = 17) groups. The experimental group performed interval training for eight weeks with a frequency of three sessions per week and an intensity of 50-75% of heart rate reserve based on the principle of gradual overload, while the control group did not participate in any training program. Plasma levels of FoxN1 were measured by the ELISA protein assay. Systolic, diastolic and mean arterial blood pressure were also measured in the subjects of the two groups before and after the training period. to evaluation the normality of the data, the Shapiro-Wilk test was used, and the homogeneity of variances was assessed with the Levene test. The analysis of covariance (ANCOVA) test was also used to compare the variables in the two groups. The data were analyzed at a significance level of 0.05 and using SPSS-23 software. The results showed that eight weeks of moderate-intensity interval training led to a significant increase in FoxN1 (P < 0.05). Also, a significant decrease was observed in systolic blood pressure, diastolic blood pressure, and mean arterial blood pressure after eight weeks of interval training (P < 0.05). According to the results of the present study, it is recommended that people with high blood pressure perform moderate-intensity interval training to control blood pressure, reduce inflammation, and improve immune function.

Abstract Glioblastoma multiforme (GBM) exhibits dysregulated p53 tumor-suppressor signaling, driving therapeutic resistance; exercise and nutraceuticals represent promising adjuvants for pathway modulation. This study investigated resistance training and nanocurcumin in an orthotopic GBM rat model (n=40), with groups including healthy controls, cancer controls, nanocurcumin (80 mg/kg/day), resistance training (ladder climbing, 50% BW + 30g, 3×/week), and combined intervention. After 4 weeks, tumor tissue analysis revealed resistance training significantly reduced p53 mRNA expression versus cancer controls (1.8 ± 0.2 vs. 3.1 ± 0.3; p = 0.021), while all interventions suppressed p21 (combination group: 1.2 ± 0.1 vs. control 4.0 ± 0.4; p < 0.001), demonstrating 70% greater p21 inhibition in the combined group versus monotherapies (p < 0.01). The synergistic p21 downregulation indicates potent disruption of the G1/S cell-cycle checkpoint, likely mediated through inter-organ cross-talk along the muscle-liver-brain axis—where exercise-induced myokines (IL-6, BDNF) mitigate tumor oxidative stress, nanocurcumin suppresses hepatic inflammatory mediators, and hemodynamic adaptations enhance blood-brain barrier penetration. These findings position resistance training and nanocurcumin as a novel non-pharmacological adjuvant strategy to potentiate conventional glioma therapies by leveraging systemic physiological communication.

Abstract NAFLD is one of the chronic liver diseases closely related to metabolic disorders. Borage and physical activity improves oxidative indices. Also, Beclin-1 is a key gene in the autophagy process, and Parkin acts as a protective mechanism against liver damage. So, this study aims to investigate the effect of aerobic training and borage extract on the expression of Beclin-1 and Parkin genes in the liver cells in NAFLD. In this experimental study,40male Wistar rats weighing were divided into 4groups. (control, supplement, training), and training+supplement. The data were analyzed using SPSS 25 software. Training and borage extract had no significant effect on Beclin-1 expression (P=0.267), with fold changes of 1.05±0.07 for training, 1.07±0.06 for borage extract, and 1.12±0.08 for training+borage extract, compared to the control. However, Parkin expression increased significantly (P=0.006), with fold changes of 1.15±0.08 for Training, 1.18±0.09 for borage extract, and 1.20±0.10 for training+borage extract. Post hoc confirmed a significant increase in Parkin expression in the training+borage extract group compared to the control (P=0.035). This study showed that it is possible that the consumption of borage extract and aerobic training together and alone have an increasing the expression of Parkin. So, both borage extract and aerobic training have individual benefits for improving liver health by targeting Beclin-1 and PARKIN pathways, and their combination could provide a more robust approach to managing NAFLD by promoting effective autophagy, mitophagy, and mitochondrial function. This dual intervention could reduce liver damage, inflammation, and fibrosis, ultimately improving metabolic outcomes in individuals suffering from NAFLD.

Abstract Osteosarcopenic adiposity (OSA) syndrome significantly impacts hepatic disorders more than each of the tissues alone. The purpose of this study is to evaluate the effects of elastic resistance training modality on hepatic health markers, including fatty liver index (FLI), lipid accumulation product (LAP), hepatic steatosis index (HSI), and Framingham steatosis index (FSI)), in the elderly with OSA. Sixty-three eligible patients aged 60-80 years meet the inclusion criteria, including a) body fat percentage (BFP) ≥32%; b) body mass index (BMI) ≥30 kg/m²; c) T-score of L1-L4, and/or total femur or femoral neck -2.5≤T-score ≤-1.0; d) gait speed (10-meter walk test (10MWT) ≤1 (m/s²); and e) skeletal muscle index (SMI) ≤28% or ≤7.76 kg/m². The participants were randomly assigned to experimental (n=32) or control (n=31) groups. The experimental group completed a 12-week elastic-band resistance training program [3x/week; 60 min/session]. The results showed a statistically significant benefit from the elastic-band resistance training on LAP (P=0.033), FLI (P=0.001), HSI (P=0.008), and FSI (P=0.001). Our findings show that an elastic-band resistance exercise training program can improve hepatic function. This relatively low-cost, highly accessible form of exercise can be easily implemented to enhance the health of this population across a wide range of settings.

Abstract The aim of the present study is to investigate the effect of aerobic exercise and nano-curcumin supplementation on cardiac TGF-β1/TRAF6 and CTGF pathways in rat with brain tumors. Forty male Wistar rats were divided into 5 groups (n=8 in each) of healthy control, brain tumor, tumor + aerobic exercise (AE), tumor + nanocurcumin (N-CUR) and tumor+AE+N-CUR. Glioblastoma was injected into the rats in the frontal cortex. Nano curcumin supplement at the dose of 80 mg/kg was gavage for 4 weeks, 5 days a week. The training groups performed aerobic exercises on the treadmill for 4 weeks, 3 days a week at a speed of 18 meters per minute, for 25-40 minutes. At the end, the rats were sacrificed and TGF-β1, TRAF6, CTGF were analyzed from the myocardium by Real-time PCR method. Compared to the healthy control group, Tumor group significantly increased TGF-β1 mRNA and TRAF6 mRNA in the myocardium (p<0.05). Also, compared to the healthy control group, all tumor groups showed a significant increase in CTGF mRNA expression (p<0.05). In contrast to the Tumor group, the Tumor+AE and Tumor+AE+N-CUR groups showed a significant decrease in TGF-β1 mRNA at myocardium (p=0.0010 and p=0.0002, respectively). It seems that aerobic exercise or exercise with nano-curcumin supplement has better protective effects on the heart of tumor rats with downregulation of TGF-β1. It is suggested that different doses and various exercise modalities should be investigated to control cardiac fibrosis from the TGF-β1/TRAF6 and CTGF pathways.

Abstract While COVID-19 vaccines have reduced the prevalence of new viral strains, they are associated with side effects, including optic neuritis (ON). Developing effective management strategies, particularly non-pharmacological interventions, may improve outcomes for affected patients. This case study evaluated the effects of 8 weeks of yoga therapy in two male patients, aged 58 and 43, who developed ON two weeks post-vaccination. Assessments included visual field and color perception tests, the Balance Error Scoring System (BESS), the National Eye Institute Visual Function Questionnaire (NEI VFQ-25), and the Beck Depression Inventory II (BDI-II). Results from the yoga therapy patient were compared to a control case. The yoga therapy patient showed marked improvements: visual field enhancements of 48% (left eye) and 42% (right eye), a 53% increase in color perception, and a 31-turn improvement in the 6-Minute Walk Test. BESS errors reduced, heart rate recovery improved by 22 beats per minute, NEI VFQ-25 scores rose, and BDI-II scores declined. The control patient experienced no changes. Yoga therapy may complement pharmacological treatments for ON, offering benefits through anti-inflammatory effects, HPA axis modulation, and neuroprotective mechanisms that support remyelination. The integration of exercise and medication, termed "MedXercise," shows potential for managing vaccine-related side effects. Further research should explore varied exercise regimens to confirm these findings.

Abstract Cancer is regarded as one of the most cunning and perilous diseases globally. Numerous studies have emphasized the significance of exercise both prior to cancer diagnosis and after hospital discharge, in conjunction with various treatment approaches. However, the role of exercise during cancer itself remains an unresolved query. Oncology research reveals that three crucial factors for metastasis and tumor progression during cancer are lactate, platelets, and angiogenesis. Interestingly, exercise can also have a noteworthy impact on stimulating these three factors. In this brief review, our aim is to shed light on the potential appropriateness of exercise during cancer.

Abstract The covid-19 disease has spread all over the world since 2019 and many people have been affected by this disease. One of the main characteristics of this disease was lung tissue damage, which subsequently affected the immune system as well. In other words, since there are no registered drugs or vaccines against COVID-19, the immune system is the best defense because it supports the body's natural ability to defend against pathogens and resist infections. As long as the immune system is working normally, infections like COVID-19 cannot cause serious damage to the body. The three types of immunity are: innate immunity (fast response), adaptive immunity (slow response), and passive immunity. Strengthening the immune system can guarantee a better fight against pathogens. Exercising can help strengthen the immune system. In other words, exercise is one of the non-pharmacological factors for controlling diseases related to the immune system. Recently, it has been identified that exercise training with muscle contraction, the secretion of myokines in an endocrine form can affect all body tissues. One of the target tissues of myokines is the immune system. Therefore, this study deals with the strengthening role of the immune system due to exercise and muscle contraction in the conditions of the Covid-19 epidemic.

Abstract Intense exercise training is associated with Lung inflammation. Fasl protein on the cell surface is responsible for the initiation of the inflammatory response that finally leads to cell death at the site of inflammation, and can be interpreted as Fasl induced apoptosis. Therefore, the aim of this study was to investigate the effects of increasing and intense interval exercise training on Fasl levels of mature rat lungs. 30 rats within three weeks of birth with mean weight 68±9 g were randomly divided into three basic, control, and exercise groups. Increasing interval training for 6 sessions per week, each session 30 minutes at a speed of 15 to 70 meters per min was employed and Fasl levels were measured using the kitby Elisa method. The data were analyzed with two-way ANOVA and LSD test was done at p≤0.05 significant level. The results showed that Fasl protein levels in the interval training group compared to baseline group increased by 23.75 % and was significant (p≤0/05). However, although the amount of this protein in the interval training group compared to the control group was high, this value was not significant. In addition, Fasl protein levels in the control group compared to the baseline group increased by13.58 % and was significant (p≤0.05). The findings indicated that intense and prolonged exercise training causes damage of the respiratory tract, and in turn, leads to the increased levels of Fasl.

Abstract The present study was conducted to investigate the effect of six weeks of intermittent exercise and curcumin consumption on plasma Apo A and Apo B concentrations in male Wistar rats. 30 male Wistar rats were randomly divided into six groups (5 rats in each group): control, diabetic, healthy intermittent exercise, intermittent exercise diabetes, curcumin diabetes and curcumin exercise diabetes. Diabetes was induced by intraperitoneal injection of streptozotocin poison (50 mg/kg). Intermittent training consisted of 5-12 bouts of intense work (75 to 100% of maximum speed) of 60 seconds with active rest intervals of 75 seconds, six days a week for six weeks. Curcumin was fed to animals by gavage at a dose of 50 mg per kilogram of body weight. The results demonstrated that diabetes induction significantly decreased plasma Apo A concentration (p≤0.01) and increased plasma Apo B concentration (p≤0.01). Intermittent training caused a significant increase in Apo A and a significant decrease in Apo B plasma in diabetic rats. Also, it was found that six weeks of curcumin consumption significantly increased the concentration of Apo A in plasma and decreased the concentration of Apo B and the ratio of Apo B to Apo A (p≤0.01). At end, the results of the present study showed that intermittent exercise, curcumin and the combination of two interventions improve the disorders caused by diabetes in apolipoproteins.

Abstract Fat mass and obesity-associated gene (FTO) is directly associated with increased risk of obesity and type 2 diabetes mellitus (T2DM). The purpose of current study was to investigate the effect of 12 weeks of resistance training (RT) on FTO expression in subcutaneous adipose tissue, glucose, and insulin levels in T2DM rats. Sixteen males Wistar rats (220±10 gr) with T2DM induced by streptozotocin-nicotinamide injection were randomly assigned into resistance training (RT; n=8) and control (Con; n=8) groups. RT was performed for 12 weeks, 5 days per week. FTO expression in subcutaneous adipose tissue, fasting blood glucose (FBS), insulin and insulin resistance (HOMA-IR) were measured 48 hours after the last exercise training session.   After the exercise training intervention, the FTO expression (p=0.004) and FBS (p=0.001) were significantly lower in the RT compared to the Con group while the insulin in the RT was significantly higher than that in the Con group (p=0.001). There was no significant difference in the insulin resistance between the two groups (p˃0.05). According to findings, it seems that RT can decrease FBS and FTO expression in subcutaneous adipose tissue of T2DM rats. Improved blood glucose in diabetic rats might be partially attributed to reduced FTO expression in response to RT.   

Abstract The present study was conducted to investigate the effect of six weeks of intermittent exercise and curcumin consumption on the lipid profile of diabetic male rats. In an experimental trial, 30 male Wistar rats were randomly divided into six groups (5 rats in each group): control, diabetic, healthy intermittent exercise, intermittent exercise +diabetes, curcumin +diabetes and curcumin+ exercise +diabetes. Diabetes was induced by intraperitoneal injection of streptozotocin poison (50 mg/kg). Intermittent training consisted of 5-12 bouts of intense work (75 to 100% of maximum speed) of 60 seconds with active rest intervals of 75 seconds, six days a week for six weeks. Curcumin was fed to animals by gavage at a dose of 50 mg per kilogram of body weight. After six weeks, unconscious animals and blood samples were collected from their hearts. The data were analyzed using ANOVA statistical test and Bonferroni post hoc test. Induction of diabetes caused an increase in cholesterol, TG and LDL levels (P=0.01). Intermittent training and curcumin, each alone, caused them to decrease (P=0.01). In addition, diabetes decreased HDL while intermittent exercise increased it, but curcumin supplementation did not have a significant effect. The effect of combining interval training with curcumin supplement was significant only for TG and did not have a significant effect on other data. Exercise training and curcumin can have an anti-inflammatory effect with reducing lipid profile and increasing HDL in diabetic animal.

Abstract Omicron, a new type of SARS-CoV-2 was first reported by South Africa to the World Health Organization (WHO) on November 24, 2021. Two days after Africa was reported to the World Health Organization, the Omicron was identified as a global threat. Omicron has many genetic mutations, the potential effects of which are more dangerous than other SARS-CoV-2 genetic mutations. With the increase in vaccination in the world, the amount of physical activity to improve the functioning of the immune system decreased. Relying on vaccines alone cannot guarantee an improvement in the functioning of the immune system and the people of the world, given the lack of knowledge about the prevalence of omicron and its potential dangers, should look for ways to boost the immune system. In this study, we highlight the importance of increasing physical activity at the time of omicron outbreaks, along with the proposed protocols.

Abstract Steatosis is the most important cause for chronic liver disease, from simple steatosis to advanced stages such as liver fibrosis and cirrhosis and liver cancer. In this study, the effect of MICT and probiotic consumption on IL15 gene expression in animal model of non-alcoholic steatosis was examined. This study is an experimental laboratory study. Thirty-two male wistar rats were divided into 4 groups of 8 in the healthy (normal diet), steatosis, steatosis + probiotic, steatosis + probiotic +MICT groups and tested for 8 weeks. The exercise protocol was as follows: in the first week from 10 minutes of running at a speed of 18 meters per minute to the eighth week with 60 minutes of running at a speed of 28 meters per minute. Consumption of probiotics; Relevant groups received 109 CFU / ml of Lactobacillus rhamnosus GG by gavage daily for 5 weeks and 5 days a week. Statistical calculation of this study was performed using SPSS 25 software. Probiotic consumption and moderate-intensity continuous training significantly increased IL-15 (p =0.000) and significantly decreased TG (p =0.000) in the non-alcoholic steatosis animal model. It seems moderate-intensity continuous training with probiotic consumption can improve the liver function of non-alcoholic fatty liver patients.

Abstract The prevalence of obesity among children and adolescents is one of the most serious public health challenges of the 21st century. Implementing social distancing policy measures, such as the stay-at-home order, to control the spread of coronavirus disease 2019 (COVID-19) not only has affected lifestyles and weights in children but has also created an obesity-inducing environment, leading to modifications in the patterns of interactions between this age group and their surrounding environment. Therefore, the COVID-19 pandemic has been effective in childhood obesity and its prevalence rate may continue increasing. This narrative review aimed to synthesize evidence from global studies on physical inactivity, and obesity among children and adolescents during COVID-19, and then prescribe an evidence-based home exercise guideline for this age group. The study findings revealed that the COVID-19 restrictions have drastically multiplied physical inactivity and obesity in children. It has been further established that childhood obesity leads to numerous chronic diseases, including diabetes mellitus, cardiovascular diseases (CVDs), psychosomatic disorders, lung diseases, and other metabolic problems in childhood and even as children grow up. Physical activity/exercise at home during and after COVID-19 has been correspondingly demonstrated to mitigate the problems associated with obesity. A wide range of resistance, aerobic, balance, flexibility and other types of exercises have been accordingly shown to protect against the negative effects of the pandemic on child health. Hence, efforts to facilitate such exercises are suggested to continue and be scaled up to prevent childhood obesity and relevant diseases during and after this unusual period.

Abstract The purpose of this research was to conduct a systematic review and meta-analysis on the effect of exercise training on neurotrophin levels in obese and overweight individuals. The research evaluated the effect of exercise training on neurotrophins in the databases of PubMed, Science Direct, Scopus, and Google Scholar with identified keywords among papers published from 2000 onwards. After preliminary screening, full-text studies as well as critical evaluation of the papers meeting the inclusion criteria were analyzed. Finally, 12 studies entered systematic research, and 6 studies entered meta-analysis research. The results show that exercise training has an addictive effect on neurotrophin levels in obese individuals, but this addictive effect is not significant. The present meta-analyze shows that the brain -Derived Neurotrophic Factor (BDNF) response to exercise in obese individuals is increasing, but the increase is not significant (Difference in means = -0.42 pg/ml, P = 0.460). On the other hand, the Nerve Growth Factor (NGF) response to exercise is also increasing which is significant (Z = 2.12, P = 0.034).  Thus, it can be concluded that exercise cannot increase neurotrophins in obese and overweight individuals; although, further studies are needed in this area.

Abstract Despite numerous studies, the association between osteoporosis and aortic valve calcification is not clear. This study aimed to investigate the relationship between aortic valve calcification and osteoporosis in an Iranian population over 60. In this cross-sectional study, patients aged over 60 years referring to the Bone Mineral Densitometry center of Baqiyatallah Hospital (Tehran, Iran) during 2019-2020 were evaluated. Trans-thoracic echocardiography was done for all patients to evaluate the existence of aortic valve calcification. Patients were compared in two groups with and without osteoporosis (T-score < -2.5) as well as in two groups with and without aortic calcification. Two-hundred patients with a mean age of 65.92 ± 5.59 years and a mean body mass index (BMI) of 25.73 ± 4.08 kg/m2 were studied (84.5% female). Patients with osteoporosis (n=104) had lower BMI and greater frequency of aortic calcification compared to the patients without osteoporosis (n = 96). Patients with aortic calcification had higher age, lower BMI, and higher proportion of osteoporosis compared to the patients without aortic calcification (P<0.05). According to the results, it is suggested that elderly patients with osteoporosis and hypertension be evaluated for aortic valve calcification. This evaluation seems more crucial for older people with high blood pressure, lower BMI, and osteoporosis. Moreover, patients with aortic valve calcification could be evaluated for osteoporosis. Confirming the above results requires further investigation with a larger sample size.

Abstract Daily stair walking is a time-efficient everyday activity that improves cardiorespiratory fitness, muscle strength, body composition, blood pressure, lipid profiles, and is associated with a reduction in all-cause mortality. However, more than one in three adult Europeans is physically inactive in their everyday life and the exemplary current rate of stair walking in Germany is not known. Therefore, 2,521 people were monitored climbing the stairs or using a parallel escalator over a period of one week in an underground train station in Munich, Germany (January 3rd to 9th, 2022). 53.4% were women and 46.6% men, 30.7% (N = 774) were classified as obviously overweight-obese. 9.1% (N = 229) of all people counted used the ascending stairs - these were slightly more male than female and a total of 19 persons who were obviously overweight-obese. On two observation days, the pedestrians' mode of descent (stairs/escalator) was also recorded on 457 people, of whom 28% (N = 128) were categorized as obviously overweight-obese. With an equal gender distribution, 27.8% (N = 127) of the people counted used the descending stairs, including 22 obviously overweight-obese people. A very small proportion of adults used the stairs in our exemplary sample (every eleventh chose the stairs for ascent and every fourth chose the stairs for descent), which confirms the high development potential for promoting short repetitive bouts of non-exercise physical activity in everyday life - also for overweight-obese people. Internalize the mantra: Stairs are good friends and not enemies!

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 Dear Editor-in-Chief
 
Recently, telocytes (TCs) have been identified in various organs of the body, which are unique stromal cells (Manetti et al., 2019). Telopodes (very long and thin cytoplasmic projections) in TCs connect directly with other TCs and adjacent structures (including blood vessels, nerve endings, smooth muscles, glandular elements) through direct homo- and heterocellular junctions, or extracellular vesicles. Studies also show that TC damage and dysfunction is involved in the pathogenesis of inflammatory and fibrotic diseases, especially aging, and may be considered as therapeutic agents in the future (Chaitow, 2017). On the other hand, the evidence suggests that sarcopenia and fertility-related aging syndromes, due to their complex etiology, make pharmacological or nutritional prescriptions ineffective in their prevention and treatment (Kwak & Kwon, 2019). Therefore, the use of multidimensional strategies such as exercise programs with nutritional interventions may be more effective in preventing these age-related diseases (Nascimento et al., 2019; Pascual-Fernández et al., 2020). Research suggests that TCs may play a critical role in such matters as cross-talk preservation, regenerative mechanisms, and support for localized stem cell differentiation. In 2021, Ravalli et al. examined the presence of TCs in the anterior tibialis muscle of healthy rats under the endurance training protocol compared with sedentary rats. TCs in this study included CD34/CD117 and CD34/vimentin, which were identified by double-positive immunofluorescence staining technique. They showed that TCs in sedentary rats decreased significantly after 16 weeks. In contrast, trained rats showed a constant number of TCs after 16 weeks. In short, it can be stated that the protective relationship between TCs and regular sports activity may present new opportunities in the field of regenerative medicine and supports the hypothesis that a possible adaptative stimulus for TCs in sarcopenia and other musculoskeletal disorders is the promotion of physical activity (Ravalli et al., 2021; Rocha et al., 2021).
In order to support the repair and reconstruction of skeletal muscle, studies performed by transmission electron microscopy also show that there is a close spatial relationship between TCs and satellite cells in adult skeletal muscle. This association is probably due to the intracellular signaling mechanism of endocrine and paracrine, and although their exact function in skeletal muscle regeneration has not yet been fully understood, TCs containing vascular endothelial growth factor and platelet-derived growth factor receptor beta has been discovered in the interstitial part of skeletal muscle. In this way, TCs play an important role in promoting satellite cell self-renewal, vascular stability, facilitating angiogenesis, and preventing fibrosis (Cretoiu & Popescu, 2014; Manetti et al., 2019; Yin et al., 2013).
It is important to note that as age increases, skeletal muscle mass and potential for post-injury regeneration decrease. However, the role of intrinsic changes in satellite cells in these reductions has been controversial because studies have documented a decrease in the number of satellite cells with increasing age in mice. On the other hand, some results indicate that there is not significant reduction in this case. Moreover, evidence suggests that the potential for innate regeneration of satellite cell pools is impaired with age. Although the number of satellite cells in old muscle decreases, the inherent myogenic potential and self-renewal capacity of satellite cells remain unchanged. Factors that can play a role in the activation and differentiation of satellite cells are: paired/homeodomain box transcription factors PAX3 and PAX7 and basic helix-loop-helix myogenic regulatory factors (MRFs) such as MYF5, MRF4, MYOD (Myogenic determination gene number 1) and myogenin (Arpke et al., 2021; Mierzejewski et al., 2020).
Unlike satellite cells and fibroblasts, skeletal muscle TCs express the c-kit cell surface marker. TC-specific antigenic markers are not yet fully understood; however, CD34 is currently used as the most reliable marker to detect TCs at the site of light microscopy, also known as TCs/CD34 + stromal cells (Manetti et al., 2019; Yin et al., 2013). The positive effects of regular physical activity on the number of satellite cells have been expressed, at the same time, skeletal muscle that contracts and relaxes is likely to be affected by the mechanical support of TCs during exercise (Ceccarelli et al., 2017; Kondo & Kaestner, 2019). Studies have shown evidence and conclusions about TCs, although, little research has been done on TCs in mammalian skeletal muscle tissue. At present, there is no direct experimental evidence and results that conclusively support a TCs-satellite cells morpho-functional interaction following skeletal muscle injury (Manetti et al., 2019). However, due to the beneficial role of exercise on satellite cells and TCs in the prevention of age-related muscle disorders, there are still many issues that need to be addressed, including identifying TC-specific biomarkers and their role in sarcopenia. Therefore, the role of regular physical activity on new interstitial cells such as TCs will be a new treatment for age-related diseases such as sarcopenia, which requires further investigations (Ravalli et al., 2021; Wang et al., 2016).

Abstract Dear Editor-in-Chief
Many studies have shown that regular physical activity has a significant effect on improving a range of disorders such as metabolic syndrome, cardiovascular disease, and cancer. Regular physical activity improves disease activity in patients by affecting hormones, the reverse cholesterol transport process, factors related to antioxidants and immune defense systems, factors that control cell apoptosis, and more (Myers, Kokkinos, & Nyelin, 2019).
Nowadays, the role of muscle-secreting cytokines (in response to physical activity) in fighting diseases has attracted the attention of scientists. Muscle-secreting cytokines (myokines) provide communication between muscle and other tissues and organs such as the brain, adipose tissue, bone, liver, intestines, pancreas, etc., and physical activity is a way to stimulate the secretion of these myokines from the muscle. Myokines are involved in critical processes of the body such as cognition, lipid, and glucose metabolism, browning of white fat, bone formation, endothelial cell function, hypertrophy, skin structure, and tumor growth (Severinsen & Pedersen, 2020); therefore, they can be studied as a mechanism for the effect of physical activity on various diseases.
Irisin is a myokine. It is secreted from skeletal muscle in response to physical activity. Physical activity increases the transcriptional activator of PGC1-α and induces the expression of the FNDC5 gene, and subsequently, irisin is released into the blood. Irisin facilitates glucose uptake by skeletal muscle, improves glucose and liver fat metabolism, has a positive effect on hyperlipidemia and hyperglycemia due to obesity and metabolic syndrome, and acts as an insulin-sensitizing hormone (Severinsen & Pedersen, 2020).
The role of irisin in cancer treatment is unclear, and further studies are needed. The results of a review study show that regular physical activity increases irisin, but the use of irisin in cancer therapeutics requires further researches (Maalouf & El Khoury, 2019). More studies should be performed to determine the mode of administration of irisin for each cancer type and investigate the amount of use. Moreover, studies on the impact of physical activity on irisin in cancer patients are required.