Enhancing Adaptations to Exercise

Study Overview
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Brief Summary
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Researchers are trying to understand how chronic inflammation affects muscle function and responses to exercise.They are also trying to determine if suppressing chronic inflammation using omega-3 fatty acids (n3-PUFA) restores skeletal muscle function and exercise responsiveness in older adults.

Detailed Description
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Participants will be divided into two groups. Men and women between the ages of 20-35 years and 65-85 years. Participants in the older age group will be randomly assigned to receive groups (n3-PUFA or placebo (soybean oil)) in a double-blind manner. Before and after the intervention, all participants will complete an outpatient study day (body composition, blood draw, treadmill test, strength test) and an inpatient study day (muscle biopsies, fat biopsies, indirect calorimetry, exercise test, mixed meal test). During the intervention phase of the study, participants will be instructed to swallow 2 softgels twice per day with meals (morning and evening) for a total of 4 softgels per day. Every 4 weeks, participants will report to the Clinical Research and Trials Unit (CRTU) to pick up a new prescription and return any remaining capsules from the previous prescription. On the day they pick up prescription refills, participants will report to the CRTU for a fasting blood sample. The duration of the intervention will be 6 months.

Official Title
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Enhancing Adaptations to Exercise

Conditions
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Inflammation

Intervention / Treatment
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* Drug: n3-PUFA
* Drug: Placebo
* Procedure: Biopsy
* Diagnostic Test: Body Composition Scan


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Men and women between the ages of 20-35 years Men and women between the ages of 65-85 years Exclusion criteria: Regular use of omega-3 nutritional supplements Diabetes or fasting plasma glucose > or equal to 126 mg/dL Anemia (female subjects hemoglobin of <11 g/dl and male subjects hemoglobin <12 g/dl) Active coronary artery disease or history of unstable macrovascular disease (unstable angina, myocardial infarction, stroke, and revascularization of coronary, peripheral or carotid artery within 3 months of recruitment) Renal failure (serum creatinine > 1.5mg/dl) Chronic active liver disease (AST>144 IU/L or ALT>165 IU/L) Oral warfarin group medications or history of blood clotting disorders. international normalized ratio (INR) >2.01.5 Smoking Pregnancy or breastfeeding Alcohol consumption greater than 2 glasses/day or other substance abuse Untreated or uncontrolled hypothyroidism Debilitating chronic disease (at the discretion of the investigators) Fish or shellfish allergy

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: n3-PUFA<br>Participants will be instructed to swallow 2 Docosahexaenoic acid (DHA)/EPA soft gels twice per day with meals (morning and evening) for a total of 4 soft gels per day. | Drug: n3-PUFA<br>* The DHA/EPA softgels will each contain  465mg of EPA and  375mg of DHA for a total daily dosage of 3.4g/day. Additionally, each capsule will contain SCI's proprietary Advance Lipid TechnologiesTM (ALTTM) containing the surfactants polysorbate 80, NF ( 381 mg) and poloxamer 237, NF ( 8.8 mg).<br>Procedure: Biopsy<br>* Two muscle biopsies from the upper part of one leg. A small ( 1cm) incision will be made through the skin, and a needle will then be used to remove the muscle.<br>Diagnostic Test: Body Composition Scan<br>* Measure of body fat percentage, skeletal muscle mass, body water, and visceral fat.<br>* Other names: DEXA (dual-energy X-ray absorptiometry) scan.;|
| Placebo Comparator: Placebo<br>Participants will be instructed to swallow 2 placebo soft gels twice per day with meals (morning and evening) for a total of 4 soft gels per day. | Drug: Placebo<br>* Looks exactly like the study drug but contains soybean oil with no active ingredient.<br>Procedure: Biopsy<br>* Two muscle biopsies from the upper part of one leg. A small ( 1cm) incision will be made through the skin, and a needle will then be used to remove the muscle.<br>Diagnostic Test: Body Composition Scan<br>* Measure of body fat percentage, skeletal muscle mass, body water, and visceral fat.<br>* Other names: DEXA (dual-energy X-ray absorptiometry) scan.;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Maximum Workload Muscle Strength | Single-leg knee extensor strength was measured on a pneumatic resistance leg extension machine (Keiser Air300, Keiser Corporation, Fresno, CA, USA) and defined as the unilateral 1-repetition maximum (1-RM). Subjects performed a unilateral knee extension warm-up consisting of 10 repetitions at minimal resistance and 3 sets of 5-10 repetitions at increasing workloads. Subjects then performed a series of single repetition attempts at increasing workloads, each separated by 3 min of rest, until the maximum load that could be moved through the entire range of motion was reached. This maximum workload was defined as the individual 1-RM. | baseline, 6 months | 
| Body Mass Index (BMI) | Subject's BMI calculated as weight in kilograms divided by height in meters squared. Uses measurements of height and weight obtained during study (with appropriate metric conversions). Measured as kg/m^2 | baseline, 6 months | 
| Body Fat | Dexa Scan based body fat, measured as a percentage of body weight | baseline, 6 months | 
| Lean Body Mass | Lean body mass as measured by a DEXA scan is the amount of soft tissue that is not fat or bone. Measured in kilograms. | baseline, 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| C-Reactive Protein (CRP) | C-reactive protein is a substance produced by the liver in response to inflammation. Normal CRP levels are below 3.0 mg/L.Units: mg/L | baseline, 6 months | 
| Erythrocyte Sedimentation Rate (ESR) | ESR is a blood test that can reveal inflammatory activity in the body. It measures the distance red blood cells fall in a test tube in one hour. The farther the red blood cells have descended, the greater the inflammatory response of the immune system. Normal results: < 16 years: < 10 mm/hr;Male < 50 years: < 15 mm/hr;Male > 50 years: < 20 mm/hr;Female < 50 years: < 20 mm/hr;Female > 50 years: < 30 mm/hr | baseline, 6 months | 
| Weight | Subjects calculated weight in kilograms | baseline, 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Exercise, muscle function