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Current
Research
 -Nutrition,
Exercise, and Metabolism Laboratory
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APPLIED CLINICAL RESEARCH: NUTRITION,
EXERCISE, AND METABOLISM LABORATORY
APPLIED
CLINICAL RESEARCH: NUTRITION, EXERCISE, AND METABOLISM LABORATORY
National Space Biomedical Research
Institute
Designation of UAMS as a charter member of the National Space
Biomedical Research Institute (NSBRI) considerably expanded
the work of the Nutrition, Metabolism, and Exercise Laboratory
(NMEL) under the direction of William J. Evans, PhD. UAMS
joined 12 other medical schools in the nation collaborating
on this intramural NASA research program. Dr. Evans is the
team leader for research on nutrition, physical fitness, and
rehabilitation. Todd A. Trappe, PhD, and Per A. Tesch, PhD,
are co-principal investigators with Dr. Evans. The funding
term is 3 years.
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NMEL: Research Goals
The research goal of the NMEL is to investigate the combined
interaction of nutrition, exercise, and aging on functional
status, macronutrient metabolism, and skeletal muscle function
and metabolism. The clinical research programs based in this
unit (outlined below) have already produced important findings
that are being used to train physicians and other health care
professionals, as well as the public, in how to greatly delay
late-life dysfunction. Studies conducted in the NMEL involve
both healthy and frail elderly persons. The NMEL also provides
the expertise and the facilities for developing health-promotion
and disease-prevention programs.
The NMEL has expanded research into additional important
areas. In collaboration with Ergun Uc, MD, in the Department
of Neurology at UAMS, Dr. Evans investigated the effect of
albuterol on body composition and symptoms in men and women
with advanced Parkinson's disease. This project demonstrated
that albuterol significantly increased skeletal muscle mass
and decreased tremor in these patients. An additional area
of research is the examination of the effects of testosterone
ablation and exercise on muscle metabolism, functional capacity,
and body composition in men with prostate cancer.
Research Training Site
Under Dr. Evans' direction, the NMEL served as a research
training site for four postdoctoral fellows (Mark Haub, PhD;
Nicholas Hays, PhD; Charles Lambert, PhD; and Raymond D. Starling,
PhD), four geriatrics fellows (Mohamed Aniff, MD; Medha N.
Munshi, MD; Burcu Ozdemir, MD; and Younis Shajaat, MD), and
many junior faculty from the College of Medicine (RDG: Wayne
W. Campbell, PhD; Clayton H. Johnson, PhD, Varsha Kaushal,
PhD; Per A. Tesch, PhD; and Todd A. Trappe, PhD; Department
of Internal Medicine: Jacob Joseph, MD; and Eugene Smith,
MD), the College of Nursing (Dr. Kathy Richards), and the
College of Health Related Professions (John Holladay, PhD).
In addition, three doctoral students in the Department of
Physiology have joined the NMEL.
Expanded Clinical Research Base
Increasing the number of faculty based primarily at the North
Little Rock VA Medical Center capable of conducting clinical
research on aging is an ongoing objective. Since joining the
GRECC, Dr. Evans has been successful in building the clinical
research program at the VA. He has helped recruit two additional
tenure-track faculty, three postdoctoral fellows, and a visiting
scientist (Dr. Tesch) from the Karolinska Institute in Sweden,
all of whom work in the NMEL.
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NMEL: Current Projects
The following projects currently underway have Dr. Evans as
principal investigator or coinvestigator:
"Adaptation of Senescent
Muscle to Exercise Training" (NIH K0l AG00831;
funded from December 1998 to November 2003; Dr. Trappe,
principal investigator; Dr. Evans, mentor and coinvestigator).
This research project investigates the cellular regulation
of protein metabolism and muscle hypertrophy in older men
and women during resistance training.
"Dietary Protein
Requirements of Elderly Men and Women" (NIH R01
AG15750-01A1; funded from April 1999 to March 2003; Dr.
Campbell, principal investigator; Dr. Evans, coinvestigator).
The goals of this project is to define the dietary protein
requirements of elderly men and women.
"Effects of Megace
(Megestrol Acetate), Testosterone, and Strength Training
on Food Intake, Body Composition, Functional Capacity, and
Metabolism in Underweight Older Men" (funded by
Bristol-Myers Squibb Company from May 1998 to August 2001).
The major purpose of this research is to investigate the
effects of megestrol acetate oral suspension on food intake,
body weight and composition, and muscle metabolism.
"Effects of Resistance
Training, Using Fly-wheel Technology, on Size and Function
of Unloaded Skeletal Muscle" (funded by NASA from
December 1998 to November 2001; Dr. Tesch, principal investigator;
Dr. Evans, coinvestigator). This research project examines
the influence of resistance training on skeletal muscle
size and function during simulated long-duration space flight.
"Exercise and a High-Carbohydrate
Diet: Effects on Insulin Action" (NIH R01 AG15385-01A1;
funded from December 1998 to November 2003). This research
examines the effects of a high-carbohydrate, ad libitum
diet and aerobic exercise on insulin action and muscle metabolism.
"Influence of Physical
Activity on Insulin Resistance in the Elderly"
(NIH R01 AG/DK19346-01A1). This grant application received
a percentile rank for funding of 16. It will likely be funded
for 3 years. The goal of this project is to examine the
effects of high- and low-intensity aerobic exercise on insulin-stimulated
glucose disposal in older patients with type 2 diabetes.
"Relationship
between Hemoglobin and Functional Capacity in Anemic Cancer
Patients" (funded by Amgen, Inc., from October
2001 to September 2002). This project will examine the maximal
aerobic capacity of anemic cancer patients and the effect
of circulating hemoglobin levels on functional capacity
and fatigue.
"Resistance Training
and Diet in Patients with Chronic Renal Failure"
(Department of Veterans Affairs Merit Review Award; funded
from May 2000 to April 2005). The goal of this research
is to examine the effects of strength training and a low-protein
diet on progression of renal disease, body composition,
and nitrogen balance.
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Dr. Charles Lambert, a postdoctoral fellow in the NMEL, continues
work funded for 3 years by an NIH National Research Service
Award.
James D. Fluckey, PhD, after submitting a revised NIH K0l
grant application entitled "Aging and Mechanisms of
Human Protein Synthesis," received a fundable priority
score and will receive funding for 5 years.
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Applied clinical research initiatives of the NMEL focus on
nutrition, muscle metabolism, and functional rehabilitation
of the frail elderly. Their goals are to identify the most
appropriate approach to the delivery of nutritional and rehabilitative
care to frail, institutionalized elderly persons, and to maintain
optimal health in the non-frail elderly. Applied clinical
research initiatives with Dennis H. Sullivan, MD, as principal
investigator include the following:
"Effects of Megace (Megestrol
Acetate), Placebo, or Megace plus Resistance Exercise Training
on the Severely Debilitated Elderly" (funded by
Bristol-Myers Squibb Company from November 1998 to October
2001). The use of male-replacement doses of testosterone
is contraindicated in women and many elderly men. Megace,
a derivative of progesterone, has been found to have both
appetite-stimulant and anabolic properties, promoting weight
gain in patients with acquired immunodeficiency syndrome
and cancer. Its effects in underweight, undernourished elderly
persons, however, is largely unknown. This phase I trial
aims to test the efficacy of progressive resistance muscle-strength
training (PRMST) and Megace, alone or in combination, to
improve muscle mass and strength and accelerate functional
recovery in a select population of very frail (i.e., high-risk)
elderly men and women who have experienced a recent functional
decline as a consequence of an acute illness from which
they are recuperating.
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"Physiologic Effects
of PRMST and Testosterone in the Debilitated Elderly"
(Department of Veterans Affairs Merit Review Award; funded
from November 1998 to October 2003). This project is an
extension of a prior VA Health Services Research and Development-funded
outcomes project directed by Dr. Sullivan. That study demonstrated
that many hospitalized elderly patients become profoundly
debilitated as a consequence of illness or major surgery
and that recovery of lost muscle mass and strength is very
slow and often incomplete.
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