Smoking, Cardiovascular Disease Risk
Conditions
Keywords
Smoking, Insulin resistance, Metabolic Syndrome, Endothelial Function, Smoking Cessation, Resistance Training, Nicotine Replacement, Exercise, Cardiovascular Disease, Arterial Stiffness, Body Composition
Brief summary
This project is prompted by the urgent public health need to identify novel strategies to prevent and treat tobacco-related cardiovascular disease (CVD) and by compelling pilot data that suggests cessation of smoking results in rapid amelioration of endothelial function. The higher prevalence of CVD and metabolic syndrome in smokers have become major health care concerns. Therefore, finding optimal intervention strategies to combat these growing epidemics is imperative. We are investigating the efficacy of resistance training to ameliorate endothelial dysfunction, oxidative stress, inflammation, and insulin resistance in four groups: presence or absence of resistance training with or without cessation treatment + nicotine replacement. The investigators hypothesize that resistance training will improve cardiovascular function in smokers; however, the responses will be better in those who also stop smoking. In addition, resistance training will decrease smoking, however, the effects of counseling and nicotine replacement alone or counseling and nicotine replacement in conjunction with resistance training will be better than resistance training alone.
Detailed description
The investigators are conducting a 12-week randomized-controlled trial of 100 young adult smokers. At week 0, participants attend three outpatient visits at baseline. Each participant is randomized to one of four groups: Resistance Training(RT)/Nicotine Replacement Therapy (NRT), RT/No NRT, No RT/NRT, and No RT/No NRT. Those receiving RT work with a certified personal trainer 3 times per week for 12 weeks at 60 minutes each session. Those receiving NRT use the nicotine patch daily for 12 weeks and call the California Smoker's Helpline for smoking cessation counseling. Those in the control group do not receive any intervention and maintain their current lifestyle and habits. At week 13, participants return for three post-intervention assessments. At week 26, survey data is collected to assess changes in lifestyle habits.
Interventions
Resistance Training program 3x/week at 60 minutes per session for 12 weeks.
BIOLOGICALNicotine Replacement Therapy (NRT)
Nicotine patch for 12 weeks (21mg, 14mg, 7mg.) and referral to California Smoker's Helpline for 6 sessions of smoking cessation counseling.
Sponsors
University of California
University of California, Los Angeles
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 35 Years
Healthy volunteers
Yes
Inclusion criteria
* Young Adults (18-35 yrs.) * Male and female smokers * Smokers (smoked at least one cigarette a day for 15 or more days in the last month and has smoked 100 cigarettes in life) * 1-3 years experience consistently exercising/training at ≤2 days/wk of RT and ≤1 day/wk of aerobic exercise * Capable of providing informed consent * UCLA students/staff and Non UCLA student/staff * Participant in good health as determined by baseline visit
Exclusion criteria
* Documented CAD * Has had cardiac surgery * Currently in weight loss or exercise program in the 6 months prior to participation. * Use of medications that influence CV function or preclude the ability to train * Syndromes or prescribed medications that may influence CVD, body composition, or insulin action (e.g. prednisone, Ritalin, Adderall, GH) * Unable to exercise * Diagnosed with syndromes or diseases that may influence body composition and CV risk (e.g. Cushing syndrome). * Known heart arrhythmia and/or abnormalities found in electrocardiogram (ECG) reading that would prevent someone from performing the exercise intervention. If the subject demonstrates abnormal ECG during their pre-intervention visit (or any follow-up visit) the subject's ECG will be reviewed (for approval) by a cardiologist to continue in the study. * Pregnant * Use of hormonal contraceptives * Currently in a smoking cessation program including use of NRT within the month of participation
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Endothelial function as determined by brachial artery Flow-Mediated Dilation (FMD) | 12 weeks |
Secondary
| Measure | Time frame |
|---|---|
| Smoking cessation percentage | 12 weeks |
| Arterial stiffness (including PWV and AIx) | 12 weeks |
| Number of cigarettes smoked | 12 weeks |
Other
| Measure | Time frame | Description |
|---|---|---|
| Endothelial Progenitor Cells (EPC) count | 12 weeks | EPC count is measured using a novel flow cytometry protocol. |
| Muscle Strength | 12 Weeks | Muscle strength is evaluated by a one-Repetition Maximum (1RM) protocol and VO2 peak is assessed by a maximal incremental cardiopulmonary exercise test. |
| Insulin sensitivity by Frequently Sampled Intravenous Glucose Tolerance Test (FSIVGTT) | 12 Weeks | — |
| Plasma biomarkers inflammation/oxidative stress (oxidized low density lipoprotein (OxLDL), CRP) | 12 Weeks | — |
| Body Composition | 12 Weeks | Lean mass and fat mass are measured by the Dual Energy X-ray Absorptiometry (DEXA) Scan. |
Countries
United States
Contacts
Primary ContactExercise and Metabolic Disease Laboratory
Outcome results
None listed