Regular movement and exercising are an elixir of health
Doc. MUDr. Barbara Ukropcová, PhD. is respected doctor and scientist from the Institute of Experimental Endocrinology BMC of the Slovak Academy of Sciences. She is focusing on the research of systemic and molecular mechanisms of the effects of physical in(activity) on health, as well as the role of exercise in the prevention and treatment of chronic metabolic, cardiovascular, oncological and neurodegenerative diseases. She gives lectures on the effects and the role of movement to the students of the Faculty of Medicine and the Faculty of Physical Education and Sports of the Comenius University in Bratislava. She also teaches PhD students from the Faculty of Medicine, the Faculty of Physical Education and Sports and the Faculty of Natural Sciences of the Comenius University.
Barbara Ukropcová M.D. comes from Bratislava and she studied at the Faculty of Medicine of the Comenius University in Bratislava. After finishing her studies in 1998, she worked as a secondary physician at the palliative department of the National Institute of Oncology in Bratislava and successfully completed her specialisation in internal medicine in 2002.
In 2002, she joined the Endocrinology Laboratory at the Pennington Biomedical Research Center in Baton Rouge, Louisiana, USA, where she worked for three and a half years under the guidance of prof. MUDr. Steven R. Smith. Her main research goal was the study of pathophysiological mechanisms of obesity and type 2 diabetes at skeletal muscle level as well as the study of mutual communication between muscle and fat tissue. She mainly focused on cellular plasticity, metabolic flexibility and fat burning capacity utilising primarily cell cultures of muscle cells from slim and obese individuals. She introduced in vitro measurement of fatty acid and glucose oxidation and became acquainted with a number of methods of molecular biology and biochemistry.
Between 2006 and 2010, she has done PhD studies at the Laboratory of Diabetes and Metabolism Disorders led by prof. MUDr. Iwar Klimeš, DrSc., and external adviser – specialist prof. Smith. During her studies, she introduced several new methods that are currently routinely used in ongoing studies (skeletal muscle biopsy, primary cell cultures of the human skeletal muscle and adipocytes, separation and purification of adipocytes from adipose tissue, isolation of monocytes, etc.), and she actively participated in the coordination and realisation of clinical studies (design of studies and recruitment of patients, clinical phenotyping, analyses of biological material).
She has received her PhD degree in 2010 after defending her dissertation work: Skeletal muscle and adipose tissue in the pathogenesis of insulin resistance. She is the author and co-author of 38 scientific papers (published in leading scientific journals such as Diabetes, J Clin Invest, Cell Metabolism, JCEM, PLOS Medicine, etc.) and the results of her work have been cited more than 1100 times. She is the author and co-author of six chapters in monographs focusing on the pathogenesis of obesity, insulin resistance, and type 2 diabetes as well as on the impact of a regular physical activity on health and its use in the prevention and treatment of chronic diseases.
Dr. Ukropcová has been leading and coordinating many home and international projects (grants of the European Federation for Research of Diabetes, grants of the Scientific Grants Agency and Slovak Research and Development Agency, Pfizer grant, Slovak Academy of Science grant – MOST Taiwan, COST, Ministry of Health of the Czech Republic grant). She is one of the founding members of the Exercise and physical activity study group at the European Diabetes Research Association and a member of the Obesitology Division of the Slovak Diabetes Society.
M. BARTOŠOVIČOVÁ: Dr. Ukropcová, with what perceptions did you go study at the Faculty of Medicine of the Comenius University in Bratislava? Did it fulfil your expectations in terms of the focus of the studies?
B. UKROPCOVÁ: The human body is fascinating and I was always curious about how we work, how we are “assembled” – at both macroscopic and microscopic levels. A human being is an incredibly complex and complicated organism, and medicine allows us to study its structures and (pato)physiological mechanisms at the level of molecules and cells through tissues, organs, up to the system level. Studying medicine was the best preparation for what I am doing today, i.e. research of the impact of physical activity on health and the possibilities of utilising regular exercise in the prevention and treatment of chronic diseases.
M. B.: Already four years after graduating from the Faculty of Medicine, you have become a post-doctoral student at the Endocrinology Laboratory in the United States. What did this extraordinary opportunity mean to you?
B. UKROPCOVÁ: Above all, a huge change and challenge. Suddenly, I found myself in the lab, with pipette in one hand and ampule with the radioactive isotope of carbon in another and microcosm of the muscle cell before the eyes. It was another world, which was very inspiring, dynamic and diverse for me. One full of surprises. Of course, you always have some hypothesis, but, ultimately, the purpose of scientific work is not only about confirmation of our expectations – it is about observing and/or finding something that represents an unknown fragment of reality (effect, molecule, mechanism) and presenting our observations in the form of a story. A scientific article is a story that puts our results in context with what we already know – interprets them and gives them meaning. It's basically a detective story, where creativity, analysis, and intuition apply. In this respect, the stay in the USA was a great school. It also meant having the opportunity to listen to lectures of outstanding scientists moving on the edge of slowly crystallising knowledge several times a week. When researching in the lab, a person often spends not only days, but also weekends and occasionally even nights testing, trying, simply experimenting. You will experience your eureka moments and times when things don't go the way you would want. Another challenge was to harmonise the work with caring for my family. Together with my husband, who was also working as a postdoc in Pennington, we were taking care of our two-year-old daughter Kristína.
M. B.: Which one of your accomplishments do you consider to be the most significant?
B. UKROPCOVÁ: We have contributed to the understanding of the relationship between fat and muscle. We may not even realise it, but they are our two largest organs and harmonious consensus among them is very important for our health. In our intervention studies conducted with the Faculty of Physical Education and Sports and with neurologists or other clinicians, we have observed an improvement in the health of patients with Parkinson's disease or in people at increased risk of diabetes and improved memory in seniors through physical training. Our just finished or ongoing projects have very interesting (perhaps the most interesting) results. So, we will see.
For me, another accomplishment is my research team composed almost exclusively of students, who work with enthusiasm and commitment, thanks to which we work as a single clinical and laboratory unit. The accomplishment for me is that we have established and keep developing the research of physical activity on the systemic, cellular and molecular level within a relatively extensive networking in Slovakia and international cooperation (with Austrian, Swiss, Australian or Czech scientists). Another great accomplishment is a number of people, who thanks to the participation in our studies started and continue exercising. This has been enabled mainly by the initiative of enthusiastic colleagues from the Faculty of Physical Education and Sports, and from the Slovak Medical University. For us, the creation of such model system linked with providing feedback, education and in particular the ability to continue exercising is a translation directly into practice and a demonstration of how it could work.
M. B.: You are the coordinator and active participant in several projects. Could you at least briefly tell us about them?
B. UKROPCOVÁ: We focus on the pathogenesis of obesity, type 2 diabetes and other chronic diseases associated with sedentary lifestyle, as well as the impact of exercise on health and disease risk. In principle, only moving life being is viable. And that is so not only because we can escape the danger. The muscles are not only the organ of movement, but also play a key role in coordinating an adaptive response to movement.
In 2016, we co-authored, with a Taiwanese partner, an international project Slovak Academy of Sciences – MOST, focused on the role of skeletal muscle as a mediator of the positive effects of regular exercise on cognitive functions and metabolism in patients with pre-clinical or early stage Alzheimer's or Parkinson's disease. In this study, we have found that as little as three months of regular exercise can improve not only physical fitness, muscle strength or balance, but also memory. All of this is very likely due to bioactive molecules, which come from muscle or other exercise-activated organs, and are labelled with a common name - exerkines.
Within the framework of the European multicentre project under the 7th Framework Program – Lipidomic Net, we have been involved in elucidating the role of the composition of the lipid spectrum of plasma and adipose tissue on the progression of a metabolic disease. Within the framework of the grant from the Ministry of Health of the Czech Republic, we monitor the metabolism of muscle cells isolated from patients with idiopathic inflammatory myopathies
Grants supported by the European Association for the Study of Diabetes have been focused on the effect of endurance or strength training on metabolism and the secretory profile of skeletal muscle in sedentary people with overweight or obesity. We have found that as little as three months of exercise can improve the body composition and metabolic profile of sedentary people with increased risk of diabetes, even without weight change. We observed a decrease in the skeletal muscle hormone – irisin – in diabetes, as well as changes in morphology and secretory activity of adipose tissue in obesity and growth hormone in adulthood.
As a scientist, I am trying to identify the molecules and mechanisms that enable the movement to heal us, and as a physician and university lecturer, I point to the effectiveness of regular exercise in the prevention and treatment of chronic diseases, as well as for various patterns and possibilities of prescription exercise, which work in other countries. Perhaps, it won't surprise you that regular exercise is literally an elixir of health. It improves metabolism, fitness, memory, bones are hardening, and every cell in our body is being restructured. Better physical fitness reduces the risk of mortality 2-4(!) times and although the exercise, of course, won't protect us from all diseases, the risk of many diseases is definitely significantly reduced.
M. B.: You also lecture on the effects and the role of movement at the Comenius University. What do you put the main emphasis on?
B. UKROPCOVÁ: The basis of evidence-based medicine is a proof, which is in our case the results of clinical trials. Typically, I start with data from large studies linked to long-term observation, which show the link between physical activity and fitness, and the risk of morbidity and mortality. For example, in the framework of one such study, over 80,000 people(!) were examined during less than four decades, including an objective physical fitness measurement. The chance to capture real relationships is really big on such a large populations and when using reliable measurement methodologies. The studies consisting of a change of the lifestyle (exercising and diet) point to the long-term effectiveness of lifestyle modification in the prevention and treatment of pre-diabetes (pre-diabetic stage) and type 2 diabetes or other chronic diseases. There is also a long-term (10-20 years) follow-up in these studies and the results indicate a significant reduction in the risk of disease in patients with long-term lifestyle changes. I will go through the mechanisms that facilitate the benefits of exercise at the systemic, organ, cellular and molecular level and then I address the possibilities of prescribing physical activity (“prescription exercise”) in clinical practice.
M. B.: How does a lack of movement affect the human organism?
B. UKROPCOVÁ: The consequences of a sedentary lifestyle are treated by nearly every doctor. It is clear that exercise doesn't cure everything, and it's very likely that many people would prefer to take a pill than to move (and no one yet discovered movement in a pill, even though many are trying to do so). On the other hand, virtually everyone can benefit from regular exercise. Even seniors participating in our studies can confirm this. Sedentary lifestyle is an independent risk factor for chronic diseases such as type 2 diabetes, cardiovascular diseases (myocardial infarction or stroke), neurodegenerative diseases (Alzheimer's or Parkinson's disease), some oncological diseases (breast or colon cancer), it contributes to the obesity pandemic, increases the risk of depression, etc.
M. B.: For which age categories is the lack of movement the riskiest and what would you recommend them?
B. UKROPCOVÁ: Lack of movement is a risk for all ages. In children, it contributes to obesity and to the early onset of metabolic disorders. In addition, it increases the risk of these diseases in adulthood. It is similar in adults too. In the elderly, the sedentary lifestyle is practically toxic – aging is accompanied by loss of muscle mass, slowing of metabolism and the decline of cognitive functions as well as many other changes that the younger body can still offset at least to some extent.
Regular movement is important for all age groups: for children, not only as part of healthy development and prevention of obesity, but also for later life in general. Ensuring enough movement for our children is truly a challenge in today's digital era. In the adult population, a sufficient dose of movement contributes not only to maintaining fitness, but also acts as a prevention of chronic diseases and, last but not least, provides relaxation and entertainment. In its own way is movement or a regular exercise with the objective of maintaining/increasing strength and fitness, in fact, a kind of “elixir of youth” – it significantly contributes to maintaining autonomy, health, and quality of life even at older age. It is prevention and to a certain extent (in early stages) treatment of memory impairment, worsening metabolism, and the decline in other physiological functions associated with aging.
M. B: Thank you for the interview.
Interview prepared and published by: Marta Bartošovičová, NCP S&T at the SCSTI
Photos are from the archive of doc. Barbara Ukropcová
Respected Slovak scientist and physician doc. MUDr. Barbara Ukropcová, PhD., was the guest of the Science Café Science in the CENTRE on 30 March 2017 at 05:00 PM, where she presented the theme: Will we survive without moving? The impact of physical (in)activity on human health.
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