This Physician's View opinion piece is written by Bret Goodpaster, Ph.D., scientific director and senior investigator for the AdventHealth Translational Research Institute and the principal investigator on the MoTrPAC study.
Despite decades of research establishing the benefits of exercise to our overall health, we still don’t know precisely what happens deep within the body at a molecular level during and after we exercise. We know cardiovascular fitness is a predictor of health, but why? We know muscle strength positively impacts function and mobility, but how? Why do some respond to certain types of exercise and other people do not?
These questions led the Translational Research Institute at AdventHealth Orlando to partner with the National Institutes of Health’s (NIH) Molecular Transducers of Physical Activity Consortium (MoTrPAC) six-year research study.
Supported by a $240 million grant, the largest NIH investment of its type to date, MoTrPAC aims to discover and characterize “the molecular map” that underlies the effects of physical activity in humans.
Our hypothesis is that there are discoverable molecular transducers that communicate and coordinate the impact of exercise on specific cells, tissues and organs within the body. We believe that identifying and characterizing these specific molecular transducers will help us to better understand how exercise improves health and prevents disease.
The AdventHealth Translational Research Institute is one of 10 clinical sites across the country chosen to participate in this groundbreaking research alongside institutions like Duke University, University of California-Irvine, Ball State University and University of Texas Health Science Center.
The MoTrPAC Study Design
MoTrPAC is an unprecedented study in terms of the sheer scale, procedures involved, and amount of data being collected. In total, 1,980 volunteers, including 150 at our site, will participate in a mechanistic randomized controlled trial.
To learn more about the design of the study, click here.
At AdventHealth, our researchers collect an extensive amount of data using blood and tissue samples from the participants before and after each exercise session – I liken it to performing a mini-human genome project on each participant.
Throughout the study, we also perform height and weight measures, body composition testing, fitness testing, strength measurements, blood pressure checks, heart rate and rhythm evaluation through electrocardiogram (EKG), and dietary pattern assessments.
While the first segment of our research is focused on healthy individuals, the next phase of the study could evaluate people with specific health conditions like Type 1 diabetes, Parkinson’s and Alzheimer’s to better understand how and why exercise can benefit them. The data-collection phase of this trial is set to wrap up in the Summer of 2024.
Once complete, all data will be sent to MoTrPAC’s nine chemical analysis sites where bioinformatics will be applied, including machine learning and artificial intelligence, to begin analyzing and identifying the specific molecular outcomes. This process can take another two to three years to uncover exercise-specific biomarkers.
How the Clinical Community Can Help
As clinicians, we understand the value of research, and we need the assistance of the medical community to help encourage participants in this important study.
AdventHealth began enrolling in MoTrPAC in August 2021, and we are still seeking additional participants, especially those who fall into the sedentary category – this could include your patients, friends, family members or even yourself.
We are currently looking for volunteers who meet the following criteria:
- 18 years or older
- No history of diabetes or heart disease
- Would like the opportunity to participate in fitness testing and study-related exams
- Do not exercise regularly OR have been cycling or weightlifting regularly (minimum one year)
One of our greatest challenges for this study has been contending with the community uncertainty created by the COVID-19 pandemic. To help keep study participants safe, AdventHealth has implemented a number of mitigation strategies including distancing, capacity limits, masking and vaccine requirements.
MoTrPAC Study Participant Benefits
Those who participate in the MoTrPAC study receive compensation and benefit from a highly structured, supervised exercise program at our state-of-the-art facility.
Participants also gain incredible insight about their own bodies from the multitude of assessments that are performed throughout the study, in addition to access to personal trainers to provide guidance and instruction regarding proper exercise techniques.
The Future of Exercise as Medicine
At the AdventHealth Translational Research Institute, our mission is to extend and improve the quality of lives through world-class, innovative research that leads to discoveries – and ultimately cures – for obesity, diabetes and cardiovascular diseases. If we are to truly make a dent in these tremendous health challenges, we must talk more about prevention and precision.
While MoTrPAC is a mechanistic trial, the molecular knowledge base created through this extensive research effort will lay the foundation for future investigations into the role of exercise as both prevention and treatment. It will allow us to better understand the specific factors that influence someone’s response to exercise.
Ultimately, we want to be able to take a precision medicine approach — to prescribe and customize the type and amount of exercise to each individual in order to achieve the best possible health outcome.
Exerkines Could Provide a Customized Approach
I recently had a paper published in the March edition of Nature Reviews Endocrinology related to molecular exercise. Specifically, how exerkines, which are defined as signaling molecules that are released into the circulatory system in response to acute and/or chronic exercise, can improve health and disease. Exerkines are a new frontier in molecular medicine that may have the potential to play a role in improving cardiovascular, metabolic, immune and neurological health. For example, they could be an important means by which exercise improves cardiovascular disease, type 2 diabetes and obesity, and there’s a possibility that exerkines could facilitate healthy aging.
One of the goals in the MoTrPAC study is to discover these novel exerkines that may be linked to the myriad of benefits to exercise. For example, we may discover unique exerkines that are produced with weight training and others that are unique to aerobic training and could determine how each individual exercises. In addition, these exerkines could reveal unique targets for exercise programs and even non-exercise therapies to treat common diseases and other conditions.
Read more about the MoTrPAC study here. To participate or refer a participant, click here. If you would like us to provide you with recruitment materials about the study for your office, call or email Call407-303-7193 or [email protected].