1. Synergic effect of exercise and nutrition intervention on disease model Wook Song, Ph.D. Health & Exercise Science Laboratory Institute of Sport Science Seoul National University

2. Definition Synergic effect VS. Additive effect Synergic effect The interaction of two or more agents or forces so that their combined effect is greater than the sum of their individual effects. Additive effect An effect in which two substances or actions used in combination produce a total effect the same as the sum of the individual effects.

3. C.K.Ashok Kumar et al. 2008 Improved insulin sensitivity by activation of PPAR and AMPK signaling pathway Target signaling of drug for type 2 DM (TZD & Metformin)

4. J Renal Nutr 2011 Animal Pharm 2008 evolutionaryhealthperspective.wordpress.com 2013 Target signaling of exercise training : PPARs, AMPK, PGC-1α

5. Synergic effect? Additive effect? Exercise Nutrition Drug Common Mechanisms for action Diabetes Obesity Hypertension Dyslipidemia CVD Osteoporosis

6. Synergic effect of anti-convulsant agents and regular exercise on kainic acid induced seizure

7. Introduction What is seizure ? " Seizure " is a general term that refers to a sudden malfunction in the brain that causes someone to collapse, convulse, or have another temporary disturbance of normal brain function, often with a loss or change in consciousness.

8. Purpose The purpose of this study was to investigate the synergic effect of regular exercise and therapy with an anticonvulsant agents could be a more efficient method for the prevention and/or treatment of epilepsy than exercise alone.

9. Materials and Methods Drugs Kainic acid (30 mg/kg; i.p.) to induce seizure activity Resveratrol (250 mg/kg, orally) - a type of natural phenol Riluzole (5 mg/kg, i.p.) - a potent neuroprotective drug Clonidine (4 mg/kg, i.p.) - α2 adrenoreceptor agonist

10. Materials and Methods Experimental groups Experimental groupn Control11-13 KA only11-13 Exercise + KA11-13 Drugs + KA11-13 Exercise + Drugs + KA11-13 Adult male ICR mice weighing approximately 35 g each (8 week-old)

11. Materials and Methods Physical exercise training 6 weeks swimming training (60 min sessions, 5 times per week) 1 st week: adaptation to swimming without weights After the water-adaptation period, the mice were made to swim with weights (5% of body weight) in order to improve endurance exercise capacity. (Arida et al., 1991).

12. Materials and Methods Experimental procedure 6 weeks swimming KA (seizure induction) Measuring seizure activity for 2 hours Riluzole, Clonidine (1 hour prior to KA) Resveratrol (6 weeks)

13. Results Neuronal injury in hippocampus KA (30 mg/kg, i.p.), Cresyl Violet Hippocampus CA3 region

14. Results Seizure activity levels

15. Results Seizure activity levels Ex : Swimming training for 6 weeks Res : Resveratrol Rilu : Riluzole

16. Results Chimney test (motor performance)

17. Results Effect on oxidative stress

18. Results Effect on mortality

19. These results indicate that the combination of regular exercise and therapy with an anticonvulsant agent could be a more efficient method for the prevention and/or treatment of epilepsy than exercise alone. Conclusion

20. Implication & Future Direction  Potential synergistic effect of diet and exercise in the prevention and treatment of chronic diseases.  Mechanisms of action and optimal diet and exercise prescription needed for benefit remain elusive.  Nutrients are directed to specific tissues and cells via physiologic processes that require much more research  Need to understand how diet (drug) and exercise interact to promote health, how changes in one affect the other.  What comprehensive prescription will be optimal in disease prevention?