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We examined the effects of 5-aminolevulinic acid (ALA) with sodium ferrous citrate (SFC) supplementation during home-based walking training in middle-aged depressive women. Nine outpatients [53\u2009\u00b1\u20098 (SD) yr] with major depressive disorder participated in the pilot study with randomized, placebo-controlled, double-blind crossover design. They underwent two trials for 7 days, each performing interval walking training (IWT) with ALA\u2009+\u2009SFC (ALA\u2009+\u2009SFC) or placebo supplement intake (PLC) intermittently with &gt;a 10-day washout period. For the first 6 days of each trial, exercise intensity for IWT was measured by accelerometry. Before and after each trial, subjects underwent a graded cycling test, and lactate concentration in plasma ([Lac<jats:sup>\u2212<\/jats:sup>]<jats:sub>p<\/jats:sub>), oxygen consumption rate (<jats:inline-formula><jats:alternatives><jats:tex-math>$${\\dot{{\\bf{V}}}{\\bf{O}}}_{{\\bf{2}}}$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:msub><mml:mrow><mml:mover><mml:mi>V<\/mml:mi><mml:mo>\u02d9<\/mml:mo><\/mml:mover><mml:mi>O<\/mml:mi><\/mml:mrow><mml:mrow><mml:mn>2<\/mml:mn><\/mml:mrow><\/mml:msub><\/mml:math><\/jats:alternatives><\/jats:inline-formula>), and carbon dioxide production rate (<jats:inline-formula><jats:alternatives><jats:tex-math>$${\\dot{{\\bf{V}}}{\\bf{\\text{CO}}}}_{{\\bf{2}}}$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:msub><mml:mrow><mml:mover><mml:mi>V<\/mml:mi><mml:mo>\u02d9<\/mml:mo><\/mml:mover><mml:mtext>CO<\/mml:mtext><\/mml:mrow><mml:mrow><mml:mn>2<\/mml:mn><\/mml:mrow><\/mml:msub><\/mml:math><\/jats:alternatives><\/jats:inline-formula>) were measured with depression severity by the Montgomery\u2013\u00c5sberg Depression Rating Scale (MADRS). We found that the increases in [Lac<jats:sup>\u2212<\/jats:sup>]<jats:sub>p<\/jats:sub>,<jats:inline-formula><jats:alternatives><jats:tex-math>$${\\dot{{\\bf{V}}}{\\bf{O}}}_{{\\bf{2}}}$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:msub><mml:mrow><mml:mover><mml:mi>V<\/mml:mi><mml:mo>\u02d9<\/mml:mo><\/mml:mover><mml:mi>O<\/mml:mi><\/mml:mrow><mml:mrow><mml:mn>2<\/mml:mn><\/mml:mrow><\/mml:msub><\/mml:math><\/jats:alternatives><\/jats:inline-formula>and<jats:inline-formula><jats:alternatives><jats:tex-math>$${\\dot{{\\bf{V}}}{\\bf{\\text{CO}}}}_{{\\bf{2}}}$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\"><mml:msub><mml:mrow><mml:mover><mml:mi>V<\/mml:mi><mml:mo>\u02d9<\/mml:mo><\/mml:mover><mml:mtext>CO<\/mml:mtext><\/mml:mrow><mml:mrow><mml:mn>2<\/mml:mn><\/mml:mrow><\/mml:msub><\/mml:math><\/jats:alternatives><\/jats:inline-formula>during the test were attenuated only in ALA\u2009+\u2009SFC ([before vs. after] \u00d7 workload; all, P\u2009&lt;\u20090.01), accompanied by increased training days, impulse, and time at fast walking during IWT (all, P\u2009&lt;\u20090.05) with decreased MADRS-score (P\u2009=\u20090.001). Thus, ALA\u2009+\u2009SFC supplementation increased IWT achievement to improve depressive symptoms in middle-aged women.<\/jats:p>","DOI":"10.1038\/s41598-018-25452-2","type":"journal-article","created":{"date-parts":[[2018,5,1]],"date-time":"2018-05-01T13:51:25Z","timestamp":1525182685000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Effects of 5-aminolevulinic acid supplementation on home-based walking training achievement in middle-aged depressive women: randomized, double-blind, crossover pilot study"],"prefix":"10.1038","volume":"8","author":[{"given":"Hiroshi","family":"Suzuki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shizue","family":"Masuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiyo","family":"Morikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Ogawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshi-ichiro","family":"Kamijo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiwamu","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motowo","family":"Nakajima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Nose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,5,8]]},"reference":[{"key":"25452_CR1","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/S2215-0366(16)30263-2","volume":"4","author":"C Kuehner","year":"2017","unstructured":"Kuehner, C. 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