Aerobic high-intensity intervals improve VO2max more than moderate training

The 10-20-30 training concept improves performance and health profile in moderately trained runners

The effect of an alteration from regular endurance to interval (10-20-30) training on the health profile, muscular adaptations, maximum oxygen uptake (V̇o2max), and performance of runners was examined. Eighteen moderately trained individuals (6 females and 12 males; V̇o2max: 52.2 ± 1.5 ml·kg−1·min−1) (means ± SE) were divided into a high-intensity training (10-20-30; 3 women and 7 men) and a control (CON; 3 women and 5 men) group. For a 7-wk intervention period the 10-20-30 replaced all training sessions with 10-20-30 training consisting of low-, moderate-, and high-speed running (<30%, <60%, and >90% of maximal intensity) for 30, 20, and 10 s, respectively, in three or four 5-min intervals interspersed by 2 min of recovery, reducing training volume by 54% (14.0 ± 0.9 vs. 30.4 ± 2.3 km/wk) while CON continued the normal training. After the intervention period V̇o2max in 10-20-30 was 4% higher, and performance in a 1,500-m and a 5-km run improved ( P < 0.05) by 21 and 48 s, respectively. In 10-20-30, systolic blood pressure was reduced ( P < 0.05) by 5 ± 2 mmHg, and total and low-density lipoprotein (LDL) cholesterol was lowered ( P < 0.05) by 0.5 ± 0.2 and 0.4 ± 0.1 mmol/l, respectively. No alterations were observed in CON. Muscle membrane proteins and enzyme activity did not change in either of the groups. The present study shows that interval training with short 10-s near-maximal bouts can improve performance and V̇o2max despite a ∼50% reduction in training volume. In addition, the 10-20-30 training regime lowers resting systolic blood pressure and blood cholesterol, suggesting a beneficial effect on the health profile of already trained individuals.

High-intensity interval training in cardiac rehabilitation

High-intensity interval training (HIIT) is frequently used in sports training. The effects on cardiorespiratory and muscle systems have led scientists to consider its application in the field of cardiovascular diseases. The objective of this review is to report the effects and interest of HIIT in patients with coronary artery disease (CAD) and heart failure (HF), as well as in persons with high cardiovascular risk. A non-systematic review of the literature in the MEDLINE database using keywords 'exercise', 'high-intensity interval training', 'interval training', 'coronary artery disease', 'coronary heart disease', 'chronic heart failure' and 'metabolic syndrome' was performed. We selected articles concerning basic science research, physiological research, and randomized or non-randomized interventional clinical trials published in English. To summarize, HIIT appears safe and better tolerated by patients than moderate-intensity continuous exercise (MICE). HIIT gives rise to many short- and long-term central and peripheral adaptations in these populations. In stable and selected patients, it induces substantial clinical improvements, superior to those achieved by MICE, including beneficial effects on several important prognostic factors (peak oxygen uptake, ventricular function, endothelial function), as well as improving quality of life. HIIT appears to be a safe and effective alternative for the rehabilitation of patients with CAD and HF. It may also assist in improving adherence to exercise training. Larger randomized interventional studies are now necessary to improve the indications for this therapy in different populations.

High-Intensity Interval Training

High-intensity interval training (HIT) is characterized by intermittent periods of work and rest and may include work bouts lasting seconds to minutes. HIT has typically been applied to older, diseased, and at-risk populations using longer work intervals (2-4 minutes), whereas more recent definitions of HIT include work intervals of 30 to 60 s. Both traditional endurance training (TET) and HIT exert a peripheral affect increasing the capacity of muscle cells to oxidize substrate via signaling cascades that support the activation of transcription factors that orchestrate the coexpression of nuclear and mitochondrial genes, with HIT triggering these benefits following minutes of training. With 1 exception, reports of central adaptations (eg, increased stroke volume) have been based on longer work intervals (eg, 4 minutes). Recent investigations have tied HIT to increased lipolysis and enhanced insulin sensitivity. HIT favors the activation of oxidative as opposed to hypertrophic pathways. Although the length of the work interval may need to be adjusted to fit the needs and capacity of the participant, HIT should be considered as an alternative to TET for older adults with the expectation that it requires less time to execute, yet promotes peripheral and perhaps central adaptations.

Effect of aerobic interval training on exercise capacity and metabolic risk factors in people with cardiometabolic disorders: a meta-analysis

PURPOSE

To compare the effectiveness of high-intensity aerobic interval training (AIT) with active recovery and continuous moderate-intensity exercise (CME) on exercise capacity and metabolic risk factors in adults with cardiometabolic disorders through a systematic review and meta-analysis.

METHODS

Studies were selected from 5 electronic databases (PubMed, MEDLINE, CINAHL, Physiotherapy Evidence Database [PEDro] and Cochrane Library Register of Controlled Trials). Randomized controlled trials (RCTs), published in English, that compared the effects of AIT with CME on exercise capacity and metabolic risk factors in adults with cardiometabolic disorders were included. Aerobic interval training was defined as high-intensity training separated by active recovery periods; CME incurred identical energy expenditure as AIT. Each trial was evaluated using the PEDro scale. Weighted mean difference (WMD) and 95% CIs were used to determine the effect size for each outcome.

RESULTS

Six RCTs with 153 participants (40 overweight/obesity, 19 with metabolic syndrome, and 94 with heart disease) were included. The mean value on the PEDro scale for these studies was 5.0. Aerobic interval training significantly increased peak oxygen consumption (WMD, 3.6 mL·kg·min; 95% CI, 2.3-4.9) with a trend of decreasing fasting glucose (WMD, -0.4 mmol/L; 95% CI, -0.9 to 0.2, P = .18) compared with CME. The effects on other metabolic risk factors were similar between AIT and CME.

CONCLUSION

Analysis of a limited number of studies with small sample sizes indicates that AIT is superior to CME in terms of improving exercise capacity. Further high quality studies with larger sample size are required to confirm this finding in adults with cardiometabolic disorders.

Physical activity as a long-term predictor of peak oxygen uptake: the HUNT Study

INTRODUCTION

A physically active lifestyle and a relatively high level of cardiorespiratory fitness are important for longevity and long-term health. No population-based study has prospectively assessed the association of physical activity levels with long-term peak oxygen uptake (VO(2peak)).

METHODS

1843 individuals (906 women and 937 men) who were between 18 and 66 yr at baseline and were free from known lung or heart diseases at both baseline (1984-1986) and follow-up (2006-2008) were included in the study. Self-reported physical activity was recorded at both occasions, and VO(2peak) was measured at follow-up. The association of physical activity levels and VO(2peak) was adjusted for age, level of education, smoking status, and weight change from baseline to follow-up, using ANCOVA statistics.

RESULTS

The level of physical activity at baseline was strongly associated with VO(2peak) at follow-up 23 yr later in both men and women (Ptrends < 0.001). Compared with individuals who were inactive at baseline, women and men who were highly active at baseline had higher (3.3 and 4.6 mL·kg(-1)·min(-1)) VO(2peak) at follow-up. Women who were inactive at baseline but highly active at follow-up had 3.7 mL·kg(-1)·min(-1) higher VO(2peak) compared with women who were inactive both at baseline and at follow-up. The corresponding comparison in men showed a difference of 5.2 mL·kg(-1)·min(-1) (95% confidence interval = 3.1-7.3) in VO(2peak).

CONCLUSIONS

Physical activity level at baseline was positively associated with directly measured cardiorespiratory fitness (VO(2peak)) 23 yr later. People who changed from low to high activity during the observation period had substantially higher V˙O(2peak) at follow-up compared with people whose activity remained low.

Aerobic interval training compensates age related decline in cardiac function

OBJECTIVES

To study the effect of aerobic interval training (AIT) on myocardial function in sedentary seniors compared to master athletes (MA) and young controls.

DESIGN

Sixteen seniors (72 ± 1 years, 10 men) performed AIT (4 × 4 minutes) at ≈ 90% of maximal heart rate three times per week for 12 weeks. Results were compared with 11 male MA (74 ± 2 years) and 10 young males (23 ± 2 years).

RESULTS

Seniors had an impaired diastolic function compared to the young at rest. AIT improved resting diastolic parameters, increased E/A ratio (44%, p <0.01), early diastolic tissue Doppler velocity (e') (11%, p <0.05) and e' during exercise (11%, p <0.01), shortened isovolumic relaxation rate (IVRT) (13%, p <0.01). Left ventricle (LV) systolic function (S') was unaffected at rest, whereas S' during stress echo increased by 29% (p <0.01). Right ventricle (RV) S' and RV fractional area change (RFAC) increased (9%, p <0.01, 12%, p =0.01, respectively), but not RV e'. MA had the highest end-diastolic volume, stroke volume, diastolic reserve and RV S'.

CONCLUSION

AIT partly reversed the impaired age related diastolic function in healthy seniors at rest, improved LV diastolic and systolic function during exercise as well as RV S' at rest.

Resposta da frequência cardíaca durante sessão de treinamento de karatê

A prática do karatê pode promover adaptações benéficas sobre os componentes da aptidão física relacionada com a saúde. Dentre esses componentes, o consumo máximo de oxigênio (VO2max) é um importante indicador de aptidão cardiorrespiratória, como também forte preditor de risco de morte por doença cardiovascular. Estudos anteriores avaliaram as respostas da Frequência Cardíaca na modalidade de karatê durante protocolos elaborados pelos pesquisadores que simularam o treinamento. No entanto, esses resultados devem ser interpretados com cautela, uma vez que protocolos podem comprometer a validade ecológica do comportamento da FC. Dessa forma, o objetivo deste estudo foi, através do monitoramento da FC, investigar a distribuição da intensidade durante uma sessão de treinamento de karatê (ST) com a validade ecológica preservada. Nove atletas (M (DP) = 22 (5,2) anos; 60,3 (12,9) kg; 170,0 (0,10) cm; 11,6 (5,7) % gordura) realizaram teste incremental máximo (T I) e uma ST, com monitoramento contínuo da FC, distribuída posteriormente conforme método proposto por Edwards. O tempo médio de duração da ST foi de 91,3 (11,9) minutos (IC95% = 82,0 - 100,5). Os valores de FC média e máxima da ST foram equivalentes a 72% (IC95% = 66-78%) e 94% (IC95% = 89-99%) da FC máxima alcançada durante T I (FCmax), respectivamente. Durante 79,9% (IC95% = 65,7-94,1%) do tempo total da ST, os karatecas permaneceram em uma intensidade superior a 60% da FCmax. Deste modo, conclui-se que a intensidade da ST de karatê atende às recomendações do ACSM com relação à intensidade, duração e frequência semanal, apresentando-se como uma interessante alternativa de exercícios físicos para promoção da aptidão cardiorrespiratória.

Role of nitric oxide and prostanoids in the regulation of leg blood flow and blood pressure in humans with essential hypertension: effect of high-intensity aerobic training

We examined the role of nitric oxide (NO) and prostanoids in the regulation of leg blood flow and systemic blood pressure before and after 8 weeks of aerobic high-intensity training in individuals with essential hypertension (n = 10) and matched healthy control subjects (n = 11). Hypertensive subjects were found to have a lower (P < 0.05) blood flow to the exercising leg than normotensive subjects (30 W: 2.92 ± 0.16 vs. 3.39 ± 0.37 l min(−1)). Despite the lower exercise hyperaemia, pharmacological inhibition of the NO and prostanoid systems reduced leg blood flow to a similar extent during exercise in the two groups and vascular relaxation to the NO-dependent vasodilator acetylcholine was also similar between groups. High-intensity aerobic training lowered (P < 0.05) resting systolic (∼9 mmHg) and diastolic (∼12 mmHg) blood pressure in subjects with essential hypertension, but this effect of training was abolished when the NO and prostanoid systems were inhibited. Skeletal muscle vascular endothelial NO synthase uncoupling, expression and phosphorylation status were similar in the two groups before and after training. These data demonstrate that a reduction in exercise hyperaemia in hypertensive subjects is not associated with a reduced capacity of the NO and prostanoid systems to induce vasodilatation or with altered acetylcholine-induced response. However, our data suggest that the observed reduction in blood pressure is related to a training-induced change in the tonic effect of NO and/or prostanoids on vascular tone.

Matched work high-intensity interval and continuous running induce similar increases in PGC-1α mRNA, AMPK, p38, and p53 phosphorylation in human skeletal muscle

The aim of the present study was to test the hypothesis that acute high-intensity interval (HIT) running induces greater activation of signaling pathways associated with mitochondrial biogenesis compared with moderate-intensity continuous (CONT) running matched for work done. In a repeated-measures design, 10 active men performed two running protocols consisting of HIT [6 × 3-min at 90% maximal oxygen consumption (Vo(2max)) interspersed with 3-min recovery periods at 50% Vo(2max) with a 7-min warm-up and cool-down period at 70% Vo(2max)] or CONT (50-min continuous running at 70% Vo(2max)). Both protocols were matched, therefore, for average intensity, duration, and distance run. Muscle biopsies (vastus lateralis) were obtained preexercise, postexercise, and 3 h postexercise. Muscle glycogen decreased (P < 0.05) similarly in HIT and CONT (116 ± 11 vs. 111 ± 17 mmol/kg dry wt, respectively). Phosphorylation (P-) of p38MAPK(Thr180/Tyr182) (1.9 ± 0.1- vs. 1.5 ± 0.2-fold) and AMPK(Thr172) (1.5 ± 0.3- vs. 1.5 ± 0.1-fold) increased immediately postexercise (P < 0.05) in HIT and CONT, respectively, and returned to basal levels at 3 h postexercise. P-p53(Ser15) (HIT, 2.7 ± 0.8-fold; CONT, 2.1 ± 0.8-fold), PGC-1α mRNA (HIT, 4.2 ± 1.7-fold; CONT, 4.5 ± 0.9-fold) and HSP72 mRNA (HIT, 4.4 ± 2-fold; CONT, 3.5 ± 1-fold) all increased 3 h postexercise (P < 0.05) although neither parameter increased (P > 0.05) immediately postexercise. There was no difference between trials for any of the above signaling or gene expression responses (P > 0.05). We provide novel data by demonstrating that acute HIT and CONT running (when matched for average intensity, duration, and work done) induces similar activation of molecular signaling pathways associated with regulation of mitochondrial biogenesis. Furthermore, this is the first report of contraction-induced p53 phosphorylation in human skeletal muscle, thus highlighting an additional pathway by which exercise may initiate mitochondrial biogenesis.

The effect of interval training combined with thigh cuffs pressure on maximal and submaximal exercise performance

The purpose of the study was to investigate the effect of interval training combined with a thigh cuffs pressure of +90 mmHg on maximal and submaximal cycling performance. Twenty untrained individuals were assigned either to a control (CON) or to an experimental (CUFF) training group. Both groups trained 3 days per week for 6 weeks at the same relative intensity; each training session consisted of 2-min work bout at 90% of VO(2max): 2-min active recovery bout at 50% of VO(2max). An incremental exercise test to exhaustion, a 6-min constant-power test at 80% of VO(2max) (Sub(80)) and a maximal constant-power test to exhaustion (TF(150)) were performed pre- and post-training. Despite the unchanged VO(2max), both groups significantly increased peak power output (CON: ∼12%, CUFF: ∼20%) that was accompanied by higher deoxygenation (ΔStO(2)) measured with near-infrared muscle spectroscopy. These changes were more pronounced in the CUFF group. Moreover, both groups reduced VO(2) during the Sub(80) test without concomitant changes in ΔStO(2). TF(150) was enhanced in both groups. Thus, an interval exercise training protocol under moderate restricted blood flow conditions does not provide any additive effect on maximal and submaximal cycling performance. However, it seems to induce peripheral muscular adaptations, despite the lower absolute training intensity.

Repeated-sprint ability - part II: recommendations for training

Short-duration sprints, interspersed with brief recoveries, are common during most team sports. The ability to produce the best possible average sprint performance over a series of sprints (≤10 seconds), separated by short (≤60 seconds) recovery periods has been termed repeated-sprint ability (RSA). RSA is therefore an important fitness requirement of team-sport athletes, and it is important to better understand training strategies that can improve this fitness component. Surprisingly, however, there has been little research about the best training methods to improve RSA. In the absence of strong scientific evidence, two principal training theories have emerged. One is based on the concept of training specificity and maintains that the best way to train RSA is to perform repeated sprints. The second proposes that training interventions that target the main factors limiting RSA may be a more effective approach. The aim of this review (Part II) is to critically analyse training strategies to improve both RSA and the underlying factors responsible for fatigue during repeated sprints (see Part I of the preceding companion article). This review has highlighted that there is not one type of training that can be recommended to best improve RSA and all of the factors believed to be responsible for performance decrements during repeated-sprint tasks. This is not surprising, as RSA is a complex fitness component that depends on both metabolic (e.g. oxidative capacity, phosphocreatine recovery and H+ buffering) and neural factors (e.g. muscle activation and recruitment strategies) among others. While different training strategies can be used in order to improve each of these potential limiting factors, and in turn RSA, two key recommendations emerge from this review; it is important to include (i) some training to improve single-sprint performance (e.g. 'traditional' sprint training and strength/power training); and (ii) some high-intensity (80-90% maximal oxygen consumption) interval training to best improve the ability to recover between sprints. Further research is required to establish whether it is best to develop these qualities separately, or whether they can be developed concurrently (without interference effects). While research has identified a correlation between RSA and total sprint distance during soccer, future studies need to address whether training-induced changes in RSA also produce changes in match physical performance.

Walk or run? is high-intensity exercise more effective than moderate-intensity exercise at reducing cardiovascular risk?

The benefits of exercise in the prevention of cardiovascular disease are irrefutable. However, the optimum ‘dose’ of exercise in order to derive the maximum cardiovascular benefit is not certain. Current national and international guidelines advocate the benefits of moderate-intensity exercise. The relative benefits of vigorous versus moderate-intensity exercise have been studied in large epidemiological studies, addressing coronary heart disease and mortality, as well as smaller randomized clinical trials which assessed effects on cardiovascular risk factors. There is evidence that exercise intensity, rather than duration or frequency, is the most important variable in determining cardioprotection. Applying this evidence into practice must take into account the impact of baseline fitness, compliance and the independent risk associated with a sedentary lifestyle. This review aims to evaluate the role of exercise intensity in the reduction of cardiovascular risk, and answer the question: should you be advising your patients to walk or run?

Endurance and sprint benefits of high-intensity and supramaximal interval training

This study examined the effect of two different interval training programs-high-intensity interval training (HIT) and supramaximal interval training (SMIT)-on measures of sprint and endurance performance. Physically active individuals (Females: n=32; age 19.3, s=2.2 years; mass 67.6, s=9.1 kg; stature 172.7, s=6.6 cm. Males: n=23; age 20.0, s=2.7 years; mass 71.3, s=8.3 kg; stature 176.6, s=5.8 cm) completed pre-testing that comprised (1) 3000 m time-trial, (2) 40 m sprint, and (3) repeated sprint ability (RSA-6×40 m sprints, 24 s active recovery) performance. Participants were then matched for average 3000 m running velocity (AV) and randomly assigned to one of three groups: (i) HIT, n=19, 4 min at 100% AV, 4 min passive recovery, 4-6 bouts per session; (ii) SMIT, n=20, 30 s at 130% AV, 150 s passive recovery, 7-12 bouts per session; and (iii) control group, n=16, 30 min continuous running at 75% AV. Groups trained three times per week for six weeks. When time to complete each test were compared among groups: (i) improvements in 3000 m time trial performance were greater following SMIT than continuous running, and (ii) improvements in 40 m sprint and RSA performance were greater following SMIT than HIT and continuous running. In addition, a gender effect was observed for the 3000 m time trial only, where females changed more following the training intervention than males. In summary, for concurrent improvements in endurance, sprint and repeated sprint performance, SMIT provides the greatest benefits for physically active individuals.

Reduced peak oxygen uptake and implications for cardiovascular health and quality of life in patients with schizophrenia

BACKGROUND

Peak oxygen uptake (VO(2peak)) is a strong predictor of cardiovascular disease (CVD) and all-cause mortality, but is inadequately described in patients with schizophrenia. The aim of this study was to evaluate treadmill VO(2peak), CVD risk factors and quality of life (QOL) in patients with schizophrenia (ICD-10, F20-29).

METHODS

33 patients, 22 men (33.7 ± 10.4 years) and 11 women (35.9 ± 11.5 years), were included. Patients VO(2peak) were compared with normative VO(2peak) in healthy individuals from the Nord-Trøndelag Health Study (HUNT). Risk factors were compared above and below the VO(2peak) thresholds; 44.2 and 35.1 ml·kg⁻¹·min⁻¹ in men and women, respectively.

RESULTS

VO(2peak) was 37.1 ± 9.2 ml·kg⁻¹·min⁻¹ in men with schizophrenia; 74 ± 19% of normative healthy men (p < 0.001). VO(2peak) was 35.6 ± 10.7 ml·kg⁻¹·min⁻¹ in women with schizophrenia; 89 ± 25% of normative healthy women (n.s.). Based on odds ratio patients were 28.3 (95% CI = 1.6-505.6) times more likely to have one or more CVD risk factors if they were below the VO(2peak) thresholds. VO(2peak) correlated with the SF-36 physical functioning (r = 0.58), general health (r = 0.53), vitality (r = 0.47), social function (r = 0.41) and physical component score (r = 0.51).

CONCLUSION

Men with schizophrenia have lower VO(2peak) than the general population. Patients with the lowest VO(2peak) have higher odds of having one or more risk factors for cardiovascular disease. VO(2peak) should be regarded as least as important as the conventional risk factors for CVD and evaluation of VO(2peak) should be incorporated in clinical practice.

High-intensity interval exercise in chronic heart failure: protocol optimization

BACKGROUND

There are little data on the optimization of high-intensity aerobic interval exercise (HIIE) protocols in patients with chronic heart failure (CHF). Therefore, we compared acute cardiopulmonary responses to 4 different HIIE protocols to identify the optimal one.

METHODS AND RESULTS

Twenty men with stable systolic CHF performed 4 different randomly ordered single HIIE sessions with measurement of gas exchange. For all protocols (A, B, C, and D) exercise intensity was set at 100% of peak power output (PPO). Interval duration was 30 seconds (A and B) or 90 seconds (C and D), and recovery was passive (A and C) or active (50% of PPO in B and D). Time spent above 85% of VO(2peak) and time above the ventilatory threshold were similar across all 4 HIIE protocols. Total exercise time was significantly longer in protocols with passive recovery intervals (A: 1,651 ± 347 s; C: 1,574 ± 382 s) compared with protocols with active recovery intervals (B: 986 ± 542 s; D: 961 ± 556 s). All protocols appeared to be safe, with exercise tolerance being superior during protocol A.

CONCLUSION

Among the 4 HIIE protocols tested, protocol A with short intervals and passive recovery appeared to be superior.

Assessing running economy during field running with changes of direction: application to 20 m shuttle runs

PURPOSE

To examine physiological responses to submaximal field running with changes of direction (COD), and to compare two approaches to assess running economy (RE) with COD, ie, during square-wave (SW) and incremental (INC) exercises.

METHODS

Ten male team-sport athletes performed, in straight-line or over 20 m shuttles, one maximal INC and four submaximal SW (45, 60, 75 and 90% of the velocity associated with maximal pulmonary O2 uptake [vVO2pmax]). Pulmonary (VO2p) and gastrocnemius (VO2m) O2 uptake were computed for all tests. For both running mode, RE was estimated as the O2 cost per kilogram of bodyweight, per meter of running during all SW and INC.

RESULTS

Compared with straight-line runs, shuttle runs were associated with higher VO2p (eg, 33 ± 6 vs 37 ± 5 mL O2·min-1·kg-1 at 60%, P < .01) and VO2m (eg, 1.1 ± 0.5 vs 1.3 ± 0.8 mL O2·min-1·100 g-1 at 60%, P = .18, Cohen's d = 0.32). With COD, RE was impaired during SW (0.26 ± 0.02 vs 0.24 ± 0.03 mL O2·kg-1·m-1, P < .01) and INC (0.23 ± 0.04 vs 0.16 ± 0.03 mL O2·kg-1·m-1, P < .001). For both SW and INC tests, the changes in RE with COD were related to height (eg, r = .56 [90%CL, 0.01;0.85] for SW) and weekly training/competitive volume (eg, r = -0.58 [-0.86;-0.04] for SW). For both running modes, RE calculated from INC was better than that from SW (both P < .001).

CONCLUSION

Although RE is impaired during field running with COD, team-sport players of shorter stature and/or presenting greater training/competitive volumes may present a lower RE deterioration with COD. Present results do not support the use of INC to assess RE in the field, irrespective of running mode.

American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise

The purpose of this Position Stand is to provide guidance to professionals who counsel and prescribe individualized exercise to apparently healthy adults of all ages. These recommendations also may apply to adults with certain chronic diseases or disabilities, when appropriately evaluated and advised by a health professional. This document supersedes the 1998 American College of Sports Medicine (ACSM) Position Stand, "The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults." The scientific evidence demonstrating the beneficial effects of exercise is indisputable, and the benefits of exercise far outweigh the risks in most adults. A program of regular exercise that includes cardiorespiratory, resistance, flexibility, and neuromotor exercise training beyond activities of daily living to improve and maintain physical fitness and health is essential for most adults. The ACSM recommends that most adults engage in moderate-intensity cardiorespiratory exercise training for ≥30 min·d on ≥5 d·wk for a total of ≥150 min·wk, vigorous-intensity cardiorespiratory exercise training for ≥20 min·d on ≥3 d·wk (≥75 min·wk), or a combination of moderate- and vigorous-intensity exercise to achieve a total energy expenditure of ≥500-1000 MET·min·wk. On 2-3 d·wk, adults should also perform resistance exercises for each of the major muscle groups, and neuromotor exercise involving balance, agility, and coordination. Crucial to maintaining joint range of movement, completing a series of flexibility exercises for each the major muscle-tendon groups (a total of 60 s per exercise) on ≥2 d·wk is recommended. The exercise program should be modified according to an individual's habitual physical activity, physical function, health status, exercise responses, and stated goals. Adults who are unable or unwilling to meet the exercise targets outlined here still can benefit from engaging in amounts of exercise less than recommended. In addition to exercising regularly, there are health benefits in concurrently reducing total time engaged in sedentary pursuits and also by interspersing frequent, short bouts of standing and physical activity between periods of sedentary activity, even in physically active adults. Behaviorally based exercise interventions, the use of behavior change strategies, supervision by an experienced fitness instructor, and exercise that is pleasant and enjoyable can improve adoption and adherence to prescribed exercise programs. Educating adults about and screening for signs and symptoms of CHD and gradual progression of exercise intensity and volume may reduce the risks of exercise. Consultations with a medical professional and diagnostic exercise testing for CHD are useful when clinically indicated but are not recommended for universal screening to enhance the safety of exercise.

Effects of high aerobic intensity training in patients with schizophrenia: a controlled trial

BACKGROUND

Patients with schizophrenia have a high risk of cardiovascular disease (CVD). High aerobic intensity training (HIT) improve peak oxygen uptake (VO(2peak)), net mechanical efficiency of walking and risk factors for CVD but has not been investigated in patients with schizophrenia.

AIMS

To investigate effects from HIT on VO(2peak), net mechanical efficiency of walking and risk factors for CVD in patients with schizophrenia.

METHODS

25 inpatients (F20-29, ICD-10) were allocated to either HIT or playing computer games (CG), 3 days per week for 8 weeks. HIT consisted of 4 × 4-min intervals with 3-min break periods, at 85-95% and 70% of peak heart rate, respectively.

RESULTS

12 and seven patients completed HIT and CG, respectively. The baseline VO(2peak) in both groups combined (n = 19) was 36.8 ± 8.2 ml/kg/min and 3.12 ± 0.55 l/min. The HIT group improved VO(2peak) by 12% from 3.17 ± 0.59 to 3.56 ± 0.68 l/min (P < 0.001), more than the CG group (P = 0.014). Net mechanical efficiency of walking improved by 12% in the HIT group from 19.8 ± 3.0% to 22.2 ± 4.5% (P = 0.005), more than the CG group (P = 0.031). The psychiatric symptoms, expressed as the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS), did not improve in either group.

CONCLUSIONS

VO(2peak) and net mechanical efficiency of walking improved significantly by 8 weeks of HIT. HIT should be included in rehabilitation in order to improve physical capacity and contribute risk reduction of CVD.

High intensity interval training alters substrate utilization and reduces oxygen consumption in the heart

AIMS

although exercise training induces hypertrophy with improved contractile function, the effect of exercise on myocardial substrate metabolism and cardiac efficiency is less clear. High intensity training has been shown to produce more profound effects on cardiovascular function and aerobic capacity than isocaloric low and moderate intensity training. The aim of the present study was to explore metabolic and mechanoenergetic changes in the heart following endurance exercise training of both high and moderate intensity.

METHODS AND RESULTS

C57BL/6J mice were subjected to 10 wk treadmill running, either high intensity interval training (HIT) or distance-matched moderate intensity training (MIT), where HIT led to a pronounced increase in maximal oxygen uptake. Although both modes of exercise were associated with a 10% increase in heart weight-to-body weight ratio, only HIT altered cardiac substrate utilization, as revealed by a 36% increase in glucose oxidation and a concomitant reduction in fatty acid oxidation. HIT also improved cardiac efficiency by decreasing work-independent myocardial oxygen consumption. In addition, it increased cardiac maximal mitochondrial respiratory capacity.

CONCLUSION

This study shows that high intensity training is required for induction of changes in cardiac substrate utilization and energetics, which may contribute to the superior effects of high compared with moderate intensity training in terms of increasing aerobic capacity.

Adaptations to aerobic interval training: interactive effects of exercise intensity and total work duration

To compare the effects of three 7-week interval training programs varying in work period duration but matched for effort in trained recreational cyclists. Thirty-five cyclists (29 male, 6 female, VO(2peak) 52 ± 6 mL kg/min) were randomized to four training groups with equivalent training the previous 2 months (∼6 h/wk, ∼1.5 int. session/wk). Low only (n=8) trained 4-6 sessions/wk at a low-intensity. Three groups (n=9 each) trained 2 sessions/wk × 7 wk: 4 × 4 min, 4 × 8 min, or 4 × 16 min, plus 2-3 weekly low-intensity bouts. Interval sessions were prescribed at the maximal tolerable intensity. Interval training was performed at 88 ± 2, 90 ± 2, and 94 ± 2% of HR(peak) and 4.9, 9.6, and 13.2 mmol/L blood lactate in 4 × 16, 4 × 8, and 4 × 4 min groups, respectively (both P<0.001). 4 × 8 min training induced greater overall gains in VO(2) peak, power@VO(2) peak, and power@4 mM bLa- (Mean ± 95%CI): 11.4 (8.0-14.9), vs 4.2 (0.4-8.0), 5.6 (2.1-9.1), and 5.5% (2.0-9.0) in Low, 4 × 16, and 4 × 4 min groups, respectively (P<0.02 for 4 × 8 min vs all other groups). Interval training intensity and accumulated duration interact to influence the adaptive response. Accumulating 32 min of work at 90% HR max induces greater adaptive gains than accumulating 16 min of work at ∼95% HR max despite lower RPE.

High-intensity interval running is perceived to be more enjoyable than moderate-intensity continuous exercise: implications for exercise adherence

The aim of this study was to objectively quantify ratings of perceived enjoyment using the Physical Activity Enjoyment Scale following high-intensity interval running versus moderate-intensity continuous running. Eight recreationally active men performed two running protocols consisting of high-intensity interval running (6 × 3 min at 90% VO(2max) interspersed with 6 × 3 min active recovery at 50% VO(2max) with a 7-min warm-up and cool down at 70% VO(2max)) or 50 min moderate-intensity continuous running at 70% VO(2max). Ratings of perceived enjoyment after exercise were higher (P < 0.05) following interval running compared with continuous running (88 ± 6 vs. 61 ± 12) despite higher (P < 0.05) ratings of perceived exertion (14 ± 1 vs. 13 ± 1). There was no difference (P < 0.05) in average heart rate (88 ± 3 vs. 87 ± 3% maximum heart rate), average VO(2) (71 ± 6 vs. 73 ± 4%VO(2max)), total VO(2) (162 ± 16 vs. 166 ± 27 L) or energy expenditure (811 ± 83 vs. 832 ± 136 kcal) between protocols. The greater enjoyment associated with high-intensity interval running may be relevant for improving exercise adherence, since running is a low-cost exercise intervention requiring no exercise equipment and similar relative exercise intensities have previously induced health benefits in patient populations.

Aerobic training stimulates growth and promotes disease resistance in Atlantic salmon (Salmo salar)

Improving fish robustness is of utmost relevance to reducing fish losses in farming. Although not previously examined, we hypothesized that aerobic training, as shown for human studies, could strengthen disease resistance in Atlantic salmon (Salmo salar). Thus, we exercised salmon pre-smolts for 6 weeks at two different aerobic training regimes; a continuous intensity training (CT; 0.8bls(-1)) and an interval training (IT; 0.8bl s(-1) 16h and 1.0bl s(-1) 8h) and compared them with untrained controls (C; 0.05bl s(-1)). The effects of endurance training on disease resistance were evaluated using an IPN virus challenge test, while the cardiac immune modulatory effects were characterized by qPCR and microarray gene expression analyses. In addition, swimming performance and growth parameters were investigated. Survival after the IPN challenge was higher for IT (74%) fish than for either CT (64%) or C (61%) fish. While both CT and IT groups showed lower cardiac transcription levels of TNF-α, IL-1β and IL-6 prior to the IPN challenge test, IT fish showed the strongest regulation of genes involved in immune responses and other processes known to affect disease resistance. Both CT and IT regimes resulted in better growth compared with control fish, with CT fish developing a better swimming efficiency during training. Overall, interval aerobic training improved growth and increased robustness of Atlantic salmon, manifested by better disease resistance, which we found was associated with a modulation of relevant gene classes on the cardiac transcriptome.

Acute Responses to High-Intensity Intermittent Exercise in CHD Patients

PURPOSE

although the acute physiological responses to continuous exercise have been well documented in CHD patients, no previous study has examined the responses to high-intensity intermittent exercise in these patients. The purpose of this study was to compare the physiological responses to a high-intensity interval exercise (HIIE) protocol versus a moderate-intensity continuous exercise (MICE) protocol of similar energy expenditure in CHD patients.

METHODS

twenty patients with stable CHD (19 males and 1 female, 62 ± 11 yr) were assigned in random order to a single session of HIIE corresponding to 15-s intervals at 100% of peak power output (PPO) and 15-s passive recovery intervals and, 2 wk later, to an isocaloric MICE corresponding to 70% of PPO.

RESULTS

both protocols were equivalent in terms of energy expenditure. The HIIE protocol resulted in lower mean ventilation (P < 0.001) for a small difference in metabolic demand. All participants preferred the HIIE mainly because the perceived exertion measured by the Borg scale was lower (P < 0.05). No elevation of serum concentration of troponin T was found in all participants at baseline and at 20 min and 24 h after the exercise sessions, thus excluding the presence of any exercise-induced myocardial injury in our patients.

CONCLUSIONS

when considering physiological responses, safety, and perceived exertion, the HIIE protocol seemed to be well tolerated and more efficient in this group of stable CHD patients.

[High intensity training (HIT) for the improvement of endurance capacity of recreationally active people and in prevention & rehabilitation]

Although intensive exercise protocols are commonly used in practical training and scientific studies, there is recently a great scientific discussion about "high intensity (interval) training" (HIT). New are the large amounts of studies and the more detailed knowledge about the physiological responses and adaptations to HIT in comparison to the classic high volume, low intensity endurance training. The present article summarizes the current knowledge about HIT in endurance exercise for clinical applications. In the first part, molecular and cellular adaptations to HIT are discussed in comparison to low intensity high volume training. Furthermore, studies are summarized which compare HIT vs. HVT in the field of prevention and rehabilitation. Terminally the differences in physiological stimuli of both training interventions are considered.

Controlled study of myocardial recovery after interval training in heart failure: SMARTEX-HF--rationale and design

BACKGROUND

The large randomized controlled multicentre clinical trial, HF-ACTION, recently demonstrated that a programme of recommendation of regular exercise training at moderate intensity is safe, improves quality of life, and reduces the combined endpoint of all-cause death and hospitalization in patients with chronic heart failure. However, the size of beneficial effects was modest compared to results published in smaller single studies and meta-analyses.

OBJECTIVE

Based on results of a pilot study, the objective of the present investigation is to test the hypothesis that a programme comprising interval training at high relative intensity would yield significantly larger effects in terms of left ventricular remodelling compared to moderate continuous exercise training.

STUDY DESIGN

In a three-armed randomized multicentre study of stable heart failure patients with left ventricular ejection fraction ≤35%, the effects of a 12-week programme of high-intensity interval training (HIT; 85-90% of peak oxygen uptake, VO(2peak)) will be compared to actual practice in Europe, represented by either an isocaloric programme of moderate continuous training (MCT; 50-60% of VO(2peak)) and a recommendation of regular exercise (RE) of the individual patients' own preference based on clinical practice at the local centre. The primary endpoint is reverse remodelling, defined as change in left ventricular end-diastolic diameter assessed by echocardiography. Secondary endpoints include peak oxygen uptake (VO(2peak)), biomarkers, quality of life, and level of physical activity assessed by questionnaires. In addition, long-term maintenance of effects after the supervised training period will be determined. Assessments will be made at baseline, after the 12-week intervention programme, and at 1-year follow up. A total number of 200 patients on treatment per protocol, randomized to the three groups in a 1 : 1 : 1 manner, is estimated to detect clinically relevant differences in effect with HIT vs. MCT and RE (p < 0.05; statistical power 0.90) for the primary endpoint. Inclusion of patients started May 2009 and will run until total number has been reached.

Vitamin C Consumption Does Not Impair Training-Induced Improvements in Exercise Performance

Purpose:

To test the hypothesis that antioxidants can attenuate high-intensity interval training–induced improvements in exercise performance.

Methods:

Two groups of recreationally active males performed a high-intensity interval running protocol, four times per week for 4 wk. Group 1 (n = 8) consumed 1 g of vitamin C daily throughout the training period, whereas Group 2 (n = 7) consumed a visually identical placebo. Pre- and posttraining, subjects were assessed for VO2max, 10 km time trial, running economy at 12 km/h and distance run on the YoYo intermittent recovery tests level 1 and 2 (YoYoIRT1/2). Subjects also performed a 60 min run before and after training at a running velocity of 65% of pretraining VO2max so as to assess training-induced changes in substrate oxidation rates.

Results:

Training improved (P < .0005) VO2max, 10 km time trial, running economy, YoYoIRT1 and YoYoIRT2 in both groups, although there was no difference (P = .31, 0.29, 0.24, 0.76 and 0.59) between groups in the magnitude of training-induced improvements in any of the aforementioned parameters. Similarly, training also decreased (P < .0005) mean carbohydrate and increased mean fat oxidation rates during submaximal exercise in both groups, although no differences (P = .98 and 0.94) existed between training conditions.

Conclusions:

Daily oral consumption of 1 g of vitamin C during a 4 wk high-intensity interval training period does not impair training-induced improvements in the exercise performance of recreationally active males.

Heart rate response to exercise and cardiorespiratory fitness of young women at high familial risk for hypertension: effects of interval vs continuous training

Exercise training is an effective intervention for treating and preventing hypertension, but its effects on heart rate (HR) response to exercise and cardiorespiratory fitness (CRF) of non-hypertensive offspring of hypertensive parents (FH+) has not been studied. We compared the effects of three times per week equal-volume high-intensity aerobic interval (AIT) and continuous moderate-intensity exercise (CME) on HR response to exercise and CRF of FH+. Forty-four young FH+ women (25.0 ± 4.4 years) randomized to control (CON; n = 12), AIT (80-90% of VO(2MAX); n = 16), or CME (50-60% of VO(2MAX); n = 16) performed a graded exercise test (GXT) before and after 16 weeks of follow-up to evaluate HR response to exercise and several parameters of CRF. Resting, maximal, and reserve HR did not change after the follow-up in all groups. HR recovery (difference between HR(MAX) and HR at 1 minute of GXT recovery phase) improved only after AIT (11.8 ± 4.9 vs. 20.6 ± 5.8 bpm, p < 0.01). Both exercise programmes were effective for improving CRF parameters, but AIT was more effective than CME for improving oxygen consumption at the respiratory compensation point (VO(2RCP); 22.1% vs. 8.8%, p = 0.008) and maximal effort (VO(2MAX); 15.8% vs. 8.0%, p = 0.036), as well as tolerance time (TT) to reach anaerobic threshold (TT(AT); 62.0 vs. 37.7, p = 0.048), TT(RCP) (49.3 vs. 32.9, p = 0.032), and TT(MAX) (38.9 vs. 29.2, p = 0.042). Exercise intensity was an important factor in improving HR recovery and CRF of FH+women. These findings may have important implications for designing exercise-training programmes for the prevention of an inherited hypertensive disorder.

High-intensity intermittent exercise and fat loss

The effect of regular aerobic exercise on body fat is negligible; however, other forms of exercise may have a greater impact on body composition. For example, emerging research examining high-intensity intermittent exercise (HIIE) indicates that it may be more effective at reducing subcutaneous and abdominal body fat than other types of exercise. The mechanisms underlying the fat reduction induced by HIIE, however, are undetermined. Regular HIIE has been shown to significantly increase both aerobic and anaerobic fitness. HIIE also significantly lowers insulin resistance and results in a number of skeletal muscle adaptations that result in enhanced skeletal muscle fat oxidation and improved glucose tolerance. This review summarizes the results of HIIE studies on fat loss, fitness, insulin resistance, and skeletal muscle. Possible mechanisms underlying HIIE-induced fat loss and implications for the use of HIIE in the treatment and prevention of obesity are also discussed.

Relative workload determines exercise-induced increases in PGC-1alpha mRNA

INTRODUCTION

The hypothesis that brief intermittent exercise-induced increases in human skeletal muscle metabolic mRNA is dependent on relative workload was investigated.

METHODS

Trained (n = 10) and untrained (n = 8) subjects performed exhaustive intermittent cycling exercise (4 x 4 min at 85% of VO(2peak), interspersed by 3 min). Trained subjects also performed the intermittent exercise at the same absolute workload as the untrained subjects, corresponding to 70% of VO(2peak) (n = 6).

RESULTS

Exercise at 85% of V(O2peak) elevated (P < 0.001) venous plasma lactate to 10.1 +/- 0.4 and 10.8 +/- 0.5 mM in the trained and untrained subjects, respectively. Peroxisome proliferator-activated receptor gamma coactivator 1alpha (PGC-1alpha) mRNA expression was increased (P < 0.001) approximately four- to fivefold for several hours after exercise in both groups. After exercise at 70% of VO(2peak), venous plasma lactate was less (P < 0.001) elevated (3.1 +/- 0.7 mM) and PGC-1alpha mRNA content was less (P < 0.05) increased (approximately threefold) than after exercise at 85% of VO(2peak). Likewise, pyruvate dehydrogenase kinase 4 and hexokinase II mRNA expressions were increased (P < 0.05) only after exercise performed at 85% of VO(2peak) in the trained subjects. Hypoxia-inducible factor 2alpha mRNA only increased (P < 0.05) 3 h into recovery in trained subjects, with no difference between the 70% and 85% of VO(2peak) trial. No change in hypoxia-inducible factor 1alpha, phosphofructokinase, citrate synthase, or lactate dehydrogenase, heart and muscle isoforms, mRNA expressions was detected after any of the exercise trials.

CONCLUSIONS

The relative intensity of brief intermittent exercise is of major importance for the exercise-induced increase of several mRNA, including PGC-1alpha.

Cardiac output but not stroke volume is similar in a Wingate and VO2peak test in young men

Wingate test (WT) training programmes lasting 2-3 weeks lead to improved peak oxygen consumption. If a single 30 s WT was capable of significantly increasing stroke volume and cardiac output, the increase in peak oxygen consumption could possibly be explained by improved oxygen delivery. Thus, we investigated whether a single WT increases stroke volume and cardiac output to similar levels than those obtained at peak exercise during a graded cycling exercise test (GXT) to exhaustion. Fifteen healthy young men (peak oxygen consumption 45.0 ± 5.3 ml kg(-1) min(-1)) performed one WT and one GXT on separate days in randomised order. During the tests, we estimated cardiac output using inert gas rebreathing (nitrous oxide and sulphur hexafluoride) and subsequently calculated stroke volume. We found that cardiac output was similar (18.2 ± 3.3 vs. 17.9 ± 2.6 l min(-1); P = 0.744), stroke volume was higher (127 ± 37 vs. 94 ± 15 ml; P < 0.001), and heart rate was lower (149 ± 26 vs. 190 ± 12 beats min(-1); P < 0.001) at the end (27 ± 2 s) of a WT as compared to peak exercise during a GXT. Our results suggest that a single WT produces a haemodynamic response which is characterised by similar cardiac output, higher stroke volume and lower heart rate as compared to peak exercise during a GXT.

What is Best Practice for Training Intensity and Duration Distribution in Endurance Athletes?

Successful endurance training involves the manipulation of training intensity, duration, and frequency, with the implicit goals of maximizing performance, minimizing risk of negative training outcomes, and timing peak fitness and performances to be achieved when they matter most. Numerous descriptive studies of the training characteristics of nationally or internationally competitive endurance athletes training 10 to 13 times per week seem to converge on a typical intensity distribution in which about 80% of training sessions are performed at low intensity (2 mM blood lactate), with about 20% dominated by periods of high-intensity work, such as interval training at approx. 90% VO2max. Endurance athletes appear to self-organize toward a high-volume training approach with careful application of high-intensity training incorporated throughout the training cycle. Training intensification studies performed on already well-trained athletes do not provide any convincing evidence that a greater emphasis on high-intensity interval training in this highly trained athlete population gives long-term performance gains. The predominance of low-intensity, long-duration training, in combination with fewer, highly intensive bouts may be complementary in terms of optimizing adaptive signaling and technical mastery at an acceptable level of stress.

Mechanisms of exercise-induced improvements in the contractile apparatus of the mammalian myocardium

One of the main outcomes of aerobic endurance exercise training is the improved maximal oxygen uptake, and this is pivotal to the improved work capacity that follows the exercise training. Improved maximal oxygen uptake in turn is at least partly achieved because exercise training increases the ability of the myocardium to produce a greater cardiac output. In healthy subjects, this has been demonstrated repeatedly over many decades. It has recently emerged that this scenario may also be true under conditions of an initial myocardial dysfunction. For instance, myocardial improvements may still be observed after exercise training in post-myocardial infarction heart failure. In both health and disease, it is the changes that occur in the individual cardiomyocytes with respect to their ability to contract that by and large drive the exercise training-induced adaptation to the heart. Here, we review the evidence and the mechanisms by which exercise training induces beneficial changes in the mammalian myocardium, as obtained by means of experimental and clinical studies, and argue that these changes ultimately alter the function of the whole heart and contribute to the changes in whole-body function.

Usefulness of cardiorespiratory fitness to predict coronary heart disease risk independent of physical activity

Cardiorespiratory fitness has often been interpreted as a surrogate measurement of physical activity rather than an independent coronary heart disease (CHD) risk factor per se. Fitness is also known to be highly heritable, however, and rats bred selectively for treadmill endurance have low CHD risk phenotypes even in the absence of physical activity. Therefore, I assessed whether cardiorespiratory fitness predicted CHD independent of physical activity in 29,721 men followed prospectively for 7.7 years as part of the National Runners' Health Study. Specifically, CHD deaths and incident participant-reported physician-diagnosed myocardial infarction, revascularization procedures (coronary artery bypass grafting and percutaneous coronary intervention), and angina pectoris during follow-up were compared to baseline cardiorespiratory fitness (10-km footrace performance, meters/second). Nonfatal end points for the 80% of these men who provided follow-up questionnaires included 121 nonfatal myocardial infarctions, 317 revascularization procedures, and 81 angina pectora. The National Death Index identified 44 CHD deaths. Per meter/second increment in baseline fitness, men's risks decreased 54% for nonfatal myocardial infarction (p <0.0001), 44% for combined CHD deaths and nonfatal myocardial infarction (p = 0.0003), 53% for angina pectoris (p = 0.001), and 32% for revascularizations (p = 0.002). Adjustment for physical activity (kilometer/day run) had little effect on the per meter/second risk decreases for nonfatal myocardial infarction (from 64% to 63%), combined CHD deaths and nonfatal myocardial infarction (from 34% to 33%), angina pectoris (from 53% to 47%) or revascularizations (from 32% to 26%). In conclusion, the results suggest that cardiorespiratory fitness is a CHD risk factor, largely independent of physical activity, which warrants clinical screening.

Mitochondrial gene expression in elite cyclists: effects of high-intensity interval exercise

Little is known about the effect of training on genetic markers for mitochondrial biogenesis in elite athletes. We tested the hypothesis that low-volume sprint interval exercise (SIE) would be as effective as high-volume interval exercise (IE). Ten male cyclists competing on national elite level (W (max) 403 ± 13 W, VO(2peak) 68 ± 1 mL kg(-1) min(-1)) performed two interval exercise protocols: 7 × 30-s "all-out" bouts (SIE) and 3 × 20-min bouts at ~87% of VO(2peak) (IE). During IE, the work was eightfold larger (1,095 ± 43 vs. 135 ± 5 kJ) and the exercise duration 17 times longer (60 vs. 3.5 min) than during SIE. Muscle samples were taken before and 3 h after exercise. The mRNA of upstream markers of mitochondrial biogenesis [peroxisome proliferator-activated receptor-γ coactivator-1 (PGC-1α), PGC-1α-related coactivator (PRC) and peroxisome proliferator-activated receptor δ (PPARδ)] increased to the same extent after SIE and IE (6-, 1.5- and 1.5-fold increase, respectively). Of the downstream targets of PGC-1α, mitochondrial transcription factor A (Tfam) increased only after SIE and was significantly different from that after IE (P < 0.05), whereas others increased to the same extent (pyruvate dehydrogenase kinase, PDK4) or was unchanged (nuclear respiratory factor 2, NRF2). We conclude that upstream genetic markers of mitochondrial biogenesis increase in a similar way in elite athletes after one exercise session of SIE and IE. However, since the volume and duration of work was considerably lower during SIE and since Tfam, the downstream target of PGC-1α, increased only after SIE, we conclude that SIE might be a time-efficient training strategy for highly trained individuals.

Block training periodization in alpine skiing: effects of 11-day HIT on VO2max and performance

Attempting to achieve the high diversity of training goals in modern competitive alpine skiing simultaneously can be difficult and may lead to compromised overall adaptation. Therefore, we investigated the effect of block training periodization on maximal oxygen consumption (VO2max) and parameters of exercise performance in elite junior alpine skiers. Six female and 15 male athletes were assigned to high-intensity interval (IT, N = 13) or control training groups (CT, N = 8). IT performed 15 high-intensity aerobic interval (HIT) sessions in 11 days. Sessions were 4 x 4 min at 90-95% of maximal heart rate separated by 3-min recovery periods. CT continued their conventionally mixed training, containing endurance and strength sessions. Before and 7 days after training, subjects performed a ramp incremental test followed by a high-intensity time-to-exhaustion (tlim) test both on a cycle ergometer, a 90-s high-box jump test as well as countermovement (CMJ) and squat jumps (SJ) on a force plate. IT significantly improved relative VO2max by 6.0% (P < 0.01; male +7.5%, female +2.1%), relative peak power output by 5.5% (P < 0.01) and power output at ventilatory threshold 2 by 9.6% (P < 0.01). No changes occurred for these measures in CT. tlim remained unchanged in both groups. High-box jump performance was significantly improved in males of IT only (4.9%, P < 0.05). Jump peak power (CMJ -4.8%, SJ -4.1%; P < 0.01), but not height decreased in IT only. For competitive alpine skiers, block periodization of HIT offers a promising way to efficiently improve VO2max and performance. Compromised explosive jump performance might be associated with persisting muscle fatigue.

High-intensity aerobic exercise training improves the heart in health and disease

Regular exercise training confers beneficial effects to the heart as well as to the entire body. This occurs partly because exercise training improves skeletal muscle work capacity and reduces resistance, thus increasing conductance in the peripheral circulation. More directly, exercise training also alters extrinsic modulation of the heart and improves the intrinsic pump capacity of the heart. Together, these effects allow for improved exercise capacity. Accumulating evidence suggests that the magnitude of these benefits increases proportionally with the intensity of individual exercise training sessions constituting the exercise training program. It has emerged that regular exercise training also confers beneficial effects to patients at risk for, or who have, established heart dysfunction and disease and, moreover, that exercise training may reduce the dysfunction of the heart itself and, at least, partly restore its ability to effectively function as a pump. The most recent studies in patients with established heart disease suggest that a high relative, yet aerobic, intensity of the exercise training improves the intrinsic pump capacity of the myocardium, an effect not previously believed to occur with exercise training. However, more and larger studies are needed to establish the safety and efficacy of such exercise training in patients with heart disease. Here, we consider the nature of the intensity dependence of exercise training and the causes of the improved heart function.