The effects of periodized concurrent and aerobic training on oxidative stress parameters, endothelial function and immune response in sedentary male individuals of middle age

Effects of Different Intensities and Durations of Aerobic Exercise on Vascular Endothelial Function in Middle-Aged and Elderly People: A Meta-analysis

Background

Previous studies have found that aerobic exercise was more effective in improving vascular endothelial function than resistance training, high-intensity interval training (HIIT), and other types of exercise, while the effects between different intensities and durations of aerobic exercise were unclear. Therefore, we performed this meta-analysis to investigate the effects of different intensities and durations of aerobic exercise on the vascular endothelial function of middle-aged and elderly people.

Methods:

Databases were searched up to April 2021 for studies evaluating the influences of different intensities and durations of aerobic exercise on endothelial function assessed by flow-mediated dilation (FMD) among healthy middle-aged and elderly people. Data were pooled using random-effects models to obtain the weighted mean difference (WMD) and 95% confidence intervals (CIs).

Results

A total of 9 studies involving 221 participants fulfilled the inclusion criteria. Aerobic exercise improved the overall FMD of healthy middle-aged and elderly people [WMD, 1.33 (95% CI, 0.37–2.28), P < 0.05]. Specifically, vigorous-intensity exercise increased FMD significantly in healthy middle-aged and elderly people [WMD, 1.10 (95% CI, 0.27–1.93), P < 0.05], while moderate-intensity exercise had no significant association with FMD [WMD, 1.49 (95% CI, −0.62 to 3.60), P = 0.17]. In addition, long-term (8 weeks or above) aerobic exercise increased the FMD in healthy middle-aged and elderly people [WMD, 1.63 (95% CI, 0.61–2.66), P < 0.05], while one-time acute aerobic exercise had no significant association with FMD of healthy middle-aged and elderly people [WMD, 0.89 (95% CI, −1.47 to 3.24), P = 0.46]. Specifically, 8 weeks or above of vigorous-intensity exercise increased FMD significantly in healthy middle-aged and elderly people [WMD, 1.48 (95% CI, 1.06–1.90), P < 0.01], while 8 weeks or above of moderate aerobic exercise had no significant association with FMD [WMD, 1.49 (95% CI, −0.62 to 3.60), P = 0.17].

Conclusion

Aerobic exercise, especially 8 weeks or above of vigorous-intensity aerobic exercise, improved the endothelial function in healthy middle-aged and elderly people.

Type and Intensity as Key Variable of Exercise in Metainflammation diseases: A Review

Monocyte and lymphocyte subpopulations exhibit functions that vary between the anti- and pro-inflammatory spectrum, such as classic CD16- and non-classical CD16+ monocytes, as well as T helper 2 lymphocytes (Th2), the Th1/Th17 lymphocytes ratio, and T regulatory lymphocytes (Treg). Metabolic disease-associated inflammation is accompanied by an imbalance in monocyte and lymphocyte phenotypes and functionality, as well as a stronger proportion of inflammatory subpopulations. These changes appear to be important for the development and progression of diseases like diabetes and cardiovascular disease. On the other hand, the regular practice of physical exercise is an important tool to restore the functionality of monocytes and lymphocytes, and to balance the subtypes ratio. However, key variables regarding exercise prescription, such as the type of exercise, intensity, and volume differentially impact on the acute and chronic immune response in individuals diagnosed with meta inflammation diseases. Here, we discuss the impact of different physical exercise protocols, acutely and chronically, on monocytes and lymphocytes of individuals with metabolic disease-associated inflammation. In this review, we focus on the best effects of different exercise protocols to dose the "exercise pill" in different inflammatory status.

Effects of Concurrent Training on 1RM and VO2 in Adults: Systematic Review with Meta-analysis

The purpose of this systematic review was to analyze the effects of concurrent training on one repetition maximum (1RM), maximum oxygen consumption (VO₂max), and peak oxygen consumption (VO₂peak) in healthy adults. The review followed PRISMA recommendations using randomized controlled trials in nine databases. Twenty-one studies met the inclusion criteria, totaling a sample of 796 subjects to perform the meta-analysis. As result, concurrent training provides similar increases in 1RM as strength training for upper limbs (standardized mean difference [SMD]: 0.12; 95% IC: [-0.18; 0.41]; p=0.43) and for the lower limbs (SMD: -0.32; 95% IC: [-0.79; 0.15]; p=0.19). Similarly, no difference was found in the aerobic capacity between the concurrent training vs. aerobic training groups ([SMD - VO₂max]: -0.19; 95% IC: [-0.71; 0.33]; p=0.48 and [SMD - VO₂peak]: -0.24; 95% IC: [-0.57; 0.08]; p=0.14). Based on the results found, we can affirm that a) similar to strength training, concurrent training provides maximum strength development for upper and lower limbs; and b) cardiorespiratory capacity is not impaired by concurrent training in relation to aerobic training, demonstrating the compatibility of the two training sessions.

Reactive oxygen species in exercise and insulin resistance: Working towards personalized antioxidant treatment

Reactive oxygen species (ROS) are well known for their role in insulin resistance and the development of cardiometabolic disease including type 2 diabetes mellitus (T2D). Conversely, evidence supports the notion that ROS are a necessary component for glucose cell transport and adaptation to physiological stress including exercise and muscle contraction. Although genetic rodent models and cell culture studies indicate antioxidant treatment to be an effective strategy for targeting ROS to promote health, human findings are largely inconsistent. In this review we discuss human research that has investigated antioxidant treatment and glycemic control in the context of health (healthy individuals and during exercise) and disease (insulin resistance and T2D). We have identified key factors that are likely to influence the effectiveness of antioxidant treatment: 1) the context of treatment including whether oxidative distress or eustress is present (e.g., hyperglycemia/lipidaemia or during exercise and muscle contraction); 2) whether specific endogenous antioxidant deficiencies are identified (redox screening); 3) whether antioxidant treatment is specifically designed to target and restore identified deficiencies (antioxidant specificity); 4) and the bioavailability and bioactivity of the antioxidant which are influenced by treatment dose, duration, and method of administration. The majority of human research has failed to account for these factors, limiting their ability to robustly test the effectiveness of antioxidants for health promotion and disease prevention. We propose that a modern "redox screening" and "personalized antioxidant treatment" approach is required to robustly explore redox regulation of human physiology and to elicit more effective antioxidant treatment in humans.

Flexibility of equine bioenergetics and muscle plasticity in response to different types of training: An integrative approach, questioning existing paradigms

Equine bioenergetics have predominantly been studied focusing on glycogen and fatty acids. Combining omics with conventional techniques allows for an integrative approach to broadly explore and identify important biomolecules. Friesian horses were aquatrained (n = 5) or dry treadmill trained (n = 7) (8 weeks) and monitored for: evolution of muscle diameter in response to aquatraining and dry treadmill training, fiber type composition and fiber cross-sectional area of the M. pectoralis, M. vastus lateralis and M. semitendinosus and untargeted metabolomics of the M. pectoralis and M. vastus lateralis in response to dry treadmill training. Aquatraining was superior to dry treadmill training to increase muscle diameter in the hindquarters, with maximum effect after 4 weeks. After dry treadmill training, the M. pectoralis showed increased muscle diameter, more type I fibers, decreased fiber mean cross sectional area, and an upregulated oxidative metabolic profile: increased β-oxidation (key metabolites: decreased long chain fatty acids and increased long chain acylcarnitines), TCA activity (intermediates including succinyl-carnitine and 2-methylcitrate), amino acid metabolism (glutamine, aromatic amino acids, serine, urea cycle metabolites such as proline, arginine and ornithine) and xenobiotic metabolism (especially p-cresol glucuronide). The M. vastus lateralis expanded its fast twitch profile, with decreased muscle diameter, type I fibers and an upregulation of glycolytic and pentose phosphate pathway activity, and increased branched-chain and aromatic amino acid metabolism (cis-urocanate, carnosine, homocarnosine, tyrosine, tryptophan, p-cresol-glucuronide, serine, methionine, cysteine, proline and ornithine). Trained Friesians showed increased collagen and elastin turn-over. Results show that branched-chain amino acids, aromatic amino acids and microbiome-derived xenobiotics need further study in horses. They feed the TCA cycle at steps further downstream from acetyl CoA and most likely, they are oxidized in type IIA fibers, the predominant fiber type of the horse. These study results underline the importance of reviewing existing paradigms on equine bioenergetics.

Effects of Nonperiodized and Linear Periodized Combined Training on Health-Related Physical Fitness in Adults With Obesity: A Randomized Controlled Trial

Streb, AR, Passos da Silva, R, Leonel, LdS, Possamai, LT, Gerage da Silva, AM, Turnes, T, and Del Duca, GF. Effects of nonperiodized and linear periodized combined training on health-related physical fitness in adults with obesity: a randomized controlled trial. J Strength Cond Res XX(X): 000-000, 2020-The aim of this randomized controlled trial study was to compare the effects of 16 weeks of linear periodized and nonperiodized combined training (CT) on cardiorespiratory fitness, muscle strength, and body composition indicators of adults with obesity. Thirty-four obese adults of both sexes (36.6 ± 4.4 years; body mass index, 32.9 ± 2.7 kg·m) were divided into nonperiodized (NG; n = 8), linear periodized (PG; n = 11), and control (CG; n = 15) groups. The NG and PG groups performed 3 weekly sessions of CT over 16 weeks in different ways. Anthropometric measures, maximal strength for leg press and barbell bench press, maximal oxygen uptake (V[Combining Dot Above]O2max), and ventilatory thresholds were determined before and after the intervention. The generalized estimation equation was used, adopting the level of significance for the interaction of 0.10, and 0.05 for the isolated effect of time or group or both. Significant and similar increases were observed in the 1-repetition maximum test for bench press (NG: 48.8 ± 5.7 to 55.0 ± 6.1 kg; PG: 48.7 ± 5.7 to 53.8 ± 5.9 kg; p = 0.001) and leg press (NG: 235.2 ± 18.7 to 268.3 ± 19.7 kg; PG: 223.1 ± 25.3 to 253.3 ± 23.1 kg; p = 0.05) in trained groups. Relative V[Combining Dot Above]O2max improved only in PG (27.8 ± 1.3 to 32.0 ± 1.4 mL·kg·min; p = 0.05), whereas ventilatory thresholds improved in NG and CG (p = 0.004 and p = 0.06). There was an increase in body mass in CG (97.6 ± 3.4 to 99.1 ± 2.9 kg) and NG (92.5 ± 5.4 to 93.5 ± 5.4 kg; p = 0.05). Combined training improved maximal upper- and lower-body strength regardless of periodization. However, for improvements in V[Combining Dot Above]O2max, linear periodization may be superior than nonperiodization in obese adults.

The effects of same-session combined exercise training on cardiorespiratory and functional fitness in older adults: a systematic review and meta-analysis

Endurance and strength training are effective strategies for counteracting age-associated reductions in physical performance in older adults, with a combination of both exercise modes recommended to maximise potential fitness benefits. This meta-analysis sought to quantify the effects of same-session combined endurance and strength training on fitness in adults aged over 50 years. Five electronic databases were searched with studies required to include one of the following outcome measures: VO_2peak, 6-min walk test (6MWT), 8-ft timed up-and-go (TUG), and 30-s chair stand. Separate random-effects meta-analyses compared combined training with (1) no-exercise control, (2) endurance training, and (3) strength training with probabilistic magnitude-based inferences subsequently applied. Twenty-seven studies involving 1346 subjects with a mean age of 68.8 years (range 54–85 years) were included in the analysis. The meta-analysed effect on VO_2peak was a moderately beneficial effect for the combined training compared to no-exercise controls (3.6 mL kg⁻¹ min⁻¹; ± 95% confidence limits 0.8 mL kg⁻¹ min⁻¹) with additional increases for studies with greater proportions of female participants and shorter training interventions. Combined training also had small-to-moderately beneficial effects on VO_2peak when compared to endurance training (0.8 mL kg⁻¹ min⁻¹; ± 1.0 mL kg⁻¹ min⁻¹), 30-s chair stand when compared with strength training (1.1 repetitions; ± 0.5 repetitions) and on TUG (0.8 s; ± 0.7 s), 30-s chair stand (2.8 repetitions; ± 1.7 repetitions), and 6MWT (31.5 m; ± 22.4 m) when compared to no-exercise controls. All other comparisons were unclear. Same-session combined training can induce clinically relevant fitness improvements in older adults.

Effects of Aerobic, Resistance, and Combined Exercise on Markers of Male Reproduction in Healthy Human Subjects: A Randomized Controlled Trial

Hajizadeh Maleki, B, Tartibian, B, and Chehrazi, M. Effects of aerobic, resistance, and combined exercise on markers of male reproduction in healthy human subjects: a randomized controlled trial. J Strength Cond Res 33(4): 1130-1145, 2019-The effects of moderate intensity treadmill exercise training (MI), resistance training (RT), and combined treadmill + resistance training (CT) on markers of male reproductive function including seminal markers of oxidative stress and inflammation, and semen quality and sperm DNA integrity were evaluated in healthy human subjects. A total of 376 healthy sedentary male volunteers (aged 25-40) were screened and 282 were randomized into 4 treatment groups: MI (n = 71), RT (n = 71), CT (n = 71), and nonexercise (NON-EX, n = 70) groups for an experimental period of 24 weeks. After the intervention, compared with the NON-EX group, all 3 MI, RT, and CT exercise modalities showed significantly reduced body mass, fat percent, waist circumference, reactive oxygen species, interleukin (IL)-1β, IL-6, IL-8 and tumor necrosis factor-α and improved maximal oxygen uptake (V[Combining Dot Above]O2max), progressive motility, sperm morphology, sperm concentration and sperm DNA integrity, as indicated by a decrease of percentage of terminal deoxynucleotidyl transferase-mediated fluorescein-dUTP nick end labeling-positive sperm cells (p ≤ 0.05). Body mass index, semen volume, number of spermatozoa, superoxide dismutase, catalase, total antioxidant capacity, malondialdehyde, and 8-isoprostane improved significantly in the MI and CT groups (p ≤ 0.05) but not significantly in the RT group (p > 0.05). In summary, all 3 MI, RT, and CT interventions attenuate seminal markers of inflammation and oxidative stress and improve body composition, semen quality parameters, and sperm DNA integrity in the studied population. In respect to all the aspects studied, those men who took part in MI intervention had the best results. Considering the seminological parameters, however, CT had a synergistic effect and was superior over the other interventions used.

Combined exercise training improves blood pressure and antioxidant capacity in elderly individuals with hypertension

Background/objective

Although regular exercise plays a role in achieving healthy aging, a specific mode of exercise may be required for elderly individuals with hypertension (HT). Therefore, this study aimed to assess the effects of combined endurance and strength training (CBT) on blood pressure (BP) and antioxidant capacity in elderly individuals with HT.

Methods

In a single-blinded, randomized controlled trial, 54 older men and women aged 67 ± 5.8 years completed endurance training (ET, n = 13), strength training (ST, n = 13), combined endurance and strength training (CBT, n = 16) or served as controls (CON, n = 12). The intervention was a supervised exercise training (1-h sessions, three per week for 12 weeks), followed by a self-supervised exercise training for 12 weeks. Measurements of BP, glutathione peroxidase (GPx), total nitrite/nitrate (NOx-), malondialdehyde (MDA), and high-sensitive C-reactive protein (hs-CRP) were obtained before and after the supervised and the self-supervised periods.

Results

After the supervised period, systolic BP (SBP) decreased by 7.9% in the ET (p < 0.05) and 8.2% in the CBT (p < 0.01); GPx activity increased by 41.3% in the ET (p < 0.01), 19.1% in the ST (p < 0.05), and 49.2% in the CBT (p < 0.01); NOx-concentrations increased by 66.2% in the ET and 71.9% in the CBT (both p < 0.01), MDA concentrations decreased by 65.1% in the ST (p < 0.05) and 61% in the CBT (p < 0.01); hs-CRP concentrations decreased by 49.2% in only the CBT (p < 0.05). After the self-supervised period, SBP decreases by 7.5% in only the CBT (p < 0.01); NOx-concentrations increased by 68.5% in the ET and 92.4% in the CBT (both p < 0.01). However, there was no significant difference in SBP, GPx activity, NOx-, MDA and hs-CRP concentrations between the training groups.

Conclusion

The hypotensive and antioxidant effects of the CBT seem to be similar to the ET after the supervised training period. However, after the self-supervised training period, the CBT program might affect better due to greater exercise adherence and attendance in elderly individuals with HT.

Neutrophil and Monocyte Bactericidal Responses to 10 Weeks of Low-Volume High-Intensity Interval or Moderate-Intensity Continuous Training in Sedentary Adults

Neutrophils and monocytes are key components of the innate immune system that undergo age-associated declines in function. This study compared the impact of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on immune function in sedentary adults. Twenty-seven (43 ± 11 years) healthy sedentary adults were randomized into ten weeks of either a HIIT (>90% maximum heart rate) or MICT (70% maximum heart rate) group training program. Aerobic capacity (VO_2peak), neutrophil and monocyte bacterial phagocytosis and oxidative burst, cell surface receptor expression, and systemic inflammation were measured before and after the training. Total exercise time commitment was 57% less for HIIT compared to that for MICT while both significantly improved VO_2peak similarly. Neutrophil phagocytosis and oxidative burst and monocyte phagocytosis and percentage of monocytes producing an oxidative burst were improved by training similarly in both groups. Expression of monocyte but not neutrophil CD16, TLR2, and TLR4 was reduced by training similarly in both groups. No differences in systemic inflammation were observed for training; however, leptin was reduced in the MICT group only. With similar immune-enhancing effects for HIIT compared to those for MICT at 50% of the time commitment, our results support HIIT as a time efficient exercise option to improve neutrophil and monocyte function.

Habitual aerobic exercise does not protect against micro- or macrovascular endothelial dysfunction in healthy estrogen-deficient postmenopausal women

Aging causes micro- and macrovascular endothelial dysfunction, as assessed by endothelium-dependent dilation (EDD), which can be prevented and reversed by habitual aerobic exercise (AE) in men. However, in estrogen-deficient postmenopausal women, whole forearm microvascular EDD has not been studied, and a beneficial effect of AE on macrovascular EDD has not been consistently shown. We assessed forearm blood flow in response to brachial artery infusions of acetylcholine (FBFACh), a measure of whole forearm microvascular EDD, and brachial artery flow-mediated dilation (FMD), a measure of macrovascular EDD, in 12 premenopausal sedentary women (Pre-S; 24 ± 1 yr; V̇o2max = 37.5 ± 1.6 ml·kg-1·min-1), 25 estrogen-deficient postmenopausal sedentary women (Post-S; 62 ± 1 yr; V̇o2max = 24.7 ± 0.9 ml·kg-1·min-1), and 16 estrogen-deficient postmenopausal AE-trained women (Post-AE; 59 ± 1 yr; V̇o2max = 40.4 ± 1.4 ml·kg-1·min-1). FBFACh was lower in Post-S and Post-AE compared with Pre-S women (135 ± 9 and 116 ± 17 vs. 193 ± 21 AUC, respectively, both P < 0.008), whereas Post-S and Post-AE women were not different (P = 0.3). Brachial artery FMD was 34% (5.73 ± 0.67%) and 45% (4.79 ± 0.57%) lower in Post-S and Post-AE, respectively, vs. Pre-S women (8.69 ± 0.95%, both P ≤ 0.01), but not different between Post-S and Post-AE women (P = 0.3). Post-AE women had lower circulating C-reactive protein and oxidized low-density lipoprotein compared with Post-S women (0.5 ± 0.1 vs. 1.1 ± 0.2 mg/l and 40 ± 4 vs. 55 ± 3 U/l, respectively, both P = 0.01), but these markers were not correlated to FBFACh (P = 0.3) or brachial artery FMD (P = 0.8). These findings are consistent with the idea that habitual AE does not protect against age/menopause-related whole forearm micro- and macrovascular endothelial dysfunction in healthy nonobese estrogen-deficient postmenopausal women, despite being associated with lower systemic markers of inflammation and oxidative stress.

NEW & NOTEWORTHY

This is the first study to demonstrate that habitual aerobic exercise may not protect against age/menopause-related whole forearm microvascular endothelial dysfunction in healthy nonobese estrogen-deficient postmenopausal women, consistent with recent findings regarding macrovascular endothelial function. This is in contrast to what is observed in healthy middle-aged and older aerobic exercise-trained men.

Effects of Different Therapeutic Ultrasound Waveforms on Endothelial Function in Healthy Volunteers: A Randomized Clinical Trial

The purpose of this study was to determine the effects of different therapeutic 1-MHz ultrasound waveforms on endothelial function before and after cyclooxygenase (COX) inhibition. Forty-two healthy volunteers aged 27.2 ± 3.8 y underwent interventions and an evaluation for endothelial function (n = 15; with COX inhibition, n = 15; duration of the vasodilator effect, n = 12) by technique flow-mediated dilation. Continuous ultrasound therapy (0.4 W/cm(2 SATA)), pulsed ultrasound therapy (20% duty cycle, 0.08 W/cm(2 SATA)) or placebo (equipment power off) was randomly applied over the brachial artery for 5 min. COX inhibition (aspirin) was carried out 30 min before treatments. In relation to the placebo, flow-mediated dilation increased by 4.8% using continuous ultrasound and by 3.4% using pulsed ultrasound. After COX, flow-mediated dilation was enhanced by 2.1% by continuous ultrasound and 2.6% by pulsed ultrasound. This vasodilation persisted for 20 min. Continuous and pulsed therapeutic 1-MHz ultrasound waveforms improved endothelial function in humans, which provided them with anti-inflammatory vascular effects.

Cell Therapy in Ischemic Heart Disease: Interventions That Modulate Cardiac Regeneration

The incidence of severe ischemic heart disease caused by coronary obstruction has progressively increased. Alternative forms of treatment have been studied in an attempt to regenerate myocardial tissue, induce angiogenesis, and improve clinical conditions. In this context, cell therapy has emerged as a promising alternative using cells with regenerative potential, focusing on the release of paracrine and autocrine factors that contribute to cell survival, angiogenesis, and tissue remodeling. Evidence of the safety, feasibility, and potential effectiveness of cell therapy has emerged from several clinical trials using different lineages of adult stem cells. The clinical benefit, however, is not yet well established. In this review, we discuss the therapeutic potential of cell therapy in terms of regenerative and angiogenic capacity after myocardial ischemia. In addition, we addressed nonpharmacological interventions that may influence this therapeutic practice, such as diet and physical training. This review brings together current data on pharmacological and nonpharmacological approaches to improve cell homing and cardiac repair.

The use of periodization in exercise prescriptions for inactive adults: A systematic review

BACKGROUND

Periodization of exercise is a method typically used in sports training, but the impact of periodized exercise on health outcomes in untrained adults is unclear.

PURPOSE

This review aims to summarize existing research wherein aerobic or resistance exercise was prescribed to inactive adults using a recognized periodization method.

METHODS

A search of relevant databases, conducted between January and February of 2014, yielded 21 studies published between 2000 and 2013 that assessed the impact of periodized exercise on health outcomes in untrained participants.

RESULTS

Substantial heterogeneity existed between studies, even under the same periodization method. Compared to baseline values or non-training control groups, prescribing periodized resistance or aerobic exercise yielded significant improvements in health outcomes related to traditional and emerging risk factors for cardiovascular disease, low-back and neck/shoulder pain, disease severity, and quality of life, with mixed results for increasing bone mineral density.

CONCLUSIONS

Although it is premature to conclude that periodized exercise is superior to non-periodized exercise for improving health outcomes, periodization appears to be a feasible means of prescribing exercise to inactive adults within an intervention setting. Further research is necessary to understand the effectiveness of periodizing aerobic exercise, the psychological effects of periodization, and the feasibility of implementing flexible non-linear methods.

Effects of concurrent training on oxidative stress and insulin resistance in obese individuals

Obesity is associated with insulin resistance (IR) and increased oxidative stress. Thus, the present study aimed to evaluate anthropometric parameters, IR, and oxidative stress in obese individuals subjected to two types of concurrent training at the same intensity but differing in frequency. Accordingly, 25 individuals were divided into two groups: concurrent training 1 (CT1) (5 d/wk) and concurrent training 2 (CT2) (3 d/wk), both with moderate intensity. Anthropometric parameters, IR, and oxidative stress were analyzed before and after 26 sessions of training. Both groups had reduced body weight and body mass index (P < 0.05), but only CT1 showed lower body fat percentage and increased basal metabolic rate (P < 0.05). Moreover, CT1 had increased HOMA-IR and decreased protein damage (carbonyl level), and CT2 had decreased HOMA-IR and increased lipid peroxidation (TBARS level) (P < 0.05). On the other hand, both training protocols reduced the GPx activity. It can be concluded that both types of concurrent training could be an alternative for lowering body weight and BMI. Also, it was observed that concurrent training, depending on the frequency, can contribute to reducing body fat, oxidative damage (protein oxidation), and IR but can induce oxidative damage to lipids. More studies are needed to elucidate the mechanisms involved.

Aerobic exercise and other healthy lifestyle factors that influence vascular aging

Cardiovascular diseases (CVDs) remain the leading cause of death in the United States and other modern societies. Advancing age is the major risk factor for CVD, primarily due to stiffening of the large elastic arteries and the development of vascular endothelial dysfunction. In contrast, regular aerobic exercise protects against the development of large elastic artery stiffness and vascular endothelial dysfunction with advancing age. Moreover, aerobic exercise interventions reduce arterial stiffness and restore vascular endothelial function in previously sedentary middle-aged/older adults. Aerobic exercise exerts its beneficial effects on arterial function by modulating structural proteins, reducing oxidative stress and inflammation, and restoring nitric oxide bioavailability. Aerobic exercise may also promote "resistance" against factors that reduce vascular function and increase CVD risk with age. Preventing excessive increases in abdominal adiposity, following healthy dietary practices, maintaining a low CVD risk factor profile, and, possibly, selective use of pharmaceuticals and nutraceuticals also play a major role in preserving vascular function with aging.

Exercise enhances wound healing and prevents cancer progression during aging by targeting macrophage polarity

Physical activity, which can include regular and repetitive exercise training, has been shown to decrease the incidence of age-related diseases. Aging is characterized by aberrant immune responses, including impaired wound healing and increased cancer risk. The behavior and polarized phenotype of tissue macrophages are distinct between young and old organisms. The balance of M1 and M2 macrophages is altered in the aged tissue microenvironment, with a tilt towards an M2-dominant macrophage population, as well as its associated signaling pathways. These M2-type responses may result in unresolved inflammation and create an environment that impairs wound healing and is favorable for cancer growth. We discuss the concept that exercise training can improve the regulation of macrophage polarization and normalize the inflammatory process, and thereby exert anticancer effects and enhance wound healing in older humans.

Edward F. Adolph Distinguished Lecture: The remarkable anti-aging effects of aerobic exercise on systemic arteries

Cardiovascular diseases (CVD) remain the leading cause of morbidity and mortality in modern societies, and advancing age is the major risk factor for CVD. Arterial dysfunction, characterized by large elastic artery stiffening and endothelial dysfunction, is the key event leading to age-associated CVD. Our work shows that regular aerobic exercise inhibits large elastic artery stiffening with aging (optimizes arterial compliance) and preserves endothelial function. Importantly, among previously sedentary late middle-aged and older adults, aerobic exercise improves arterial stiffness and enhances endothelial function in most groups and, therefore, also can be considered a treatment for age-associated arterial dysfunction. The mechanisms by which regular aerobic exercise destiffens large elastic arteries are incompletely understood, but existing evidence suggests that reductions in oxidative stress associated with decreases in both adventitial collagen (fibrosis) and advanced glycation end-products (structural protein cross-linking molecules), play a key role. Aerobic exercise preserves endothelial function with aging by maintaining nitric oxide bioavailability via suppression of excessive superoxide-associated oxidative stress, and by inhibiting the development of chronic low-grade vascular inflammation. Recent work from our laboratory supports the novel hypothesis that aerobic exercise may exert these beneficial effects by directly inducing protection to aging arteries against multiple adverse factors to which they are chronically exposed. Regular aerobic exercise should be viewed as a "first line" strategy for prevention and treatment of arterial aging and a vital component of a contemporary public health approach for reducing the projected increase in population CVD burden.

A randomized trial of exercise for blood pressure reduction in type 2 diabetes: effect on flow-mediated dilation and circulating biomarkers of endothelial function

OBJECTIVE

To investigate the effect of an exercise intervention on flow-mediated dilation (FMD) and circulating endothelial biomarkers in adults with type 2 diabetes (T2DM).

METHODS

Sedentary adults (n = 140), aged 40-65, with T2DM and untreated pre or Stage I hypertension or treated hypertension were randomized to a 6-month, supervised, exercise program (3× week) or a sedentary control. Assessments included BMI, body and visceral fat, blood pressure, lipids, HbA1c, insulin sensitivity (QUICKI), fitness, FMD, E-selectin, P-selectin, intracellular and vascular cellular adhesion molecules (ICAM, VCAM), and tissue plasminogen activator (tPA). Intervention effects were compared by t-tests. Pearson's correlations were calculated between changes in cardiovascular risk factors and endothelial outcomes.

RESULTS

Exercisers significantly improved BMI (-0.6 kg/m(2)), body fat % (-1.4%), HbA1c (-0.5%), and fitness (2.9 mL/kg min) vs. controls (p < 0.05). However, there were no differences between groups in changes in FMD, E-selectin, P-selectin, ICAM, VCAM, or tPA. Among exercisers, changes in cardiovascular risk factors correlated with several biomarkers. Decreased P-selectin correlated with decreased BMI (r = 0.29, p = 0.04) and increased HDL cholesterol (r = -0.36, p = 0.01). Decreased ICAM correlated with decreased triglycerides and HbA1c (r = 0.30, p = 0.04; r = 0.31, p = 0.03) and increased QUICKI (r = - 0.28, p = 0.05). Decreased tPA correlated with decreased total body and visceral fat (r = 0.28, p = 0.05; r = 0.38, p = 0.008) and increased QUICKI (r = -0.38, p = 0.007).

CONCLUSIONS

While exercise resulted in improved fitness, body composition, and glycemic control, there were no changes in FMD or circulating endothelial biomarkers. The associations of changes in cardiovascular risk factors and endothelial biomarkers suggest that improvement in risk factors could mediate the exercise-induced improvements in endothelial function seen in prior studies.

Exercise and the aging immune system

Aging is associated with a decline in the normal functioning of the immune system that is described by the canopy term "immunosenescence". This contributes to poorer vaccine responses and the increased incidence of infection and malignancy seen in the elderly. Regular exercise has been associated with enhanced vaccination responses, lower numbers of exhausted/senescent T-cells, increased T-cell proliferative capacity, lower circulatory levels of inflammatory cytokines ("inflamm-aging"), increased neutrophil phagocytic activity, lowered inflammatory response to bacterial challenge, greater NK-cell cytotoxic activity and longer leukocyte telomere lengths in aging humans, all of which indicate that habitual exercise is capable of regulating the immune system and delaying the onset of immunosenescence. This contention is supported by the majority of animal studies that report improved immune responses and outcomes to viral infections and malignancies due to exercise training. However, whether or not exercise can reverse, as well as prevent, immunosenescence is a contentious issue, particularly because most longitudinal exercise training studies do not report the same positive effects of exercise on immunity that have been widely reported in studies with a cross-sectional design. In this review, we summarize some of the known effects of exercise on immunosenescence, discuss avenues for future research, and provide potential mechanisms by which exercise may help rejuvinate the aging immune system.