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Corona G, Rastrelli G, Sparano C, Vignozzi L, Sforza A, Maggi M. Advances in the treatment of functional male hypogonadism. Expert Rev Endocrinol Metab 2024; 19:163-177. [PMID: 38117229 DOI: 10.1080/17446651.2023.2296022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Functional hypogonadism is frequently found in obese men, particularly those with metabolic complications. Several possible therapeutic approaches could be considered. AREAS COVERED An extensive search on Medline, Embase, and Cochrane databases was performed to retrieve the available studies assessing the change of testosterone (T) and sexual function upon dieting or physical activity programs, as well as glucagon-like peptide 1 analogues. The role of lifestyle interventions associated with T replacement therapy (TRT) was also evaluated. The expert opinion provided here has been corroborated by meta-analyzing the results of the retrieved studies. EXPERT OPINION Current evidence supports the beneficial role of lifestyle modifications in increasing T and improving sexual function as a function of weight loss. While dieting programs are associated with greater effects in younger populations, physical exercise has major effects in older ones. Among the dieting programs, a very low-calorie ketogenic diet shows the best results; aerobic or endurance physical exercise perform similarly. The advantages of functional hypogonadism in lifestyle modifications are empowered by the association with TRT. Therefore, TRT may be a valuable complementary strategy to increase muscle mass and facilitate physical exercise while improving sexual symptoms, thus favoring the motivation and compliance for lifestyle interventions.
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Affiliation(s)
- Giovanni Corona
- Endocrinology Unit, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Giulia Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence, Italy
| | - Clotilde Sparano
- Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Endocrinology Unit, Florence, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence, Italy
| | - Alessandra Sforza
- Endocrinology Unit, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Mario Maggi
- Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Endocrinology Unit, Florence, Italy
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Bayatiani M, Seif F, Molavi S, Ansari Z, Parastesh M. The effect of resistance training on serum levels of sex hormones and sperm quality in male rats under X-ray radiation. Horm Mol Biol Clin Investig 2022; 43:441-447. [PMID: 35521895 DOI: 10.1515/hmbci-2021-0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 03/25/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The present study aims to investigate the effects of resistance training on sex hormones and sperm parameters in male rats under X-ray. METHODS In this experimental study, 24 Sprague Dawley rats (200-250 g) were randomly assigned into four groups: healthy control, irradiated control, healthy training and irradiated training. Irradiation was induced at a dose of 4 Gy on the whole body. The resistance training protocol was performed for 10 weeks. Finally, blood serum was used to assess FSH, LH and testosterone and sperm quality. Data were analyzed using ANOVA and Tukey's post hoc test. RESULTS The results showed that radiation significantly reduced serum levels of LH (p=0.42), FSH (p=0.001) and testosterone (p=0.28) between radiation control and healthy control groups. Also, no significant difference was observed between serum levels of LH (p=0.135) and testosterone (p=0.419) in radiation resistance training and the healthy control groups. In addition, significant differences were observed between radiation resistance training and radiation control groups in sperm parameters such as sperm count (p=0.02) and progressively motile sperm (p=0.031). CONCLUSIONS It seems that short-term resistance training can improve sperm parameters, including sperm count and sperm motility through increasing serum levels testosterone and LH in male rat under X-ray.
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Affiliation(s)
- Mohammadreza Bayatiani
- Department of Radiotherapy and Medical Physics, Faculty of Para Medicine, Arak University of Medical Sciences and Khansari Hospital, Arak, Iran
| | - Fatemeh Seif
- Department of Radiotherapy and Medical Physics, Faculty of Para Medicine, Arak University of Medical Sciences and Khansari Hospital, Arak, Iran
| | - Shiva Molavi
- Department of Sports Physiology and Pathology, Faculty of Sport Sciences, Arak University, Arak, Iran
| | - Zahra Ansari
- Department of Sports Physiology and Pathology, Faculty of Sport Sciences, Arak University, Arak, Iran
| | - Mohammad Parastesh
- Department of Sports Physiology, Faculty of Sport Sciences and Research Institute of Applied Studies of Sports Sciences, Arak University, Arak, Iran
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Hackett D, Ghayomzadeh M, Farrell S, Davies T, Sabag A. Influence of total repetitions per set on local muscular endurance: A systematic review with meta-analysis and meta-regression. Sci Sports 2022. [DOI: 10.1016/j.scispo.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Zouhal H, Jayavel A, Parasuraman K, Hayes LD, Tourny C, Rhibi F, Laher I, Abderrahman AB, Hackney AC. Effects of Exercise Training on Anabolic and Catabolic Hormones with Advanced Age: A Systematic Review. Sports Med 2021; 52:1353-1368. [PMID: 34936049 PMCID: PMC9124654 DOI: 10.1007/s40279-021-01612-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2021] [Indexed: 12/19/2022]
Abstract
Background Ageing is accompanied by decreases in physical capacity and physiological regulatory mechanisms including altered hormonal regulation compared with age-matched sedentary people. The potential benefits of exercise in restoring such altered hormone production and secretion compared to age-matched physically inactive individuals who are ageing remains unclear. Objectives The aim of this systematic review was to summarise the findings of exercise training in modulating levels of ostensibly anabolic and catabolic hormones in adults aged > 40 years. Methods We searched the following electronic databases (to July 2021) without a period limit: Cochrane Library, PubMed, Science Direct, Scopus, SPORTDiscus and Web of Science. Additionally, a manual search for published studies in Google Scholar was conducted for analysis of the ‘grey literature’ (information produced outside of traditional commercial or academic publishing and distribution channels). The initial search used the terms ‘ageing’ OR ‘advanced age’ OR ‘old people’ OR ‘older’ OR elderly’ AND ‘anabolic hormones’ OR ‘catabolic hormones’ OR ‘steroid hormones’ OR ‘sex hormones’ OR ‘testosterone’ OR ‘cortisol’ OR ‘insulin’ OR ‘insulin-like growth factor-1’ OR ‘IGF-1’ OR ‘sex hormone-binding globulin’ OR ‘SHBG’ OR ‘growth hormone’ OR ‘hGH’ OR ‘dehydroepiandrosterone’ OR ‘DHEA’ OR ‘dehydroepiandrosterone sulfate (DHEA-S)’ AND ‘exercise training’ OR ‘endurance training’ OR ‘resistance training’ OR ‘ strength training’ OR ‘weight-lifting’ OR ‘high-intensity interval training’ OR ‘high-intensity interval exercise’ OR ‘high-intensity intermittent training’ OR ‘high-intensity intermittent exercise’ OR ‘interval aerobic training’ OR ‘interval aerobic exercise’ OR ‘intermittent aerobic training’ OR ‘intermittent aerobic exercise’ OR ‘high-intensity training’ OR ‘high-intensity exercise’ OR ‘sprint interval training’ OR ‘sprint interval exercise’ OR ‘combined exercise training’ OR ‘anaerobic training’. Only eligible full texts in English or French were considered for analysis. Results Our search identified 484 records, which led to 33 studies for inclusion in the analysis. Different exercise training programs were used with nine studies using endurance training programs, ten studies examining the effects of high-intensity interval training, and 14 studies investigating the effects of resistance training. Most training programs lasted ≥ 2 weeks. Studies, regardless of the design, duration or intensity of exercise training, reported increases in testosterone, sex hormone-binding globulin (SHBG), insulin-like growth factor-1 (IGF-1), human growth hormone (hGH) or dehydroepiandrosterone (DHEA) (effect size: 0.19 < d < 3.37, small to very large) in both older males and females. However, there was no consensus on the effects of exercise on changes in cortisol and insulin in older adults. Conclusion In conclusion, findings from this systematic review suggest that exercise training increases basal levels of testosterone, IGF-1, SHBG, hGH and DHEA in both male and females over 40 years of age. The increases in blood levels of these hormones were independent of the mode, duration and intensity of the training programs. However, the effects of long-term exercise training on cortisol and insulin levels in elderly people are less clear.
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Affiliation(s)
- Hassane Zouhal
- M2S, Laboratoire Mouvement, Sport, Santé, EA 1274, Université Rennes, 35000, Rennes, France.
- Institut International des Sciences du Sport (2I2S), 35850, Irodouer, France.
| | - Ayyappan Jayavel
- SRM College of Physiotherapy, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Kanchipuram, Chennai, TN, 603203, India
| | - Kamalanathan Parasuraman
- SRM College of Physiotherapy, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Kanchipuram, Chennai, TN, 603203, India
| | - Lawrence D Hayes
- Institute of Clinical Exercise and Health Science, School of Health and Life Sciences, University of the West of Scotland, Lanarkshire Campus, Glasgow, G72 0LH, UK
| | | | - Fatma Rhibi
- M2S, Laboratoire Mouvement, Sport, Santé, EA 1274, Université Rennes, 35000, Rennes, France
| | - Ismail Laher
- Faculty of Medicine, Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, Vancouver, Canada
| | | | - Anthony C Hackney
- Department of Exercise and Sport Science, Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA.
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Pesonen H, Walker S, Ahtiainen JP, Hautasaari P, Tarkka IM. Ten-year resistance training background modulates somatosensory P3 cognitive brain resonse in older men: A magnetoencephalograpy study. Exp Gerontol 2021; 149:111312. [PMID: 33716112 DOI: 10.1016/j.exger.2021.111312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 02/10/2021] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
The brain electrophysiological component P3, associated with good cognitive abilities, deteriorates during healthy aging. Both cognitive functions and P3 component amplitude respond positively to exercise, but the effects of resistance training on P3 are much less studied. Short-term resistance training interventions in older adults indicate modulation towards larger P3 amplitude, but this association has not been studied with a longitudinal study design. We investigated magnetoencephalographically recorded P3 (P3m) in a unique study design of nine aged men (mean age 77.7 y) with quasi-supervised resistance training background over a 10-year period and eight controls of similar age (mean age 77.5 y) with no training background. We elicited P3m utilizing lower limb electrical stimulation, as the resistance training program was mostly directed to lower limbs. Somatosensory oddball paradigm was performed with the right foot's fourth toe as standard (90%) and hallux as deviant (10%). Participants were asked to respond to deviants with a button press using their left index finger. Topographic maps showed bilateral temporoparietal activation for P3m in both groups. No amplitude differences were found in active P3m regions between groups. However, the groups differed in hemispheric activity of P3m. The exercise group showed stronger activation in the right frontotemporal and parietal sensor-groups compared to the left sensor-groups, and the control group showed stronger activation in right frontotemporal sensor-group compared to left. The control group showed shorter P3m latency in the right temporal sensor-group than the exercise group, but the latencies in other sensor-groups were similar. In aging, the brain utilizes compensatory areas to perform cognitive tasks. Our results suggest modulation in topographic distribution of P3m activity in aging men with long-term resistance training background compared to their controls. This might arise from a difference in age-related compensatory mechanisms in P3m generation.
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Affiliation(s)
- Heidi Pesonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - Simon Walker
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Juha P Ahtiainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pekka Hautasaari
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Ina M Tarkka
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Jyväskylä Centre for Interdisciplinary Brain Research (CIBR), University of Jyväskylä, Jyväskylä, Finland
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Upper-Body Resistance Training Following Soccer Match Play: Compatible, Complementary, or Contraindicated? Int J Sports Physiol Perform 2021; 16:165-175. [PMID: 33440333 DOI: 10.1123/ijspp.2020-0762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/19/2020] [Accepted: 10/19/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE During heavily congested schedules, professional soccer players can experience exacerbated fatigue responses, which are thought to contribute to an increased risk of injury. Given that match-induced residual fatigue can last up to 72 hours, many coaches naturally prioritize recovery in the days immediately following match day. While it is intuitive for coaches and training staff to decrease the amount of auxiliary training practices to focus on recovery, prescribing upper-body resistance training on the day after match play has recently emerged as a specific training modality in this context. While these sessions may be implemented to increase training stimulus, there are limited data available regarding the efficacy of such a practice to improve recovery kinetics. METHODS In this narrative review, the authors look at the theoretical implications of performing upper-body resistance training on the day after match play on the status of various physiological and psychological systems, including neuromuscular, metabolic, hormonal, perceptual, and immunological recovery. RESULTS The available evidence suggests that in most cases this practice, as currently implemented (ie, low volume, low intensity), is unlikely to be complementary (ie, does not accelerate recovery) but is potentially compatible (ie, does not impair recovery). CONCLUSION Overall, because the perception of such sessions may be player dependent, their programming requires an individualized approach and should take into account match dynamics (eg, fixture scheduling, playing time, travel).
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Fink JE, Hackney AC, Matsumoto M, Maekawa T, Horie S. Mobility and Biomechanical Functions in the Aging Male: Testosterone and the Locomotive Syndrome. Aging Male 2020; 23:403-410. [PMID: 30269622 DOI: 10.1080/13685538.2018.1504914] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In the current aging society, the occurrence of the locomotive syndrome, a condition in which the locomotive organs are impaired, is increasing. The locomotive system includes support (bones), mobility and impact absorption (joints and intervertebral disks), drive and control (muscles, nerves), and network (blood vessels). The impairment of any of those systems can lead to a major decrease in quality of life. In recent years, several studies on methods to improve and prevent conditions impairing the locomotive syndrome have been conducted. Almost in parallel with the structure supporting mobility and body functions, testosterone levels decrease with age. Testosterone is a hormone-regulating several pathways affecting each aspect of the locomotive syndrome. Testosterone is regulated by the pituitary gland triggering several processes in the body through genomic and non-genomic pathways, affecting muscles, bones, nerves, joints, intervertebral discs, and blood vessels. The purpose of this review is to investigate the role of testosterone in each of the systems involved in the locomotive syndrome.
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Affiliation(s)
- Julius E Fink
- Graduate School of Medicine, Department of Metabolism and Endocrinology, Juntendo University, Tokyo, JAPAN
| | - Anthony C Hackney
- Department of Exercise & Sport Science; Department of Nutrition - School of Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Masahito Matsumoto
- Advanced Diabetic Therapeutics, Department of Metabolic Endocrinology, Juntendo University,Tokyo, Japan
| | - Takahiro Maekawa
- Department of Rehabilitation for the Movement Functions Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
| | - Shigeo Horie
- Graduate School of Medicine, Department of Urology, Juntendo University, Tokyo, Japan
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Walker S, Häkkinen K, Newton RU, Markworth JF, Pundir S, Haff GG, Cameron-Smith D, Blazevich AJ. Acute responses of comprehensive gonadosteroids and corticosteroids to resistance exercise before and after 10 weeks of supervised strength training. Exp Physiol 2020; 105:438-448. [PMID: 31837091 DOI: 10.1113/ep087995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 12/11/2019] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Although acute responses of the principal gonadosteroid and corticosteroid hormones to resistance exercise are well documented, there is no information regarding how the key lower-concentration intermediary hormones respond and potentially influence these hormonal pathways. What is the main finding and its importance? This study provides evidence for cascading conversions of some gonadosteroids, and the data suggest that the testosterone concentration increases independently of these hormones. These findings challenge future studies to determine the exact physiological roles of the lower-concentration gonadosteroids and corticosteroids during and immediately after resistance exercise. ABSTRACT Resistance training is a potent stimulus for muscle growth, and steroid hormones are known to play a role in this adaptation. However, very little is known about the acute exercise-induced gonadosteroid and corticosteroid hormone responses, including those of key lower-concentration intermediate hormones. The present study determined the acute responses of these steroid hormone families using quantitative ultra-high performance liquid chromatography tandem mass spectrometry after resistance exercise in strength-trained men. Venous and fingertip blood samples were obtained pre-, mid-, 5 min post- and 15 min post-resistance exercise, both before and after 10 weeks of supervised resistance training. The experimental resistance exercise sessions consisted of three sets of 10 repetitions of bilateral leg-press exercise and three sets of 10 repetitions of unilateral knee-extension exercise, with 2 and 1 min recovery between sets, respectively. Statistically significant (P < 0.05) increases in the concentration of hormones in the gonadosteroid [including dehydroepiandrosterone (DHEA), androstenedione, testosterone and estrone] and the corticosteroid (including cortisol, corticosterone and cortisone) families were demonstrated after both experimental resistance exercise sessions, irrespective of training status. Correlation analyses revealed relationships between the following hormones: (i) DHEA and androstenedione; (ii) DHEA and cortisol; (iii) androstenedione and estrone; and (iv) 11-deoxycortisol and cortisol. Testosterone appears to increase acutely and independently of other intermediary hormones after resistance exercise. In conclusion, lower-concentration intermediary gonadosteroids (e.g. estrone) and corticosteroids (e.g. corticosterone) respond robustly to resistance exercise in strength-trained men, although it seems that testosterone concentrations are regulated by factors other than the availability of precursor hormones and changes in plasma volume.
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Affiliation(s)
- Simon Walker
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Keijo Häkkinen
- NeuroMuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Robert U Newton
- Centre for Exercise and Sports Science Research (CESSR), Edith Cowan University, Joondalup, WA, Australia
| | - James F Markworth
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA.,Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Shikha Pundir
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Guy G Haff
- Centre for Exercise and Sports Science Research (CESSR), Edith Cowan University, Joondalup, WA, Australia
| | | | - Anthony J Blazevich
- Centre for Exercise and Sports Science Research (CESSR), Edith Cowan University, Joondalup, WA, Australia
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Kraemer WJ, Ratamess NA, Hymer WC, Nindl BC, Fragala MS. Growth Hormone(s), Testosterone, Insulin-Like Growth Factors, and Cortisol: Roles and Integration for Cellular Development and Growth With Exercise. Front Endocrinol (Lausanne) 2020; 11:33. [PMID: 32158429 PMCID: PMC7052063 DOI: 10.3389/fendo.2020.00033] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 01/16/2020] [Indexed: 12/16/2022] Open
Abstract
Hormones are largely responsible for the integrated communication of several physiological systems responsible for modulating cellular growth and development. Although the specific hormonal influence must be considered within the context of the entire endocrine system and its relationship with other physiological systems, three key hormones are considered the "anabolic giants" in cellular growth and repair: testosterone, the growth hormone superfamily, and the insulin-like growth factor (IGF) superfamily. In addition to these anabolic hormones, glucocorticoids, mainly cortisol must also be considered because of their profound opposing influence on human skeletal muscle anabolism in many instances. This review presents emerging research on: (1) Testosterone signaling pathways, responses, and adaptations to resistance training; (2) Growth hormone: presents new complexity with exercise stress; (3) Current perspectives on IGF-I and physiological adaptations and complexity these hormones as related to training; and (4) Glucocorticoid roles in integrated communication for anabolic/catabolic signaling. Specifically, the review describes (1) Testosterone as the primary anabolic hormone, with an anabolic influence largely dictated primarily by genomic and possible non-genomic signaling, satellite cell activation, interaction with other anabolic signaling pathways, upregulation or downregulation of the androgen receptor, and potential roles in co-activators and transcriptional activity; (2) Differential influences of growth hormones depending on the "type" of the hormone being assayed and the magnitude of the physiological stress; (3) The exquisite regulation of IGF-1 by a family of binding proteins (IGFBPs 1-6), which can either stimulate or inhibit biological action depending on binding; and (4) Circadian patterning and newly discovered variants of glucocorticoid isoforms largely dictating glucocorticoid sensitivity and catabolic, muscle sparing, or pathological influence. The downstream integrated anabolic and catabolic mechanisms of these hormones not only affect the ability of skeletal muscle to generate force; they also have implications for pharmaceutical treatments, aging, and prevalent chronic conditions such as metabolic syndrome, insulin resistance, and hypertension. Thus, advances in our understanding of hormones that impact anabolic: catabolic processes have relevance for athletes and the general population, alike.
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Affiliation(s)
- William J. Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
- *Correspondence: William J. Kraemer
| | - Nicholas A. Ratamess
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ, United States
| | - Wesley C. Hymer
- Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA, United States
| | - Bradley C. Nindl
- Department of Sports Medicine, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
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Fragala MS, Cadore EL, Dorgo S, Izquierdo M, Kraemer WJ, Peterson MD, Ryan ED. Resistance Training for Older Adults: Position Statement From the National Strength and Conditioning Association. J Strength Cond Res 2019; 33:2019-2052. [PMID: 31343601 DOI: 10.1519/jsc.0000000000003230] [Citation(s) in RCA: 518] [Impact Index Per Article: 103.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Fragala, MS, Cadore, EL, Dorgo, S, Izquierdo, M, Kraemer, WJ, Peterson, MD, and Ryan, ED. Resistance training for older adults: position statement from the national strength and conditioning association. J Strength Cond Res 33(8): 2019-2052, 2019-Aging, even in the absence of chronic disease, is associated with a variety of biological changes that can contribute to decreases in skeletal muscle mass, strength, and function. Such losses decrease physiologic resilience and increase vulnerability to catastrophic events. As such, strategies for both prevention and treatment are necessary for the health and well-being of older adults. The purpose of this Position Statement is to provide an overview of the current and relevant literature and provide evidence-based recommendations for resistance training for older adults. As presented in this Position Statement, current research has demonstrated that countering muscle disuse through resistance training is a powerful intervention to combat the loss of muscle strength and muscle mass, physiological vulnerability, and their debilitating consequences on physical functioning, mobility, independence, chronic disease management, psychological well-being, quality of life, and healthy life expectancy. This Position Statement provides evidence to support recommendations for successful resistance training in older adults related to 4 parts: (a) program design variables, (b) physiological adaptations, (c) functional benefits, and (d) considerations for frailty, sarcopenia, and other chronic conditions. The goal of this Position Statement is to a) help foster a more unified and holistic approach to resistance training for older adults, b) promote the health and functional benefits of resistance training for older adults, and c) prevent or minimize fears and other barriers to implementation of resistance training programs for older adults.
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Affiliation(s)
| | - Eduardo L Cadore
- School of Physical Education, Physiotherapy and Dance, Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Sandor Dorgo
- Department of Kinesiology, University of Texas at El Paso, El Paso, Texas
| | - Mikel Izquierdo
- Department of Health Sciences, Public University of Navarre, CIBER of Frailty and Healthy Aging (CIBERFES), Navarrabiomed, Pamplona, Navarre, Spain
| | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, Ohio
| | - Mark D Peterson
- Department of Physical Medicine and Rehabilitation, University of Michigan-Medicine, Ann Arbor, Michigan
| | - Eric D Ryan
- Department of Exercise and Sport Science, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
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Gharahdaghi N, Rudrappa S, Brook MS, Idris I, Crossland H, Hamrock C, Abdul Aziz MH, Kadi F, Tarum J, Greenhaff PL, Constantin-Teodosiu D, Cegielski J, Phillips BE, Wilkinson DJ, Szewczyk NJ, Smith K, Atherton PJ. Testosterone therapy induces molecular programming augmenting physiological adaptations to resistance exercise in older men. J Cachexia Sarcopenia Muscle 2019; 10:1276-1294. [PMID: 31568675 PMCID: PMC6903447 DOI: 10.1002/jcsm.12472] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/14/2019] [Accepted: 06/12/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The andropause is associated with declines in serum testosterone (T), loss of muscle mass (sarcopenia), and frailty. Two major interventions purported to offset sarcopenia are anabolic steroid therapies and resistance exercise training (RET). Nonetheless, the efficacy and physiological and molecular impacts of T therapy adjuvant to short-term RET remain poorly defined. METHODS Eighteen non-hypogonadal healthy older men, 65-75 years, were assigned in a random double-blinded fashion to receive, biweekly, either placebo (P, saline, n = 9) or T (Sustanon 250 mg, n = 9) injections over 6 week whole-body RET (three sets of 8-10 repetitions at 80% one-repetition maximum). Subjects underwent dual-energy X-ray absorptiometry, ultrasound of vastus lateralis (VL) muscle architecture, and knee extensor isometric muscle force tests; VL muscle biopsies were taken to quantify myogenic/anabolic gene expression, anabolic signalling, muscle protein synthesis (D2 O), and breakdown (extrapolated). RESULTS Testosterone adjuvant to RET augmented total fat-free mass (P=0.007), legs fat-free mass (P=0.02), and appendicular fat-free mass (P=0.001) gains while decreasing total fat mass (P=0.02). Augmentations in VL muscle thickness, fascicle length, and quadriceps cross-section area with RET occured to a greater extent in T (P < 0.05). Sum strength (P=0.0009) and maximal voluntary contract (e.g. knee extension at 70°) (P=0.002) increased significantly more in the T group. Mechanistically, both muscle protein synthesis rates (T: 2.13 ± 0.21%·day-1 vs. P: 1.34 ± 0.13%·day-1 , P=0.0009) and absolute breakdown rates (T: 140.2 ± 15.8 g·day-1 vs. P: 90.2 ± 11.7 g·day-1 , P=0.02) were elevated with T therapy, which led to higher net turnover and protein accretion in the T group (T: 8.3 ± 1.4 g·day-1 vs. P: 1.9 ± 1.2 g·day-1 , P=0.004). Increases in ribosomal biogenesis (RNA:DNA ratio); mRNA expression relating to T metabolism (androgen receptor: 1.4-fold; Srd5a1: 1.6-fold; AKR1C3: 2.1-fold; and HSD17β3: two-fold); insulin-like growth factor (IGF)-1 signalling [IGF-1Ea (3.5-fold) and IGF-1Ec (three-fold)] and myogenic regulatory factors; and the activity of anabolic signalling (e.g. mTOR, AKT, and RPS6; P < 0.05) were all up-regulated with T therapy. Only T up-regulated mitochondrial citrate synthase activity (P=0.03) and transcription factor A (1.41 ± 0.2-fold, P=0.0002), in addition to peroxisome proliferator-activated receptor-γ co-activator 1-α mRNA (1.19 ± 0.21-fold, P=0.037). CONCLUSIONS Administration of T adjuvant to RET enhanced skeletal muscle mass and performance, while up-regulating myogenic gene programming, myocellular translational efficiency and capacity, collectively resulting in higher protein turnover, and net protein accretion. T coupled with RET is an effective short-term intervention to improve muscle mass/function in older non-hypogonadal men.
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Affiliation(s)
- Nima Gharahdaghi
- MRC-ARUK Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby, UK
| | - Supreeth Rudrappa
- MRC-ARUK Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby, UK
| | - Matthew S Brook
- MRC-ARUK Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby, UK
| | - Iskandar Idris
- MRC-ARUK Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby, UK
| | - Hannah Crossland
- MRC-ARUK Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby, UK
| | - Claire Hamrock
- Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Muhammad Hariz Abdul Aziz
- MRC-ARUK Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby, UK
| | - Fawzi Kadi
- Division of Sports Sciences, School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Janelle Tarum
- Division of Sports Sciences, School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Paul L Greenhaff
- MRC-ARUK Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Nottingham, Nottingham, UK
| | - Dumitru Constantin-Teodosiu
- MRC-ARUK Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Nottingham, Nottingham, UK
| | - Jessica Cegielski
- MRC-ARUK Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby, UK
| | - Bethan E Phillips
- MRC-ARUK Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby, UK
| | - Daniel J Wilkinson
- MRC-ARUK Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby, UK
| | - Nathaniel J Szewczyk
- MRC-ARUK Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby, UK
| | - Kenneth Smith
- MRC-ARUK Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby, UK
| | - Philip J Atherton
- MRC-ARUK Centre for Musculoskeletal Ageing Research and Nottingham NIHR BRC, School of Medicine, University of Nottingham, Derby, UK
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12
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Physical activity as an adjunct treatment for erectile dysfunction. Nat Rev Urol 2019; 16:553-562. [PMID: 31239541 DOI: 10.1038/s41585-019-0210-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2019] [Indexed: 01/04/2023]
Abstract
Increasing data are available to suggest that physical activity and lifestyle modification in general can benefit erectile function, with effect sizes comparable with established treatment options such as testosterone therapy and phosphodiesterase type 5 inhibitors. Despite this evidence, primary-care physicians are rarely afforded critical information on the underlying mechanisms through which physical activity works as a treatment, severely hampering treatment credibility for both physician and patient. Physical activity is associated with psychological and metabolic adaptations that are compatible with the adaptations required for the treatment of erectile dysfunction (ED). These adaptations include increased expression and activity of nitric oxide synthase, strengthened endothelial function, acute rises in testosterone, decreased stress and anxiety, and improved body image. Use of physical activity as a first-line treatment option for ED is limited, and explicit physical activity guidelines for the treatment of ED are required. Such guidelines should include not only a suggested exercise programme but also guidelines for physician-patient communication that might enhance patient receptivity and therapy continuation. An understanding of how physical activity affects erectile function, as well as its effectiveness in treating ED compared with other established treatments, can benefit urologists and primary-care physicians searching for noninvasive treatment options for men presenting with poor erectile function.
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13
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Tacey A, Parker L, Yeap BB, Joseph J, Lim EM, Garnham A, Hare DL, Brennan-Speranza T, Levinger I. Single-dose prednisolone alters endocrine and haematologic responses and exercise performance in men. Endocr Connect 2019; 8:111-119. [PMID: 30673629 PMCID: PMC6373622 DOI: 10.1530/ec-18-0473] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 01/23/2019] [Indexed: 12/11/2022]
Abstract
The aim of this study was to investigate the effect of a single dose of prednisolone on (A) high-intensity interval cycling performance and (B) post-exercise metabolic, hormonal and haematological responses. Nine young men participated in this double-blind, randomised, cross-over study. The participants completed exercise sessions (4 × 4 min cycling bouts at 90-95% of peak heart rate), 12 h after ingesting prednisolone (20 mg) or placebo. Work load was adjusted to maintain the same relative heart rate between the sessions. Exercise performance was measured as total work performed. Blood samples were taken at rest, immediately post exercise and up to 3 h post exercise. Prednisolone ingestion decreased total work performed by 5% (P < 0.05). Baseline blood glucose was elevated following prednisolone compared to placebo (P < 0.001). Three hours post exercise, blood glucose in the prednisolone trial was reduced to a level equivalent to the baseline concentration in the placebo trial (P > 0.05). Prednisolone suppressed the increase in blood lactate immediately post exercise (P < 0.05). Total white blood cell count was elevated at all time-points with prednisolone (P < 0.01). Androgens and sex hormone-binding globulin were elevated immediately after exercise, irrespective of prednisolone or placebo. In contrast, prednisolone significantly reduced the ratio of testosterone/luteinizing hormone (P < 0.01). Acute prednisolone treatment impairs high-intensity interval cycling performance and alters metabolic and haematological parameters in healthy young men. Exercise may be an effective tool to minimise the effect of prednisolone on blood glucose levels.
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Affiliation(s)
- Alexander Tacey
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
- Department of Medicine-Western Health, Australian Institute for Musculoskeletal Science (AIMSS), Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lewan Parker
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Bu B Yeap
- Medical School, University of Western Australia, and Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - John Joseph
- PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Ee M Lim
- PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Andrew Garnham
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
| | - David L Hare
- University of Melbourne and the Department of Cardiology, Austin Health, Melbourne, Victoria, Australia
| | - Tara Brennan-Speranza
- Department of Physiology and Bosch Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Itamar Levinger
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Victoria, Australia
- Department of Medicine-Western Health, Australian Institute for Musculoskeletal Science (AIMSS), Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- Correspondence should be addressed to I Levinger:
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14
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Hayes LD, Elliott BT. Short-Term Exercise Training Inconsistently Influences Basal Testosterone in Older Men: A Systematic Review and Meta-Analysis. Front Physiol 2019; 9:1878. [PMID: 30692929 PMCID: PMC6339914 DOI: 10.3389/fphys.2018.01878] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 12/11/2018] [Indexed: 12/21/2022] Open
Abstract
Background: The age-associated decrease in testosterone is one mechanism suggested to accelerate the aging process in males. Therefore, approaches to increase endogenous testosterone may be of benefit. The aim of this paper was to undertake a Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)-accordant meta-analysis concerning the effect of exercise on total (TT), bioavailable (bio-T), free (free-T), and salivary (sal-T) testosterone in older males. Methods: Databases were searched up to and including 20th February 2018 for the terms "testosterone AND exercise AND aging AND males," "testosterone AND exercise AND old AND males," "testosterone AND training AND aging AND males," and "testosterone AND training AND old AND males". From 1259 originally identified titles, 22 studies (randomized controlled trials; RCTs; n = 9, and uncontrolled trials; UCTs; n = 13) were included which had a training component, participants ≥60 years of age, and salivary or serum testosterone as an outcome measure. Meta-analyses were conducted on change to testosterone following training using standardized difference in means (SDM) and random effects models. Results: The overall SDM for endurance training, resistance training, and interval training was 0.398 (95% CI = 0.034-0.761; P = 0.010), -0.003 (95% CI = -0.330-0.324; P = 0.986), and 0.283 (95% CI = 0.030-0.535; P = 0.028), respectively. Resistance training exhibited a qualitative effect of hormone fraction whereby free-T resulted in the greatest SDM (0.253; 95% CI = -0.043-0.549; P = 0.094), followed by TT (0.028; 95% CI = -0.204-0.260; P = 0.813), and resistance training negatively influenced bio-T (-0.373; 95% CI = -0.789-0.042; P = 0.078). Due to the small number of studies, subgroup analysis was not possible for endurance training and interval training studies. Conclusions: Data from the present investigation suggests that resistance training does not significantly influence basal testosterone in older men. Magnitude of effect was influenced by hormone fraction, even within the same investigation. Aerobic training and interval training did result in small, significant increases in basal testosterone. The magnitude of effect is small but the existing data are encouraging and may be an avenue for further research.
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Affiliation(s)
- Lawrence D Hayes
- Active Ageing Research Group, Department of Medical and Sport Sciences, University of Cumbria, Lancaster, United Kingdom
| | - Bradley T Elliott
- Translational Physiology Research Group, School of Life Sciences, University of Westminster, London, United Kingdom
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15
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Walker S, Häkkinen K, Haff GG, Blazevich AJ, Newton RU. Acute elevations in serum hormones are attenuated after chronic training with traditional isoinertial but not accentuated eccentric loads in strength-trained men. Physiol Rep 2017; 5:5/7/e13241. [PMID: 28400506 PMCID: PMC5392527 DOI: 10.14814/phy2.13241] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 02/24/2017] [Accepted: 03/11/2017] [Indexed: 12/25/2022] Open
Abstract
It has been proposed that the maintenance of acute hormonal responses reveal an efficacy of a training stimulus to evoke ongoing increases in strength and muscle mass. We previously observed that maximum strength continued to improve throughout a 10-week period in an accentuated eccentric loading group (AEL) but not a traditional isoinertial loading (ISO) group. Therefore, this study investigated whether the magnitude of acute hormonal responses was greater (i.e., maintained) in AEL compared to ISO at the end of the training period. Subjects in AEL (eccentric load = concentric load + 40%) and ISO performed experimental loading tests (three sets of 10 repetitions in the leg press and knee extension exercises) during weeks 2 and 9 of the training period. Blood samples collected during these experimental loadings were analyzed for serum testosterone, growth hormone and cortisol concentrations. Maximum isometric knee extension torque (MVC) and lower-limb lean mass were assessed before and after 5 and 10 weeks of training. Acute testosterone, growth hormone and cortisol responses to traditional isoinertial loading were reduced at the end of the training period but were not reduced after accentuated eccentric load training (P < 0.05‒0.1 between-groups). Increases in MVC and lower-limb lean mass over weeks 6‒10 were greater in AEL compared to ISO (MVC: 7.3 ± 5.4 vs. -0.4 ± 7.2%, P = 0.026 for between-group difference; lower-limb lean mass: 1.6 ± 2.2 vs. -0.2 ± 1.4%, P = 0.063 for between-group difference). The maintenance of acute hormonal responses and continued strength gain in AEL but not ISO are consistent with the hypothesis that maintained acute responses indicate an efficacy of a training stimulus to evoke ongoing adaptation. However, since relationships between hormonal responses and training-induced adaptations were not statistically significant, the data suggest that tracking of acute hormonal responses on an individual level may not provide a sensitive enough guide for decisions regarding program design and periodization.
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Affiliation(s)
- Simon Walker
- Faculty of Sport and Health Science and Neuromuscular Research Center, University of Jyväskylä, Jyväskylä, Finland .,Centre for Exercise and Sports Science Research (CESSR), Edith Cowan University, Joondalup, Australia
| | - Keijo Häkkinen
- Faculty of Sport and Health Science and Neuromuscular Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Guy Gregory Haff
- Centre for Exercise and Sports Science Research (CESSR), Edith Cowan University, Joondalup, Australia
| | - Anthony J Blazevich
- Centre for Exercise and Sports Science Research (CESSR), Edith Cowan University, Joondalup, Australia
| | - Robert U Newton
- Institute of Human Performance, The University of Hong Kong, Hong Kong, China
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Hooper DR, Kraemer WJ, Focht BC, Volek JS, DuPont WH, Caldwell LK, Maresh CM. Endocrinological Roles for Testosterone in Resistance Exercise Responses and Adaptations. Sports Med 2017; 47:1709-1720. [DOI: 10.1007/s40279-017-0698-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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