Investigating the reproducibility of maximal oxygen uptake responses to high-intensity interval training

Standard Deviation of Individual Response for VO2max Following Exercise Interventions: A Systematic Review and Meta-analysis

BACKGROUND

Although numerous attempts to demonstrate inter-individual differences in trainability across various outcomes have been unsuccessful, the investigation of maximal oxygen consumption (VO2max) trainability warrants further study.

OBJECTIVE

Our objective was to conduct the first systematic review and meta-analysis to evaluate inter-individual differences in VO2max trainability across aerobic exercise training protocols utilizing non-exercising comparator groups.

METHODS

We conducted a literature search across three databases: EMBASE, PubMed and SCOPUS. The search strategy incorporated two main concepts: aerobic exercise training and VO2max. Studies were included if they used human participants, employed standardized and supervised exercise training, reported absolute or relative VO2max, included a non-exercise comparator group, reported VO2max change scores for non-exercise and exercise groups and provided the standard deviation (SD) of change for all groups. We calculated the SD of individual response (SDIR) to estimate the presence of inter-individual differences in trainability across all studies.

RESULTS

The literature search generated 32,968 studies, 24 of which were included in the final analysis. Our findings indicated that (1) the majority of variation in observed change scores following an intervention is due to measurement error, (2) calculating SDIR within a single study would not yield sufficient accuracy of SDIR due to generally small sample sizes and (3) meta-analysis of SD IR 2 across studies does not provide strong evidence for a positive value.

CONCLUSION

Overall, our meta-analysis demonstrated that there is not strong evidence supporting the existence of VO2max trainability across single interventions. As such, it appears unlikely that clinically relevant predictors of VO2max response will be discovered. Registration can be found online ( https://doi.org/10.17605/OSF.IO/X9VU3 ).

Modelling inter-individual variability in acute and adaptive responses to interval training: insights into exercise intensity normalisation

PURPOSE

To investigate the influence of exercise intensity normalisation on intra- and inter-individual acute and adaptive responses to an interval training programme.

METHODS

Nineteen cyclists were split in two groups differing (only) in how exercise intensity was normalised: 80% of the maximal work rate achieved in an incremental test (% W ˙ max) vs. maximal sustainable work rate in a self-paced interval training session (% W ˙ max-SP). Testing duplicates were conducted before and after an initial control phase, during the training intervention, and at the end, enabling the estimation of inter-individual variability in adaptive responses devoid of intra-individual variability.

RESULTS

Due to premature exhaustion, the median training completion rate was 88.8% for the % W ˙ max group, but 100% for the % W ˙ max-SP the group. Ratings of perceived exertion and heart rates were not sensitive to how intensity was normalised, manifesting similar inter-individual variability, although intra-individual variability was minimised for the % W ˙ max-SP group. Amongst six adaptive response variables, there was evidence of individual response for only maximal oxygen uptake (standard deviation: 0.027 L·min-1·week-1) and self-paced interval training performance (standard deviation: 1.451 W·week-1). However, inter-individual variability magnitudes were similar between groups. Average adaptive responses were also similar between groups across all variables.

CONCLUSIONS

To normalise completion rates of interval training, % W ˙ max-SP should be used to prescribe relative intensity. However, the variability in adaptive responses to training may not reflect how exercise intensity is normalised, underlining the complexity of the exercise dose-adaptation relationship. True inter-individual variability in adaptive responses cannot always be identified when intra-individual variability is accounted for.

The Additional Effect of Training Above the Maximal Metabolic Steady State on VO2peak, Wpeak and Time-Trial Performance in Endurance-Trained Athletes: A Systematic Review, Meta-analysis, and Reality Check

BACKGROUND

To improve sport performance, athletes use training regimens that include exercise below and above the maximal metabolic steady state (MMSS).

OBJECTIVE

The objective of this review was to determine the additional effect of training above MMSS on VO2peak, Wpeak and time-trial (TT) performance in endurance-trained athletes.

METHODS

Studies were included in the review if they (i) were published in academic journals, (ii) were in English, (iii) were prospective, (iv) included trained participants, (v) had an intervention group that contained training above and below MMSS, (vi) had a comparator group that only performed training below MMSS, and (vii) reported results for VO2peak, Wpeak, or TT performance. Medline and SPORTDiscus were searched from inception until February 23, 2023.

RESULTS

Fourteen studies that ranged from 2 to 12 weeks were included in the review. There were 171 recreational and 128 competitive endurance athletes. The mean age and VO2peak of participants ranged from 15 to 43 years and 38 to 68 mL·kg-1·min-1, respectively. The inclusion of training above MMSS led to a 2.5 mL·kg-1·min-1 (95% CI 1.4-3.6; p < 0.01; I2 = 0%) greater improvement in VO2peak. A minimum of 81 participants per group would be required to obtain sufficient power to determine a significant effect (SMD 0.44) for VO2peak. No intensity-specific effect was observed for Wpeak or TT performance, in part due to a smaller sample size.

CONCLUSION

A single training meso-cycle that includes training above MMSS can improve VO2peak in endurance-trained athletes more than training only below MMSS. However, we do not have sufficient evidence to conclude that concurrent adaptation occurs for Wpeak or TT performance.

Including supramaximal verification reduced uncertainty in VO2peak response rate

Many reports describe using a supramaximal verification phase-exercising at a power output higher than the highest power output recorded during an incremental cardiopulmonary test-to validate VO2max. The impact of verification phases on estimating the proportion of individuals who increased VO2peak in response to high-intensity interval training (HIIT) remains an underexplored area in the individual response literature. This analysis investigated the influence of same-day and separate-day verification phases during repeated measurements (incremental tests-INCR1 and INCR2; incremental tests + supramaximal verification phases-INCR1+ and INCR2+) of VO2peak on typical error (TE) and the proportion of individuals classified as responders (i.e., the response rate) following 4 weeks of HIIT (n = 25) or a no-exercise control period (n = 9). Incorporation of supramaximal verification consistently reduced the standard deviation of individual response, TE, and confidence interval (CI) widths. However, variances were statistically similar across all groups (p > 0.05). Response rates increased when incorporating either one (INCR1 to INCR1+; 24%-48%, p = 0.07) or two (INCR2 to INCR2+; 28%-48%, p = 0.063) supramaximal verification phases. However, response rates remained unchanged when either zero-based thresholds or smallest worthwhile difference response thresholds were used (50% and 90% CIs, all p > 0.05). Supramaximal verification phases reduced random variability in VO2peak response to HIIT. Compared with separate-day testing (INCR2 and INCR2+), the incorporation of a same-day verification (INCR1+) reduced CI widths the most. Researchers should consider using a same-day verification phase to reduce uncertainty and better estimate VO2peak response rate to HIIT.

Coaches' Perceptions of Factors Driving Training Adaptation: An International Survey

OBJECTIVE

We surveyed coaches' views on topics related to the training process to elucidate whether their opinions are aligned with the current literature. Here the results for a sub-set of questions regarding factors affecting the training adaptation process are presented and discussed.

METHODS

106 coaches [age range 18-65 + years, 31% 15 + years coaching, 58% individual-events/sports and 32% international level] from a number of countries completed a novel cross-sectional online survey about the planning of training and the training process.

RESULTS

Only 28% of participants indicated that physical training was the most important factor in determining sport performance; whereas 99% indicated non-physical factors influence physical training response. The top five factors in modifying an athlete's ability to physically adapt to a training plan, as rated 'absolutely essential', were 'coach-athlete relationship' (56%), 'life stress' (41%), 'athletes' belief in the plan' (37%), 'psychological and emotional stress' (35%) and 'physical training' (33%).

CONCLUSIONS

Amongst coaches surveyed less than a third rated physical training as the most important factor in determining sports performance. Non-physical factors were acknowledged by the majority to exert an influence on physical training response and adaptation, despite the lack of discussion in training research, though there was no consensus on the relative importance of each individual factor. We echo previous sentiments that coaches need to be engaged in the research process. If training research continues as present the field runs the risk of not only becoming detached but increasingly irrelevant to those it is trying to help.

Coaches' Perceptions of Common Planning Concepts Within Training Theory: An International Survey

BACKGROUND

The planning of training is a popular yet controversial topic among coaches and sports scientists. Periodisation is often presented in the literature as the most efficacious approach to planning training. While historically surveys of coaches appeared to support this a key failing was that no unified definition of periodisation exists. Recent surveys offering a periodisation definition and an alternative planning methodology found many choosing the alternative therefore questioning periodisation's wide acceptance. The current survey looked to explore how coaches perceived specific concepts, drawn from the literature, that relate to the planning of training.

METHODS

106 coaches [age range: 18-65+ years, 31% 15+ years coaching, 58% individual-events/sports and 32% international level] from across the world completed a novel cross-sectional online survey on the planning of training and the training process. Topics included use of periodisation, division of time into discrete periods, assignment of goals and training to pre-determined periods and the adaptability of pre-established plans.

RESULTS

The majority described their planning approach as training periodisation (71%). Similarly, there was strong agreement with the necessity to determining a goal for the season (85%) and divide the season into distinct manageable periods of time (73%). When examining whether physical adaptations are achievable within specific and fixed timeframes only a minority (33%) agreed, a similar result was found for training physical capacities in a sequential order (37%). Finally, there was limited support for training targets remaining fixed over a training period (10%).

CONCLUSIONS

As a tool for the planning of athlete's training, periodisation is often presented as the best and most popular approach. Recent research however has highlighted possible discrepancies in its usage among practitioners. The results of this survey echo this and question the acceptance of periodisation concepts even among periodisation users. In part this may be due to key tenets of periodisation no longer being supported by research or practice. A lingering question then is whether the beliefs of coaches, developed through experience and supported by research, will continue to be marginalized. If sports scientists wish to aid coaches then they need to be engaged in future research initiatives as co-collaborators.

The proportional distribution of training by elite endurance athletes at different intensities during different phases of the season

The present review examines retrospective analyses of training intensity distribution (TID), i.e., the proportion of training at moderate (Zone 1, Z1), heavy (Z2) and severe (Z3) intensity by elite-to-world-class endurance athletes during different phases of the season. In addition, we discuss potential implications of our findings for research in this field, as well as for training by these athletes. Altogether, we included 175 TIDs, of which 120 quantified exercise intensity on the basis of heart rate and measured time-in-zone or employed variations of the session goal approach, with demarcation of zones of exercise intensity based on physiological parameters. Notably, 49% of the TIDs were single-case studies, predominantly concerning cross-country skiing and/or the biathlon. Eighty-nine TIDs were pyramidal (Z1 > Z2 > Z3), 65 polarized (Z1 > Z3 > Z2) and 8 "threshold" (Z2 > Z1 = Z3). However, these relative numbers varied between sports and the particular phases of the season. In 91% (n = 160) of the TIDs >60% of the endurance exercise was of low intensity. Regardless of the approach to quantification or phase of the season, cyclists and swimmers were found to perform a lower proportion of exercise in Z1 (<72%) and higher proportion in Z2 (>16%) than athletes involved in the triathlon, speed skating, rowing, running, cross-country skiing or biathlon (>80% in Z1 and <12% in Z2 in all these cases). For most of the athletes their proportion of heavy-to-severe exercise was higher during the period of competition than during the preparatory phase, although with considerable variability between sports. In conclusion, the existing literature in this area does not allow general conclusions to be drawn. The methods utilized for quantification vary widely and, moreover, contextual information concerning the mode of exercise, environmental conditions, and biomechanical aspects of the exercise is often lacking. Therefore, we recommend a more comprehensive approach in connection with future investigations on the TIDs of athletes involved in different endurance sports.

Risk of bias and reporting practices in studies comparing VO2max responses to sprint interval vs. continuous training: A systematic review and meta-analysis

BACKGROUND

It remains unclear whether studies comparing maximal oxygen uptake (VO2max) response to sprint interval training (SIT) vs. moderate-intensity continuous training (MICT) are associated with a high risk of bias and poor reporting quality. The purpose of this study was to evaluate the risk of bias and quality of reporting in studies comparing changes in VO2max between SIT and MICT.

METHODS

We conducted a comprehensive literature search of 4 major databases: AMED, CINAHL, EMBASE, and MEDLINE. Studies were excluded if participants were not healthy adult humans or if training protocols were unsupervised, lasted less than 2 weeks, or utilized mixed exercise modalities. We used the Cochrane Collaboration tool and the CONSORT checklist for non-pharmacological trials to evaluate the risk of bias and reporting quality, respectively.

RESULTS

Twenty-eight studies with 30 comparisons (3 studies included 2 SIT groups) were included in our meta-analysis (n = 360 SIT participants: body mass index (BMI) = 25.9 ± 3.7 kg/m2, baseline VO2max = 37.9 ± 8.0 mL/kg/min; n = 359 MICT participants: BMI = 25.5 ± 3.8 kg/m2, baseline VO2max = 38.3 ± 8.0 mL/kg/min; all mean ± SD). All studies had an unclear risk of bias and poor reporting quality.

CONCLUSION

Although we observed a lack of superiority between SIT and MICT for improving VO2max (weighted Hedge's g = -0.004, 95% confidence interval (95%CI): -0.08 to 0.07), the overall unclear risk of bias calls the validity of this conclusion into question. Future studies using robust study designs are needed to interrogate the possibility that SIT and MICT result in similar changes in VO2max.

Interindividual Differences in Trainability and Moderators of Cardiorespiratory Fitness, Waist Circumference, and Body Mass Responses: A Large-Scale Individual Participant Data Meta-analysis

Although many studies have assumed variability reflects variance caused by exercise training, few studies have examined whether interindividual differences in trainability are present following exercise training. The present individual participant data (IPD) meta-analysis sought to: (1) investigate the presence of interindividual differences in trainability for cardiorespiratory fitness (CRF), waist circumference, and body mass; and (2) examine the influence of exercise training and potential moderators on the probability that an individual will experience clinically important differences. The IPD meta-analysis combined data from 1879 participants from eight previously published randomized controlled trials. We implemented a Bayesian framework to: (1) test the hypothesis of interindividual differences in trainability by comparing variability in change scores between exercise and control using Bayes factors; and (2) compare posterior predictions of control and exercise across a range of moderators (baseline body mass index (BMI) and exercise duration, intensity, amount, mode, and adherence) to estimate the proportions of participants expected to exceed minimum clinically important differences (MCIDs) for all three outcomes. Bayes factors demonstrated a lack of evidence supporting a high degree of variance attributable to interindividual differences in trainability across all three outcomes. These findings indicate that interindividual variability in observed changes are likely due to measurement error and external behavioural factors, not interindividual differences in trainability. Additionally, we found that a larger proportion of exercise participants were expected to exceed MCIDs compared with controls for all three outcomes. Moderator analyses identified that larger proportions were associated with a range of factors consistent with standard exercise theory and were driven by mean changes. Practitioners should prescribe exercise interventions known to elicit large mean changes to increase the probability that individuals will experience beneficial changes in CRF, waist circumference and body mass.

Implementation of multiple statistical methods to estimate variability and individual response to training

HIGHLIGHTS

What are the findings? We implemented five statistical methods in a single study to estimate the magnitude of within-subject variability and quantify responses to exercise training at the individual level.The various proposed methods used to estimate individual responses to training provide different types of information and rely on different assumptions that are difficult to test.Within-subject variability is often large in magnitude, and as such, should be systematically evaluated and carefully considered in future studies to successfully estimate individual responses to training. How might it impact on clinical practice in the future? Within-subject variability in response to exercise training is a key factor that must be considered in order to obtain a reproducible measurement of individual response to exercise training. This is akin to ensuring data is reproducible for each subject.Our findings provide guidelines for future exercise training studies to ensure results are reproducible within participants and to minimize wasting precious research resources.By implementing five suggested methods to estimate individual response to training, we highlight their feasibility, strengths, weaknesses, and costs, for researchers to make the best decision on how to accurately measure individual responses to exercise training.

Regular exercise and patterns of response across multiple cardiometabolic traits: the HERITAGE family study

OBJECTIVES

We investigated whether high responsiveness or low responsiveness to exercise training aggregates in the same individuals across seven cardiometabolic traits.

METHODS

A total of 564 adults (29.2% black, 53.7% female) from the HERITAGE family study completed a 20-week endurance training programme (at 55%-75% of participants' maximal oxygen uptake (VO₂max)) with VO₂max, per cent body fat, visceral adipose tissue, fasting levels of insulin, high-density lipoprotein cholesterol, small low-density lipoprotein particles and inflammatory marker GlycA measured before and after training. For each exercise response trait, we created ethnicity-specific, sex-specific and generation-specific quintiles. High responses were defined as those within the 20th percentile representing the favourable end of the response trait distribution, low responses were defined as the 20th percentile from the least favourable end, and the remaining were labelled as average responses.

RESULTS

Only one individual had universally high or low responses for all seven cardiometabolic traits. Almost half (49%) of the cohort had at least one high response and one low response across the seven traits. About 24% had at least one high response but no low responses, 24% had one or more low responses but no high responses, and 2.5% had average responses across all traits.

CONCLUSIONS

Interindividual variation in exercise responses was evident in all the traits we investigated, and responsiveness did not aggregate consistently in the same individuals. While adherence to an exercise prescription is known to produce health benefits, targeted risk factors may not improve.

A Systematic Review Examining the Approaches Used to Estimate Interindividual Differences in Trainability and Classify Individual Responses to Exercise Training

Background: Many reports describe statistical approaches for estimating interindividual differences in trainability and classifying individuals as "responders" or "non-responders." The extent to which studies in the exercise training literature have adopted these statistical approaches remains unclear. Objectives: This systematic review primarily sought to determine the extent to which studies in the exercise training literature have adopted sound statistical approaches for examining individual responses to exercise training. We also (1) investigated the existence of interindividual differences in trainability, and (2) tested the hypothesis that less conservative thresholds inflate response rates compared with thresholds that consider error and a smallest worthwhile change (SWC)/minimum clinically important difference (MCID). Methods: We searched six databases: AMED, CINAHL, EMBASE, Medline, PubMed, and SportDiscus. Our search spanned the aerobic, resistance, and clinical or rehabilitation training literature. Studies were included if they used human participants, employed standardized and supervised exercise training, and either: (1) stated that their exercise training intervention resulted in heterogenous responses, (2) statistically estimated interindividual differences in trainability, and/or (3) classified individual responses. We calculated effect sizes (ES_IR) to examine the presence of interindividual differences in trainability. We also compared response rates (n = 614) across classification approaches that considered neither, one of, or both errors and an SWC or MCID. We then sorted response rates from studies that also reported mean changes and response thresholds (n = 435 response rates) into four quartiles to confirm our ancillary hypothesis that larger mean changes produce larger response rates. Results: Our search revealed 3,404 studies, and 149 were included in our systematic review. Few studies (n = 9) statistically estimated interindividual differences in trainability. The results from these few studies present a mixture of evidence for the presence of interindividual differences in trainability because several ES_IR values lay above, below, or crossed zero. Zero-based thresholds and larger mean changes significantly (both p < 0.01) inflated response rates. Conclusion: Our findings provide evidence demonstrating why future studies should statistically estimate interindividual differences in trainability and consider error and an SWC or MCID when classifying individual responses to exercise training. Systematic Review Registration: [website], identifier [registration number].

Directions for Exercise Treatment Response Heterogeneity and Individual Response Research

Treatment response heterogeneity and individual responses following exercise training are topics of interest for personalized medicine. Proposed methods to determine the contribution of exercise to the magnitude of treatment response heterogeneity and categorizing participants have expanded and evolved. Setting clear research objectives and having a comprehensive understanding of the strengths and weaknesses of the available methods are vital to ensure the correct study design and analytical approach are used. Doing so will ensure contributions to the field are conducted as rigorously as possible. Nonetheless, concerns have emerged regarding the ability to truly isolate the impact of exercise training, and the nature of individual responses in relation to mean group changes. The purpose of this review is threefold. First, the strengths and limitations associated with current methods for quantifying the contribution of exercise to observed treatment response heterogeneity will be discussed. Second, current methods used to categorize participants based on their response to exercise will be outlined, as well as proposed mechanisms for factors that contribute to response variation. Finally, this review will provide an overview of some current issues at the forefront of individual response research.

MEDICAL EFFECT OF SPORTS ON IMPROVING THE MAXIMUM OXYGEN

ABSTRACT Introduction: Maximum oxygen uptake is an effective indicator of the level of human cardiopulmonary function and aerobic work capacity. Observing the effects of aerobic training and formulating scientific training plans are of considerable value. Objective: To observe the effect of physical exercise on the human body's maximum oxygen uptake and arterial blood ketone body ratio. Methods: Before and after 4 weeks of physical exercise, the maximum oxygen uptake, blood lactic acid and heart rate changes, and ketone body content in the incremental load exercise experiment was measured in the human body. Results: The subjects’ maximum oxygen uptake, maximum exercise load, heart rate, and blood lactic acid levels increased significantly after physical exercise. Conclusion: The human body's maximum oxygen uptake is enhanced under sports. Level of evidence II; Therapeutic studies - investigation of treatment results.

Is a verification phase useful for confirming maximal oxygen uptake in apparently healthy adults? A systematic review and meta-analysis

BACKGROUND

The 'verification phase' has emerged as a supplementary procedure to traditional maximal oxygen uptake (VO2max) criteria to confirm that the highest possible VO2 has been attained during a cardiopulmonary exercise test (CPET).

OBJECTIVE

To compare the highest VO2 responses observed in different verification phase procedures with their preceding CPET for confirmation that VO2max was likely attained.

METHODS

MEDLINE (accessed through PubMed), Web of Science, SPORTDiscus, and Cochrane (accessed through Wiley) were searched for relevant studies that involved apparently healthy adults, VO2max determination by indirect calorimetry, and a CPET on a cycle ergometer or treadmill that incorporated an appended verification phase. RevMan 5.3 software was used to analyze the pooled effect of the CPET and verification phase on the highest mean VO2. Meta-analysis effect size calculations incorporated random-effects assumptions due to the diversity of experimental protocols employed. I2 was calculated to determine the heterogeneity of VO2 responses, and a funnel plot was used to check the risk of bias, within the mean VO2 responses from the primary studies. Subgroup analyses were used to test the moderator effects of sex, cardiorespiratory fitness, exercise modality, CPET protocol, and verification phase protocol.

RESULTS

Eighty studies were included in the systematic review (total sample of 1,680 participants; 473 women; age 19-68 yr.; VO2max 3.3 ± 1.4 L/min or 46.9 ± 12.1 mL·kg-1·min-1). The highest mean VO2 values attained in the CPET and verification phase were similar in the 54 studies that were meta-analyzed (mean difference = 0.03 [95% CI = -0.01 to 0.06] L/min, P = 0.15). Furthermore, the difference between the CPET and verification phase was not affected by any of the potential moderators such as verification phase intensity (P = 0.11), type of recovery utilized (P = 0.36), VO2max verification criterion adoption (P = 0.29), same or alternate day verification procedure (P = 0.21), verification-phase duration (P = 0.35), or even according to sex, cardiorespiratory fitness level, exercise modality, and CPET protocol (P = 0.18 to P = 0.71). The funnel plot indicated that there was no significant publication bias.

CONCLUSIONS

The verification phase seems a robust procedure to confirm that the highest possible VO2 has been attained during a ramp or continuous step-incremented CPET. However, given the high concordance between the highest mean VO2 achieved in the CPET and verification phase, findings from the current study would question its necessity in all testing circumstances.

PROSPERO REGISTRATION ID

CRD42019123540.

Repeatability of training-induced skeletal muscle adaptations in active young males

OBJECTIVES

Measurements of protein content, enzymatic activity, and/or capillarization are frequently utilized as markers of skeletal muscle adaptation following exercise training. Whether changes in these markers of muscle adaptation are repeatable when individuals are repeatedly exposed to the same training stimulus is unknown. The purpose of this study was to test the repeatability of skeletal muscle adaptations to two identical training periods.

METHODS

Ten active young males (age: 22 ± 2 years; VO₂max: 57 ± 7 ml/kg/min) were exposed to two identical four-week periods of supervised high-intensity interval running (4 × 4 min at 90-95% of HRmax interspersed with 3-min at 70-75% HRmax) separated by a 3-month wash-out period. Vastus lateralis biopsies were obtained before and after each training period for the measurement of protein content, enzyme activity, and capillary density.

RESULTS

Training-induced changes in citrate synthase (CS) maximal activity, protein content (PGC-1α, OXPHOS, and LDH-A), and capillary density were not repeatable within individuals (r = -0.52-0.15; ICCs: -0.42-0.04; CVs: 11-67%). Several OXPHOS complex subunits also demonstrated dissimilar group-level adaptations (period × time interaction effects, p < 0.05) with large differences (η_p² > 0.4) between training periods. A large (η_p² = 0.65) increase in capillary density was apparent irrespective of training period (main effect of time, p = 0.05).

CONCLUSIONS

An individual (or a group of individuals) may exhibit dissimilar skeletal muscle adaptations when re-exposed to the same training stimulus. Our findings challenge the utility of classifying of individuals as high/low responders using measurements of mitochondrial protein content, CS activity and/or capillary density following a single training period.

Endogenous transient doping: physical exercise acutely increases testosterone levels-results from a meta-analysis

PURPOSE

Although endogenous testosterone levels are demonstrated to be affected by both acute exercise and resistance training, the dynamic regulation of androgen production after physical activity is still a matter of debate. This meta-analysis was designed to assess whether physical exercise acutely affects testosterone levels in men.

METHODS

The literature search was conducted to identify longitudinal trials evaluating the acute change of both total testosterone (TT) and free testosterone (fT) after physical activity in adult men. Sensitivity analyses were performed considering the sample collected (blood or saliva), the intensity of the physical exercise and the interval between the end of the exercise and the sample collection.

RESULTS

Forty-eight studies were included in the analysis, accounting for 126 trials. A total of 569 patients were enrolled (mean age 29.7 ± 13.1 years). The physical activity increased acutely TT (standardized mean difference 0.74, 95%CI: 0.56, 0.91 nmol/L), considering both serum and saliva samples (p < 0.001). Testosterone increased after moderate (p < 0.001) and high-intensity (p < 0.001) exercises, but not after mild physical activity (p = 0.19). Moreover, the testosterone increase was evident when measured immediately at the end of the exercise and within 30 min (p < 0.001), but not after 30 min (p = 0.930). Similar significant results were obtained considering fT, while SHBG did not change after physical activity (p = 0.090).

CONCLUSION

The comprehensive evaluation of the acute physical activity effect on testosterone levels identified a clear increase after exercise, irrespective of the sample collected. The main determinant of this fluctuation was the exercise intensity, with a mechanism that seems to be mostly SHBG independent. In particular, moderate/intense physical activity resulted able to increase endogenous androgenic production, albeit acutely and transitory.

TRIAL REGISTRATION NUMBER

PROSPERO registration ID: 157348.

Reproducible improvement in endothelial function following two separate periods of high-intensity interval training in young men

High-intensity interval training (HIIT) can improve vascular function, as assessed by brachial artery flow-mediated dilation (FMD). However, when separated by a period of detraining, the reproducibility of FMD responses to repeated periods of HIIT is unknown. The purpose of this study was to determine the group mean and intraindividual reproducibility of FMD responses to two 4-wk periods of HIIT, separated by 3 mo of detraining. Thirteen healthy, recreationally active men (21 ± 2 yr) completed the study. Each 4-wk HIIT period included 40 min of treadmill training four times/week. Each training session included four 7-min intervals: 4 min at 90%-95% heart rate maximum (HR_max) and 3 min at 70%-75% HR_max. Vascular (FMD) and cardiorespiratory fitness (maximal oxygen consumption [V̇o_2max]) assessments were conducted before and following each 4-wk training period. Training resulted in significant improvements in V̇o_2max (P < 0.001). Training also improved FMD (P < 0.001), with no differences between periods (P = 0.394), even after controlling for changes in baseline diameter and the shear rate stimulus. There was a significant, moderate relationship between the change in FMD in HIIT period 1 versus period 2 [R² = 0.493, P = 0.011, intraclass correlation coefficient: 0.600, coefficient of variation: 17.3%]. Consecutive periods of HIIT separated by detraining resulted in similar improvements in FMD at the group level, and individual FMD changes in period 1 of HIIT predicted FMD changes in response to period 2. Considered alongside substantial between-participant variability in magnitude of FMD improvement, this suggests that there are reproducible, interindividual differences in the potential to improve vascular function with HIIT.NEW & NOTEWORTHY This is the first study examining endothelial function [flow-mediated dilation (FMD)] following repeated periods of high-intensity interval training (HIIT). Two periods of HIIT separated by detraining resulted in reproducible group-level improvements in FMD. Despite considerable between-subject variability in FMD adaptation, individual FMD changes with the first HIIT period predicted FMD changes in the second period. This indicates the existence of reproducible between-subject differences in susceptibility to FMD improvement with HIIT.