Combined effects of aerobic exercise and l-arginine ingestion on blood pressure in normotensive postmenopausal women: A crossover study

Absence of Effects of L-Arginine and L-Citrulline on Inflammatory Biomarkers and Oxidative Stress in Response to Physical Exercise: A Systematic Review with Meta-Analysis

BACKGROUND

The repercussions on oxidative and inflammatory stress markers under the effects of arginine and citrulline in response to exercise are not fully reached. We completed a systematic review to investigate the effects of L-Citrulline or L-Arginine on oxidative stress and inflammatory biomarkers following exercise. EMBASE, MEDLINE (PubMed), Cochrane Library, CINAHL, LILACS, and Web of Science databases were used to record the trials. This study includes randomized controlled trials (RCTs) and non-RCTs with subjects over 18 years old. Those under the intervention protocol consumed L-Citrulline or L-Arginine, and the controls ingested placebo. We recognized 1080 studies, but only 7 were included (7 studies in meta-analysis). We observed no difference between pre- vs. post-exercise for oxidative stress (subtotal = -0.21 [CI: -0.56, 0.14], p = 0.24, and heterogeneity = 0%. In the sub-group "L-Arginine" we found a subtotal = -0.29 [-0.71, 0.12], p = 0.16, and heterogeneity = 0%. For the "L-Citrulline" subgroup we observed a subtotal = 0.00 [-0.67, 0.67], p = 1.00, and heterogeneity was not applicable. No differences were observed between groups (p = 0.47), and I² = 0%) or in antioxidant activity (subtotal = -0.28 [-1.65, 1.08], p = 0.68, and heterogeneity = 0%). In the "L-Arginine" sub-group, we found a subtotal = -3.90 [-14.18, 6.38], p = 0.46, and heterogeneity was not applicable. For the "L-Citrulline" subgroup, we reported a subtotal = -0.22 [-1.60, 1.16], p = 0.75, and heterogeneity was not applicable. No differences were observed between groups (p = 0.49), and I² = 0%), inflammatory markers (subtotal = 8.38 [-0.02, 16.78], p = 0.05, and heterogeneity = 93%. Tests for subgroup differences were not applicable, and anti-inflammatory markers (subtotal = -0.38 [-1.15, 0.39], p = 0.34 and heterogeneity = 15%; testing for subgroup differences was not applicable). In conclusion, our systematic review and meta-analysis found that L-Citrulline and L-Arginine did not influence inflammatory biomarkers and oxidative stress after exercise.

Oral Arginine Supplementation in Healthy Individuals Performing Regular Resistance Training

Resistance exercise training is well documented as having cardiovascular benefits, but paradoxically, it seems to increase arterial stiffness, favoring the development of high blood pressure. The present study investigates the potential effects of oral supplementation with arginine in healthy individuals performing exercise resistance training. We studied 70 non-smoking male subjects between the ages of 30 and 45 with normal or mildly increased blood pressure on ambulatory monitoring (for 24 h) and normal blood samples and echocardiography, who performed regular resistance exercise training for at least five years with a minimum of three workouts per week. They were divided into two groups in a random manner: 35 males were placed in the arginine group (AG) that followed a 6-month supplementation of their regular diets with 5 g of oral arginine powder taken before their exercise workout, and the control (non-arginine) group (NAG) consisted of 35 males. All subjects underwent body composition analysis, 24 h blood pressure monitoring and pulse wave analysis at enrollment and at six months. After six months of supplementation, blood pressure values did not change in the NAG, while in the AG, we found a decrease of 5.6 mmHg (p < 0.05) in mean systolic blood pressure and a decrease of 4.5 mmHg (p < 0.05) in diastolic values. There was also a 0.62% increase in muscle mass in the AG vs. the NAG (p < 0.05), while the body fat decreased by 1% (p < 0.05 in AG vs. NAG). Overall, the AG gained twice the amount of muscle mass and lost twice as much body fat as the NAG. No effects on the mean weighted average heart rate were recorded in the subjects. The results suggest that oral supplementation with arginine can improve blood pressure and body composition, potentially counteracting the stress induced by resistance exercise training. Supplementation with arginine can be a suitable adjuvant for these health benefits in individuals undertaking regular resistance training.

Blood Pressure and Heart Rate Variability Responses to High-Intensity Interval Training in Untrained Postmenopausal Women

Purpose: The aim of this study was to analyze the blood pressure (BP) and heart rate variability (HRV) responses in untrained postmenopausal women submitted to acute single sessions of high-intensity interval training (HIT). Method: Sixteen postmenopausal women (59.9 ± 5.6 years, 26.7 ± 3.0 kg/m²) participated in a random order of two acute sessions in a balanced crossover format: control without exercise in sitting position or HIT session. BP and heart rate (HR) were recorded before and during 60 min following the sessions. Results: Diastolic (DBP), mean BP (MBP), and double product (DPO) showed interaction (p < .01). DBP, MBP, and DPO increased (p < .01) after HIT but not after the control session. The area under the curve (AUC) of DBP (p = .02) and DPO (p < .01) were different between conditions. Time and frequency indices of HRV presented interaction (p < .05) which impaired these indices post-HIT, but not post-control. The AUC of time and frequency HRV indices were different between conditions. Conclusions: A single session of HIT may increase BP and cardiac stress and cause perturbation of the autonomic function in untrained postmenopausal women.

Effects of light-emitting diode therapy on cardiovascular and salivary nitrite responses in postmenopausal women submitted to a single bout of high-intensity interval training

The aim of the present study was to analyze the effects of light-emitting diode therapy (LEDT) on cardiovascular effort during a single bout of high-intensity interval training (HIIT) and on blood pressure (BP), salivary nitrite, and heart rate variability (HRV) responses after the exercise session in postmenopausal women. Sixteen postmenopausal women between 50 and 70 years of age participated in the present study. The intervention comprised two sessions: placebo plus HIIT and LEDT plus HIIT, with a 14-day interval between sessions. The oxygen uptake (VO₂), heart rate (HR), and rating of perceived exertion (RPE) were monitored throughout the HIIT sessions. Salivary samples were taken before, immediately post, and 30' and 60' post-HIIT sessions for nitric oxide (NO) analysis. In addition, HR and BP were checked before, 15 min, 30 min, 45 min, and 60 min post-HIIT sessions. HR data were used to calculate the HRV indices. Cardiovascular parameters during HIIT and BP, HRV, and NO responses were not different between placebo and LEDT conditions (p > 0.05). BP responses increased after compared to pre-exercise (p < 0.01). HRV was impaired post- compared to pre-exercise (p < 0.05). LEDT did not improve physiological performance during HIIT and did not accelerate the recovery of BP and autonomic modulation or change the NO release after exercise in postmenopausal women.

Isoflavone Supplementation Does Not Potentiate the Effect of Combined Exercise Training on Resting and Ambulatory Blood Pressure in Non-Obese Postmenopausal Women: A Randomized Double-Blind Controlled Trial-A Pilot Study

Physical exercise and isoflavone supplementation are potential strategies to prevent and treat cardiovascular diseases in postmenopausal women. The aim of this study was to investigate whether there are additive effects of isoflavone supplementation when associated with combined aerobic and resistance exercise on resting and ambulatory blood pressure monitoring (ABPM) and in blood pressure variability (BPV). Thirty-one non-obese postmenopausal women were randomly allocated into two groups: placebo and exercise (Placebo n = 19); and isoflavone supplementation (100 mg/day) and exercise (isoflavone n = 19). ABPM and BPV were evaluated before and after 10 weeks of moderate combined (aerobic and resistance) exercise training. Generalized Estimating Equation (GEE) with Bonferroni correction and intention-to-treat analysis was used to compare the effects of interventions on resting BP, ABPM and BPV. Combined exercise training decreased resting systolic (SBP) and diastolic blood pressure (DBP) and reduced 24 h and awake ambulatory SBP, DBP and mean blood pressure over time, with no additional effects of isoflavone supplementation. No changes were observed in sleep period, or in BPV indexes (Standard Deviation of 24 h (SD), daytime and nighttime interval (SDdn) and average real variability (ARV) in both groups. We conclude that isoflavone supplementation does not potentiate the effects of combined training on resting and ambulatorial systolic and diastolic blood pressure in non-obese postmenopausal women.

Role of Nutrition and Exercise Programs in Reducing Blood Pressure: A Systematic Review

The combined effect of diet and strength training (ST) on blood pressure (BP) seems to be very important for the treatment of prehypertension and hypertension (HT). Therefore, the aim of this study was to determine whether ST alone or combined with nutrition or supplementation has an impact on the arterial pressure reduction in normotensive and hypertensive populations. A systematic computerized literature search was performed according to the PRISMA guidelines using PubMed, Scopus and Google Scholar; only English language studies published from 1999 until 2018 were included. This systematic search identified the results of 303 individuals from nine studies. The ST program alone had a similar effectiveness as the nutrition program (NP) alone; however, their combination did not result in increased effectiveness in terms of a high BP reduction. The consumption of L-citrulline had a similar effect as ST on lowering BP; on the other hand, caffeine led to an increase in BP during the ST session. Our data suggest that a combination of ST 2-3 times a week at moderate intensity and a NP seems to be equally effective in terms of lowering BP (systolic and diastolic) as ST and NP alone.

Effect of physical exercise on cardiometabolic parameters in post-menopause: an integrative review

Abstract Objective: To identify the evidence available in literature which relates the practice of physical exercise to improvements in the cardiovascular and metabolic parameters of postmenopausal women. Method: A search was performed of works published between 2008 and 2018 included in the MEDLINE, BDENF, IBCS and LILACS databases. Of the 792 studies identified, 23 met the inclusion criteria. Results: Following analysis, the studies were separated into three categories. In the first category it was observed that physical exercise improved lipid metabolism, reduced abdominal circumference and promoted weight loss. The second category revealed that physical exercise reduced systolic blood pressure, prevented the development of arterial hypertension and reduced the release of sympathomimetic hormones. In the third category the studies indicated that physical exercise elevated the antioxidant mediators and reversed the oxidative stress involved in the inflammatory reactions present in cardiovascular diseases. Conclusion: The studies confirm the beneficial effects of physical exercise on the metabolic and cardiovascular parameters of postmenopausal women.

Isoflavone supplementation plus combined aerobic and resistance exercise do not change phase angle values in postmenopausal women: A randomized placebo-controlled clinical trial

OBJECTIVE

The aim of this study was to evaluate the effect of isoflavone supplementation plus combined exercise protocol on phase angle (PhA) values in postmenopausal women.

METHODS

Thirty postmenopausal women were randomly assigned in a double blind, placebo-controlled clinical trial divided into two groups: 100 mg/day of isoflavone supplementation (n = 16) and 100 mg/day of starch (placebo; n = 14). In addition, both groups performed a combined aerobic and resistance exercise during 10 weeks. Body composition and PhA were evaluated by bioelectrical impedance.

RESULTS

PhA values did not change in the isoflavone group (PRE: 6.7 ± 0.7° to POST: 6.7 ± 0.6°) and in the placebo group (PRE: 7.2 ± 1.0° to POST: 6.8 ± 0.5°); p group = 0.304, p time = 0.227, p group x time interaction = 0.137. Additionally, delta values were not different (0.04 ± 0.5° vs. -0.40 ± 0.99°; p = 0.176) between isoflavone and placebo groups, respectively.

CONCLUSION

We conclude that isoflavone supplementation plus combined aerobic and resistance exercise did not change PhA in postmenopausal women. The patients were part of ClinicalTrials.gov: NCT03008785.

The Effects of Isoflavone Supplementation Plus Combined Exercise on Lipid Levels, and Inflammatory and Oxidative Stress Markers in Postmenopausal Women

This study tested the effect of isoflavone supplementation in addition to combined exercise training on plasma lipid levels, inflammatory markers and oxidative stress in postmenopausal women. Thirty-two healthy and non-obese postmenopausal women without hormone therapy were randomly assigned to exercise + placebo (PLA; n = 15) or exercise + isoflavone supplementation (ISO; n = 17) groups. They performed 30 sessions of combined exercises (aerobic plus resistance) over ten weeks and consumed 100 mg of isoflavone supplementation or placebo. Blood samples were collected after an overnight fast to analyze the lipid profile, interleukin-6 (IL-6), interleukin-8 (IL-8), superoxide dismutase (SOD), total antioxidant capacity (FRAP), and thiobarbituric acid reactive substances (TBARS), before and after ten weeks of the intervention. There were no differences in the changes (pre vs. post) between groups for any of the inflammatory markers, oxidative stress markers or lipid profile variables. However, interleukin-8 was different between pre- and post-tests (p < 0.001) in both groups (&Delta; = 7.61 and 5.61 pg/mL) as were cholesterol levels (p < 0.05), with no interaction between groups. The combination of isoflavone supplementation and exercise training did not alter oxidative stress markers in postmenopausal women, but exercise training alone may increase IL-8 and decrease total cholesterol levels.

Combined exercise training reduces climacteric symptoms without the additive effects of isoflavone supplementation: A clinical, controlled, randomised, double-blind study

BACKGROUND

Exercise and supplementation with isoflavones are therapies used to prevent and treat climacteric symptoms.

AIM

To verify the effects of 10 weeks of combined aerobic and resistance training and isoflavone supplementation on climacteric symptoms in postmenopausal women.

METHODS

A randomised, double-blind, controlled clinical trial was performed. A total of 32 postmenopausal women, aged 54.4 ± 5.4 years, with a body mass index of 26.6 ± 3.0 kg/m² and 5.6 ± 4.6 years after menopause, were randomly assigned to groups: placebo and exercise (PLA + EXE, n = 15) or 100 mg of isoflavone and exercise (ISO + EXE, n = 17). At the beginning and after 10 weeks of aerobic + resistance (20 min each, moderate intensity) training, climacteric symptoms were evaluated using the Blatt-Kupperman Menopausal Index, Cervantes Scale and Menopause Rating Scale. ANCOVA was used for analysis between groups and at different times, with the covariate adjusted by the pre-value. The level of significance considered was p < 0.05.

RESULTS

A reduction in climacteric symptoms was observed in both groups, without differences between the interventions. The reductions were 45% and 50% for the Blatt-Kupperman Menopausal Index, 41% and 52% for the MRS and 39% and 39% for the Cervantes Scale in the ISO + EXE and PLA + EXE groups, respectively. In the descriptive analysis of the Blatt-Kupperman Menopausal Index values, there was an increase in the absence of symptoms from 48-77% in the ISO + EXE group and 24-58% in the PLA + EXE group.

CONCLUSIONS

A period of 10 weeks of combined training was effective in improving climacteric symptoms in post-menopausal women. However, isoflavone supplementation did not promote additional effects in improving symptoms.

Effects of l-arginine supplementation associated with continuous or interval aerobic training on chronic heart failure rats

OBJECTIVE

Chronic heart failure (CHF) is related with exercise intolerance and impaired nitric oxide (NO) production, which can lead to several functional capacity alterations. Considering the possible superiority of aerobic interval training compared to continuous training and the capacity of l-arginine to restore the NO pathway, the aim of the present study was to investigate whether these treatments are beneficial to exercise capacity, muscle mass preservation and hemodynamic, inflammatory and oxidative stress parameters in CHF rats.

METHODS

Thirty-eight male Wistar rats post 6weeks of myocardial infarction (MI) surgery were randomly assigned into 6 CHF groups: sedentary (SED, n=6); SED+Arg (n=7); ACT (n=8); ACT+Arg (n=5); AIT (n=7); AIT+Arg (n=5). Exercise test capacity (ETC) was performed pre and post 8weeks of intervention. Supplemented rats received Arg (1g/kg) by oral gavage (7×/week). Exercise training was performed on a rat treadmill (5×/week). Hemodynamic variables, tissue collection, congestion, inflammatory cytokines, and oxidative parameters were evaluated at the end of protocols.

RESULTS

All trained groups showed a superior exercise capacity compared to SED groups on the post-intervention test (p<0.0001). Pulmonary congestion was attenuated in AIT and AIT+Arg compared with the SED group (p<0.05). Left ventricular end-diastolic pressure (LVEDP) was lower in ACT+Arg, AIT, and AIT+Arg groups than SED group (p<0.05). Association of AIT with Arg supplementation was able to improve hemodynamic responses (left ventricular systolic pressure (LVSP), systolic blood pressure (SBP), +dP/dt_max, and -dP/dt_max (p<0.05), likewise, decrease muscular and renal lipid peroxidation and tumor necrosis factor (TNF)-α, and increase interleukin (IL)-10/TNF-α plasmatic levels (p<0.01). Groups that associated aerobic exercise with Arg supplementation (ACT+Arg and AIT+Arg) revealed higher gastrocnemius mass compared to the SED group (p<0.01).

CONCLUSIONS

Both aerobic training protocols were capable to improve aerobic capacity, and the association with Arg supplementation was important to attenuate muscle loss. Moreover, interval training associated with Arg supplementation elicits greater improvements in hemodynamic parameters, contributing to reduction in pulmonary congestion, and demonstrated particular responses in the inflammatory profile and in the antioxidant status.