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

Combined versus independent effects of exercise training and intermittent fasting on body composition and cardiometabolic health in adults: a systematic review and meta-analysis

INTRODUCTION AND AIM

Exercise training (Ex) and intermittent fasting (IF) are effective for improving body composition and cardiometabolic health overweight and obese adults, but whether combining Ex and IF induces additive or synergistic effects is less well established. We therefore, performed a systematic review and meta-analysis to compare the combined versus independent effects of Ex and IF on body composition and cardiometabolic health in adults.

METHOD

An electronic search was conducted in three main online databases including PubMed, Web of Science, and Scopus, from inception to March 9, 2023 for studies involving Ex plus IF trials versus standalone Ex and/or IF interventions in adults. Interventions had a duration of ≥ 2 weeks. Standardized (SMD) or weighted mean differences (WMD) and 95% confidence intervals were calculated in order to compare effects on body weight, body mass index (BMI), body fat lean body mass (LBM), visceral fat, and waist circumference. For cardiometabolic health, outcomes included fasting glucose, insulin, total cholesterol (TC), low-density lipoprotein cholesterol (LDL), triglycerides (TG), high-density lipoprotein cholesterol (HDL), systolic (SBP) and diastolic (DBP) blood pressure, and VO2max/peak.

RESULTS

Ex plus IF decreased body weight [WMD: -3.03 kg (95% CI: -3.44 to -2.61), p = 0.001], BMI [WMD: -1.12 kg.m2 (95% CI: -1.28 to -0.95), p = 0.001], body fat [SMD: -0.72 (95% CI: -1.23 to -0.21), p = 0.005], visceral fat [SMD: -0.34 (95% CI: -0.63 to -0.05), p = 0.01], and waist circumference [WMD: -2.63 cm (95% CI: -4.16 to -1.11), p = 0.001] more than Ex alone. However, changes in body composition and cardiometabolic health markers were not significantly different for Ex plus IF when compared with IF alone, with the exception of VO2max/peak [SMD: 0.55 (95% CI: 0.14 to 0.97), p = 0.009].

CONCLUSION

We demonstrate that a combination of Ex and IF produces superior changes in body composition, but not in markers of cardiometabolic health when compared with Ex or IF alone. Ex plus IF could therefore be effective for weight and fat loss but has no additive or synergistic effects for other cardiometabolic health markers.

The physiological and physical benefits of two types of concurrent training: a randomized controlled trial

BACKGROUND

It is widely acknowledged that aerobic exercise and strength training are crucial components of most workout programs. However, there is no consensus as to whether the effectiveness of exercises is affected by the sequence in which they are performed. Therefore, the overarching aim of the study was to understand the optimal order of two types of concurrent training program for 13 weeks by comparing the effectiveness of the training on body composition, predicated maximal oxygen uptake (VO2max), dynamic respiratory parameters and muscle strength in healthy middle-aged people.

METHODS

Thirty-three middle-aged individuals, who were categorized as moderately active based on their responses to International Physical Activity Questionnaires, underwent random allocation. The participants were randomly assigned into two groups: the Strength Training followed by Aerobic Training group (SAG, n = 16) and the Aerobic Training followed by Strength Training group (ASG, n = 17). Body composition, aerobic endurance, respiratory parameters, and upper and lower strength were assessed at baseline and after (post-test) a 13-week intervention. The chi-square test and the independent t-test were used to compare sociodemographic variables between the groups. A 2 × 2 analysis of variance (ANOVA) with repeated measures (group x measurement) was conducted. The study was retrospectively registered on clinicaltrials.gov in May of 2023 (clinicaltials.gov identifier: NCT05862415; in 04/25/2023).

RESULTS

Findings showed no significant differences between the group in the VO2max, FVC or FEV1 (F = 1.122, 0.028, 0.06, 2.483; p > 0.05, respectively). Intragroup analysis revealed changes in PEF compared to baseline in the ASG (F = 5.895; p < 0.05). Increases were observed in all strength parameters for both training programs.

CONCLUSIONS

The concurrent training effect on muscle composition, oxygen consumption and muscle strength specifically 1RM, in middle-aged individuals are equivocal, regardless of the exercise order. The results indicate that both exercise sequences can elicit similar benefits in terms of cardiovascular fitness, muscular strength, and endurance. This lack of difference suggests that the order of exercise does not play a significant role in determining the effectiveness of the workout or the subsequent physiological adaptations. CLINICALTIALS.

GOV IDENTIFIER

NCT05862415. Date of registration: 04/25/2023.

Influence of exercise type and duration on cardiorespiratory fitness and muscular strength in post-menopausal women: a systematic review and meta-analysis

Background and aim

Both cardiorespiratory fitness (CRF) and muscular strength are reported to decrease with age and menopause, which considered to be risk for cardiovascular diseases (CVDs). Previous relevant meta-analyses are inconclusive on the beneficial effects of exercise, particularly in post-menopausal women. In this systematic review and meta-analysis, we investigated the effects of exercise modalities on CRF and muscular strength in post-menopausal women, and identified the effective exercise type and duration.

Methods

A comprehensive search was conducted on PubMed, Web of Science, CINAHL, and Medline to identify the randomized controlled trials, which evaluated exercise effect on CRF, lower- and upper-body muscular strength, and/or handgrip strength in post-menopausal women and compared the results with control. Standardized mean differences (SMD), weighted mean differences (WMD), and 95% confidence intervals (95% CIs) were calculated using random effects models.

Results

A total of 129 studies comprising 7,141 post-menopausal women with mean age and BMI ranging from ∼53 to 90 years and 22 to 35 kg/m², respectively, were included in the meta-analysis. Overall, exercise training effectively increased CRF (SMD: 1.15; 95% CI: 0.87, 1.42; p = 0.001), lower-body muscular strength (SMD: 1.06; 95% CI: 0.90, 1.22; p = 0.001), upper-body muscular strength (SMD: 1.11; 95% CI: 0.91, 1.31; p = 0.001), and handgrip strength (WMD: 1.78 kg; 95% CI: 1.24, 2.32; p = 0.001) in post-menopausal women. These increments were found to be irrespective of ages and intervention durations. Regarding exercise type, aerobic, resistance, and combined training significantly increased CRF and lower-body muscular strength, while resistance and combined training effectively increased handgrip strength. However, only resistance training increased the upper-body muscular strength in women.

Conclusion

Our findings suggest that exercise training is effective in increasing CRF and muscular strength in post-menopausal women, which might be cardioprotective. Both aerobic and resistance training alone or in combination increased CRF and lower-body muscular strength, but only resistance training increased upper-body strength in women.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=283425, identifier: CRD42021283425.

Structured physical exercise for bipolar depression: an open-label, proof-of concept study

BACKGROUND

Physical exercise (PE) is a recommended lifestyle intervention for different mental disorders and has shown specific positive therapeutic effects in unipolar depressive disorder. Considering the similar symptomatology of the depressive phase in patients with bipolar disorder (BD) and unipolar depressive disorder, it is reasonable to suggest that PE may also be beneficial for bipolar depression. However, there is an absence of studies evaluating the antidepressant effect of a structured PE intervention in BD.

METHODS

This is an open-label, single-arm study trial. Fifteen patients with a diagnosis of BD Type I or Type II, presenting a depressive episode were included in the study. After physical and functional evaluation, patients participated in supervised training sessions with aerobics followed by strength exercises, three times per week, for 12 weeks (36 training sessions). Depressive and manic symptoms were assessed at baseline and 2, 4, 8, and 12 weeks. Additionally, quality of Life and functioning were assessed at baseline and 4, 8, and 12 weeks). Finally, we tested cardiorespiratory fitness, muscle strength and body composition at baseline and week-12.

RESULTS

The mean (± SD) Montgomery Asberg Depression Rating Scale (MADRS) score at baseline was 23.6 ± 8.3 points and after 12 weeks of PE the mean score was 10.2 ± 4.8 points. Nine patients (82%) presented an antidepressant response defined as a reduction of more than 50% of depressive symptoms at week 12 with five of those patients (45%) presenting criteria for full remission. A large and significant Cohen's D Effect Size (pre-post) was verified for MADRS reduction [1.98 (95% Confidence interval = 0.88 to 3.08)]. We did not detect a significant change in manic symptoms, functioning, and quality of life during the 12-week follow-up. At week-12, all patients increased their muscular strength (one repetition maximal test - 1RM) and reduced the percentage of body fat (spectral bioelectrical impedance analysis).

CONCLUSIONS

This study, using rigorous criteria and a structured intervention, provides valid pilot data, showing the feasibility of a structured PE intervention for the treatment of depressive symptoms in BD, and suggesting a potential adjunctive antidepressant effect. Moreover, PE showed a positive impact on muscle strength and body composition. This should be further verified by randomized controlled studies.

Acute Effects of Combined Lower-Body High-Intensity Interval Training and Upper-Body Strength Exercise on Explosive Strength Performance in Naturally Menstruating Women

PURPOSE

We aimed at investigating the acute effects of lower-body high-intensity interval training (HIIT) on upper- and lower-body explosive strength assessed by mean propulsive velocity (MPV) in naturally menstruating women. In addition, we assessed the combination of lower-body HIIT and squat, as well as lower-body HIIT and bench press, on bench press and squat MPV.

METHODS

Thirteen women (age: 23 [2] y, menstrual cycle length: 28.4 [2.0] d) completed 2 training modalities on separate days (separated by 30 [4.2] d) consisting of HIIT followed by lower-body (HIIT + LBS) or upper-body (HIIT + UBS) strength loading. Squat and bench press MPV were assessed before HIIT (T0), after HIIT (T1), after the strength loading (T2), and 24 hours postloading (T3).

RESULTS

Mixed factorial analysis of variance indicated a significant effect for time in bench press and squat (P < .001) but not for interaction. Pairwise comparison showed that bench press MPV remained unchanged (P = 1.000) at T1 but was reduced at T2 compared with T0 (HIIT + LBS: -8.2% [3.9%], HIIT + UBS: -13.8% [12.1%], P < .001) and T1 (HIIT + LBS: -7.1% [3.2%], HIIT + UBS: -12.7% [8.7%], P < .001). Squat MPV decreased at T1 (HIIT + LBS: -6.0% [8.8%], HIIT + UBS: -4.8% [5.4%], P = .009) and was found to be decreased at T2 compared with T0 in both conditions (HIIT + LBS: -6.9% [3.3%], HIIT + UBS: -7.4% [6.1%], P < .001) but not compared with T1 (P = 1.000). Bench press and squat MPV returned to baseline at T3 compared with T0 (P > .050).

CONCLUSION

Lower- but not upper-body explosive strength was reduced by HIIT. HIIT combined with upper- or lower-body strength loading resulted in a reduction of squat and bench press explosive strength.

Acute Effects of Concurrent High-Intensity Interval Cycling and Bench-Press Loading on Upper- and Lower-Body Explosive Strength Performance

PURPOSE

This study examined the acute effects of lower-body high-intensity interval loading (HIIT) on explosive upper- and lower-body strength, as well as the combined effect of HIIT and bench-press loading versus HIIT and squat loading on the explosive upper- and lower-body strength.

METHODS

Fifteen physically active men completed 2 sessions consisting of HIIT (4 × 4 min cycling at 80% of peak power output) immediately followed by lower- (HIIT + LBS) or upper-body (HIIT + UBS) strength loading (3 × 5 + 3 × 3 repetitions at 80% 1-repetition maximum [ie, 6 sets in total]) in a randomized order. Squat and bench-press mean propulsive velocity (MPV) was assessed before HIIT (T0), immediately after HIIT (T1), immediately after the strength loading (T2), and 24 hours after the experimental session (T3).

RESULTS

Squat MPV decreased to a similar magnitude at T1 in HIIT + LBS (-5.3% [7.6%], P = .117, g = .597) and HIIT + UBS (-5.7% [6.9%], P = .016, g = .484), while bench press remained unchanged (-1.4% [4.7%], P = 1.000, g = .152, and -1.0% [7.0%], P = 1.000, g = .113, respectively). Both squat and bench-press MPV were statistically reduced at T2 compared to T0 (HIIT + LBS: -7.5% [7.8%], P = .016, g = .847, and -6.8% [4.6%], P < .001, g = .724; HIIT + UBS: -3.9% [3.8%], P = .007, g = .359, and -15.5% [6.7%], P < .001, d = 1.879). Bench-press MPV at T2 was significantly lower in HIIT + UBS when compared to HIIT + LBS (P = .002, d = 1.219).

CONCLUSION

These findings indicate lower- but not upper-body explosive strength to be acutely reduced by preceding lower-body HIIT. However, lower-body HIIT combined with either upper- or lower-body strength loading resulted in a similar acute reduction of both squat and bench-press explosive strength.