Effects of resistance or aerobic exercise training on total and regional body composition in sedentary overweight middle-aged adults

Intrahospital supervised exercise training improves survival rate among hypertensive patients with COVID-19

Among the people most affected by coronavirus disease 2019 (COVID-19) are those suffering from hypertension (HTN). However, pharmacological therapies for HTN are ineffective against COVID-19 progression and severity. It has been proposed that exercise training (EX) could be used as post-COVID treatment, which does not rule out the possible effects during hospitalization for COVID-19. Therefore, we aimed to determine the impact of supervised EX on HTN patients with COVID-19 during hospitalization. Among a total of 1,508 hospitalized patients with COVID-19 (confirmed by PCR), 439 subjects were classified as having HTN and were divided into two groups: EX (n = 201) and control (n = 238) groups. EX (3-4 times/wk during all hospitalizations) consisted of aerobic exercises (15-45 min; i.e., walking); breathing exercises (10-15 min) (i.e., diaphragmatic breathing, pursed-lip breathing, active abdominal contraction); and musculoskeletal exercises (8-10 sets of 12-15 repetitions/wk; lifting dumbbells, standing up and sitting, lumbar stabilization). Our data revealed that the EX (clinician: patient, 1:1 ratio) intervention was able to improve survival rates among controlled HTN patients with COVID-19 during their hospitalization when compared with the control group (chi-squared: 4.83; hazard ratio: 1.8; 95% CI: 1.117 to 2.899; P = 0.027). Multivariate logistic regression analysis revealed that EX was a prognostic marker (odds ratio: 0.449; 95% CI: 0.230-0.874; P = 0.018) along with sex and invasive and noninvasive mechanical ventilation. Our data showed that an intrahospital supervised EX program reduced the mortality rate among patients with HTN suffering from COVID-19 during their hospitalization.NEW & NOTEWORTHY In the present study, we found that exercise training improves the survival rate in hypertensive patients with COVID-19 during their hospitalization period. Our results provide strong evidence for the therapeutic efficacy of exercise training as a feasible approach to improving the outcomes of patients with COVID-19 who suffer from hypertension during their hospitalization.

Physical prehabilitation improves the postoperative outcome of associating liver partition and portal vein ligation for staged hepatectomy in experimental model

Aiming to improve the postoperative outcome of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), the effect of physical prehabilitation (PP) was investigated in experimental model. Male Wistar rats (n = 106) divided to PP and sedentary (S) groups underwent ALPPS. Changes in liver weight, Ki67 index and liver volume by magnetic resonance imaging (MRI) were evaluated. Liver function was assessed by laboratory parameters and ^99mTc-mebrofenin single-photon emission computed tomography (SPECT) hepatobiliary scintigraphy (HBS). Utilizing endotoxemia model mortality and septic parameters were investigated. Liver mass (p < 0.001), Ki67 index (p < 0.001) and MRI liver volume (p < 0.05) increased in the PP group compared to the S group. Both standard laboratory parameters (p < 0.001) and HBS (p < 0.05) showed enhanced liver function in the PP group compared to the S group. The vulnerability of animals improved in the PP group, as mortality decreased (p < 0.001), while septic laboratory parameters improved (p < 0.05) compared to the S group in the endotoxemia model. Our study demonstrated for the first time the beneficial role of PP on not only volumetric but also functional liver regeneration and postoperative vulnerability after ALLPS.

Single- and Multi-Joint Maximum Weight Lifting Relationship to Free-Fat Mass in Different Exercises for Upper- and Lower-Limbs in Well-Trained Male Young Adults

This study aimed to analyze whether the relationship between regional and whole-body fat-free mass (FFM) and strength is related to FFM distribution and area according to limb involvement. Thirty well-trained male young adults underwent one-repetition maximum test (1RM) to assess the strength in arm curl (AC), bench press (BP), seated row (SR), leg press 45° (LP45), knee extension (KE), and leg curl (LC). Dual-energy X-ray absorptiometry was used to evaluate FFM. The values for 1RM in AC, BP, and R correlated to FFM in upper limb (R² = 0.69, 0.84 and 0.75), without an effect of appendicular mass index (API) or area. For 1RM in KE, the correlation with FFM in lower limb increased with thigh area (R² = 0.56), whereas 1RM in LC and LP45 correlation to whole-body FFM increased with API (R² = 0.64 and 0.49). The upper limb’s FFM may be reliable for indexing the arms and upper trunk strengths, whereas the relationships between FFM and strength in lower limb improve as muscle mass and thigh area increases between subjects.

A Sports Nutrition Perspective on the Impacts of Hypoxic High-Intensity Interval Training (HIIT) on Appetite Regulatory Mechanisms: A Narrative Review of the Current Evidence

High-intensity interval training (HIIT) and low-oxygen exposure may inhibit the secretion of appetite-stimulating hormones, suppress appetite, and inhibit dietary intake. Physiological changes affecting appetite are frequent and include appetite hormone (ghrelin, leptin, PYY, and GLP-1) effects and the subjective loss of appetite, resulting in nutritional deficiencies. This paper is a narrative review of the literature to verify the HIIT effect on appetite regulation mechanisms and discusses the possible relationship between appetite effects and the need for high-intensity exercise training in a hypoxic environment. We searched MEDLINE/PubMed and the Web of Science databases, as well as English articles (gray literature by Google Scholar for English articles) through Google Scholar, and the searched studies primarily focused on the acute effects of exercise and hypoxic environmental factors on appetite, related hormones, and energy intake. In a general normoxic environment, regular exercise habits may have accustomed the athlete to intense training and, therefore, no changes occurred in their subjective appetite, but there is a significant effect on the appetite hormones. The higher the exercise intensity and the longer the duration, the more likely exercise is to cause exercise-induced appetite loss and changes in appetite hormones. It has not been clear whether performing HIIT in a hypoxic environment may interfere with the exerciser’s diet or the nutritional supplement intake as it suppresses appetite, which, in turn, affects and interferes with the recovery efficiency after exercise. Although appetite-regulatory hormones, the subjective appetite, and energy intake may be affected by exercise, such as hypoxia or hypoxic exercise, we believe that energy intake should be the main observable indicator in future studies on environmental and exercise interventions.

Metabolic and inflammatory health in SARS-CoV-2 and the potential role for habitual exercise in reducing disease severity

Introduction

The rapid emergence and spread of SARS-CoV-2 in late 2019 has infected millions of people worldwide with significant morbidity and mortality with various responses from health authorities to limit the spread of the virus. Although population-wide inoculation is preferred, currently, there is large variation and disparity in the acquisition, development, and deployment of vaccination programs in many countries. Even with availability of a vaccine, achieving herd immunity does not guarantee against reinfection from SARS-CoV-2. Emerging evidence indicates that vaccines do not eliminate infection but protect against severe disease and potential hospitalisation. Therefore, additional strategies which strengthen the immune system should be strongly considered to assist in reducing the overall health care burden and stem the rate of infection. There is now substantial evidence that SARS-CoV-2 disease severity and death are linked to existing comorbidities such as cardiovascular disease, obesity, and metabolic disorders.

Purpose

In this review, we discuss the potential medium-to-long-term strategy of habitual exercise and its relationship to targeted comorbidities and underlying inflammation as a protective mechanism against SARS-CoV-2 disease severity.

Conclusion

We conclude that engagement in habitual physical activity and exercise could be a strategy to mitigate the development of comorbidities and improve the response of the immune system, potentially reducing the risk of symptoms and life-threatening complications if infected.

Reductions in Cardiopulmonary Disease Risk Following Calisthenic Concurrent Aerobic and Resistance Training in Young Adults in a Low Resource Setting

Background: Studies have demonstrated that young adults, especially in low- to middle-income countries, are increasingly susceptible to unfavorable alterations in body composition during their transition from adolescence to adulthood. This places young adults at an increased risk for numerous chronic diseases, such as cardiovascular, and/or pulmonary diseases. Objectives: This study aimed to determine if concurrent aerobic and resistance calisthenic training could reduce cardiopulmonary disease risk in young adults in a low resource setting. Methods: Thirty young adult males were randomly assigned to either a six-week non-exercising control group (NON) or concurrent aerobic or resistance training group (CON) that engaged in three, non-consecutive, 60-minute exercise sessions using a combination of 4 - 5 progressive resistance training exercises for two sets of 15 - 20 repetitions and 30 minutes of aerobic exercises at a rating of perceived exertion of 9 - 15. This study assessed anthropometry (body mass, stature, body mass index waist-to-hip ratio, waist-to-stature ratio, sum of skinfolds, percentage body fat, fat mass, fat free mass and conicity index) and lung function (forced vital capacity (FVC), forced expired volume in one second (FEV1), forced expiratory volume in one second/forced vital capacity ratio (FEV1/FVC), peak expiratory flow (PEF), maximal expiratory flow at 75% (MEF75%), maximal expiratory flow at 50% (MEF50%) and maximal expiratory flow at 25 (MEF25%). Results: Concurrent training resulted in significant (P ≤ 0.05) improvements in waist-to-hip ratio (0.94 ± 0.04 to 0.92 ± 0.05; P = 0.042), fat free mass (57.46 ± 9.16 to 58.21 ± 8.65 kg; P = 0.018), percentage body fat (14.56 ± 5.96 to 13.24 ± 5.77%, P = 0.006), fat mass (10.22 ± 5.31 to 9.29 ± 5.17 kg; P = 0.008), sum of skinfolds (96.22 ± 35.64 to 87.67 ± 32.15 mm; P = 0.004), PEF (5.06 ± 2.04 to 6.57 ± 2.51 L; P = 0.018), MEF75% (4.78 ± 2.01 to 6.24 ± 1.99 L.sec-1; P = 0.026), MEF50% (4.08 ± 1.20 to 5.24 ± 1.44 L.sec-1; P = 0.043) and MEF25% (2.66 ± 0.63 to 3.31 ± 1.87 L.sec-1; P = 0.038). Conclusions: The findings support the feasibility and efficacy of a simple and inexpensive concurrent aerobic and resistance training program to simultaneously improve body composition and lung function in an attempt to curb the increasing incidence of overweight/obesity and associated lung dysfunction in young adults in a low resource setting.

Differential relationships between waist circumference and cardiorespiratory fitness among people with and without type 2 diabetes

Adults with type 2 diabetes mellitus tend to exhibit an increased level of central adiposity, augmenting their risk of further non-communicable diseases (NCDs). Importantly, consistent evidence demonstrates a significant, negative association between cardiorespiratory fitness (CRF) and waist circumference (WC). However, no previous studies have investigated differences in these CRF-related reductions in WC between adults with and without diabetes. This study used data from the Aerobic Center for Longitudinal Studies, conducted between 1970 and 2006 among predominately Non-Hispanic White, middle-to-upper class adults in Texas. Quantile regression models were used to estimate CRF-related differences in WC between persons with and without diabetes. Age, height, smoking status and birth cohort served as covariates. The analytic sample included 45901 adults. Significantly larger reductions in WC were observed among adults with diabetes as compared to without diabetes across all WC percentiles. Among males, high CRF levels were associated with significant reductions, as compared to their low-fit counterparts, in WC as large as 21.9 cm for adults without diabetes and as large as 27 cm for adults with diabetes. Among females, high CRF levels were associated with significant reductions, as compared to their low-fit counterparts, in WC as large as 22.3 and 30.0 cm for adults without and with diabetes, respectively. This study demonstrated that higher CRF is associated with significant reductions in WC, with greater magnitudes found among adults with diabetes, especially among the most centrally obese, highlighting the necessity of exercise prescription in this clinical population potentially leading to lower risks of future NCDs.

Inter-individual differences in weight change following exercise interventions: a systematic review and meta-analysis of randomized controlled trials

Previous reports of substantial inter-individual differences in weight change following an exercise intervention are often based solely on the observed responses in the intervention group. Therefore, we aimed to quantify the magnitude of inter-individual differences in exercise-mediated weight change. We synthesized randomized controlled trials (RCTs) of structured, supervised exercise interventions. Fourteen electronic databases were searched for relevant studies published up to March 2017. Search terms focused on structured training, RCTs and body weight. We then sifted these results for those RCTs (n = 12, 1500 participants) that included relevant comparator group data. Standard deviations (SDs) of weight change were extracted, thereby allowing the SD for true inter-individual differences in weight loss to be calculated for each study. Using a random effects meta-analysis, the pooled SD (95% CI) for true individual responses was 0.8 (-0.9 to 1.4) kg. The 95% prediction interval (based on 2SDs) for true inter-individual responses was -2.8 to 3.6 kg. The probability (% chance) that the true individual response variability would be clinically meaningful (>2.5 kg) in a future study in similar settings was 23% ('unlikely'). Therefore, we conclude that evidence is limited for the notion that there are clinically important individual differences in exercise-mediated weight change.

Effects of Different Modes of Exercise Training on Body Composition and Risk Factors for Cardiovascular Disease in Middle-aged Men

Background:

Previous studies have indicated that exercise training improves body composition and cardiovascular disease risk factors. The aim of the present study was to investigate the effect of 12 weeks of aerobic, strength and combined training on body composition, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and C-reactive protein (CRP) in sedentary middle-aged men.

Methods:

Forty-seven male aged 40–60 years voluntarily participated in this study and were divided in four groups: aerobic (n = 12), strength (n = 12), combined (n = 11), and control (n = 12) groups randomly. Body composition, ICAM-1, VCAM-1, and CRP were measured before and after 12 weeks. Data were analyzed using paired t-test and analysis of variance statistical methods.

Results:

There were significant differences in body weight between aerobic and strength training (P = 0.004) and aerobic and control groups (P = 0.018), body mass index between combined and strength training (P = 0.004) and combined and control groups (P = 0.001), fat percentage between aerobic training and control group (P = 0.017) and combined training and control groups (P = 0.004), and finally, fat-free mass between aerobic and strength training (P = 0.024), aerobic and combined training (P = 0.0001), strength and control groups (P = 0.035), and combined and control groups (P = 0.0001).

Conclusions:

The results indicated that 12-week workout, 20–60 min/session, 3 days a week of moderate intensity exercise improved body composition, ICAM-1, VCAM-1, and CRP compared to those who did not participate in any training. However, all three types of exercises had small benefits on body composition, ICAM-1, VCAM-1, and CRP in sedentary middle-aged men, and the importance of combined training required further investigations.

Impact of Physical Resistance Training on the Sexual Function of Women with Polycystic Ovary Syndrome

INTRODUCTION

There is a need for specific measures to address overall care in women with polycystic ovary syndrome (PCOS). Physical resistance training (PRT) has been shown to improve certain body parameters. However, the effect of PRT on the sexual function of PCOS women has not been evaluated.

AIM

The study aimed to assess sexual function and emotional status of PCOS women after 16 weeks of PRT.

METHODS

This case-control study involved 43 women with PCOS and 51 control ovulatory women, aged 18-37 years. All women were subjected to a supervised PRT protocol for 16 weeks and evaluated at the end of the program. Sexual function was assessed at baseline and after PRT protocol.

MAIN OUTCOME MEASURES

The main outcome measure used was the Female Sexual Function Index (FSFI).

RESULTS

Of the 43 women with PCOS, 30 (69.70%) had a basal total FSFI score ≤ 26.55 and 24 of them (58.54%) had a score ≤ 26.55 after PRT (P = 0.08). Of the 51 control women, 32 (62.7%) and 27 (52.9%) had FSFI scores < 26.55 at baseline and after PRT, respectively (P = 0.06). Control women experienced a significant improvement in pain domain score after PRT (P < 0.03). PCOS women experienced significant increases in total score and in the desire, excitement and lubrication domains after PRT (P < 0.01 each). After PRT, there was a significant difference between the PCOS and control groups in the sexual desire domain (4.09 ± 1.29 vs. 3.75 ± 1.42, P = 0.04). Significantly fewer women in the PCOS group were at risk of depression (P < 0.01) and anxiety (P < 0.02) after than before PRT, whereas the differences in the control group were not significant. Mean depression and anxiety scores were reduced significantly in both the PCOS (P < 0.01 each) and control (P < 0.01) groups.

CONCLUSIONS

PRT significantly enhanced total score and the desire, excitement, and lubrication domains of the FSFI in PCOS women. PRT reduced pain, and total depression and anxiety scores in both groups.