Effects of high-intensity exercise training on body composition, abdominal fat loss, and cardiorespiratory fitness in middle-aged Korean females

Effects of different exercise modalities on inflammatory markers in the obese and overweight populations: unraveling the mystery of exercise and inflammation

In the realm of obesity and overweight, the risk of chronic diseases significantly escalates, closely intertwined with inflammatory factors. Research suggests that specific exercise interventions, particularly aerobic exercise and resistance exercise, can have beneficial effects on inflammation levels. However, debates persist regarding the actual impact of exercise in the obese and overweight population. We employed meta-analysis research methods and searched the China National Knowledge Infrastructure Wanfang Data, PubMed, and Web of Science databases to gather controlled experiments on the effects of resistance exercise or aerobic exercise on C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Two researchers independently conducted literature screening and data extraction. The quality of the literature was assessed according to the Cochrane Handbook standards, and subgroup analyses of CRP, IL-6, and TNF-α were performed using RevMan 5.4 software. Through quantitative synthesis of results from 22 selected studies encompassing a total of 1,135 research subjects, this study systematically explored the specific regulatory effects of different exercise modalities on inflammatory markers in the obese and overweight population. The findings indicate that both aerobic exercise and resistance exercise effectively reduce CRP levels in obese individuals, with aerobic exercise demonstrating a more pronounced effect. Aerobic exercise also significantly lowers IL-6 levels, while the impact of resistance exercise on IL-6 is relatively minor. However, in terms of reducing TNF-α levels, neither modality appears to exert a significant effect. Overall, exercise, especially aerobic exercise, emerges as a positive regulator of inflammatory markers in the context of obesity and overweight.

Active video games for improving health-related physical fitness in older adults: a systematic review and meta-analysis

Background

The global population is experiencing a rapid rise in the quantity and percentage of older people. In an effort to enhance physical activity among older adults, active video games (AVGs) are being suggested as a compelling alternative and are currently under scrutiny to evaluate their efficacy in promoting the health of older people.

Objective

This review aims to synthesize current studies and formulate conclusions regarding the impact of AVGs on the health-related physical fitness of older adults.

Methods

Seven databases (PubMed, Web of Science, SCOPUS, SPORTDiscus, EMBASE, MEDLINE, and CINAHL) were searched from inception to January 21, 2024. Eligible studies included randomized controlled trials examining the effect of AVGs compared to control conditions on health-related physical fitness outcomes in older adults. The methodological quality of the included trials was assessed using the PEDro scale, and the certainty of evidence was evaluated using the GRADE approach. A random-effects model was used to calculate effect sizes (ES; Hedge's g) between experimental and control groups.

Results

The analysis included 24 trials with a total of 1428 older adults (all ≥ 60 years old). Compared to controls, AVGs produced significant increases in muscular strength (moderate ES = 0.64-0.68, p < 0.05) and cardiorespiratory fitness (moderate ES = 0.79, p < 0.001). However, no significant effects were found for body composition (trivial ES = 0.12-0.14; p > 0.05) and flexibility (trivial ES = 0.08; p = 0.677). The beneficial effects of AVGs were greater after a duration of ≥ 12 vs. < 12 weeks (cardiorespiratory fitness; ES = 1.04 vs. 0.29, p = 0.028) and following ≥ 60 minutes vs. < 60 minutes of session duration (muscular strength; ES = 1.20-1.24 vs. 0.27-0.42, p < 0.05).

Conclusion

AVGs appear to be an effective tool for enhancing muscular strength and cardiorespiratory fitness in older adults, although their impact on improving body composition and flexibility seems limited. Optimal improvement in cardiorespiratory fitness is associated with a longer duration of AVGs (≥ 12 weeks). Moreover, a session duration of ≥ 60 minutes may provide greater benefits for the muscular strength of older adults.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=482568, identifier CRD42023482568.

Long-term exercise training and inflammatory biomarkers in healthy subjects: a meta-analysis of randomized controlled trials

Objective

This meta-analysis investigated the effect of long-term exercise training (ET) including aerobic, resistance, and multicomponent ET on the levels of inflammatory biomarkers in randomized controlled trials (RCTs) involving healthy subjects.

Methods

We searched seven databases for articles until May 1st, 2023. A random-effect meta-analysis, subgroup analysis, meta-regressions as well as trim and fill method were conducted using STATA 16.0.

Result

Thirty-eight studies were included in the meta-analysis, involving 2,557 healthy subjects (mean age varies from 21 to 86 years). Long-term ET induced significantly decreased in the levels of interleukin-6 (IL-6) (SMD -0.16, 95% CI -0.30 to -0.03, p = 0.017), C-reactive protein (CRP) (SMD -0.18, 95% CI -0.31 to -0.06, p = 0.005), as well as tumor necrosis factor alpha (TNFα) (SMD -0.43, 95% CI -0.62 to -0.24, p < 0.001). Subgroup analysis revealed that Long-term ET conducted for more than 12 weeks and exercise of moderate intensity had greater anti-inflammatory effects. Meta-regression analysis showed that the reduction in CRP level induced by long-term ET was weakened by increasing exercise intensity.

Conclusion

Long-term ET induced significant anti-inflammatory effects in healthy subjects. Long-term ET-induced anti-inflammatory effects were associated with exercise of moderate intensity and training conducted for more than 12 weeks.Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/# myprospero, PROSPERO, identifier CRD42022346693.

Dose-response effects of exercise and caloric restriction on visceral adiposity in overweight and obese adults: a systematic review and meta-analysis of randomised controlled trials

OBJECTIVE

To determine and compare the dose-response effects of exercise and caloric restriction on visceral adipose tissue in overweight and obese adults, while controlling for the weekly energy deficit induced by the interventions.

METHODS

PubMed, Embase, CINAHL and Web of Science were searched for randomised controlled trials comparing exercise or caloric restriction against eucaloric controls in overweight or obese adults. The primary outcome was the change in visceral fat measured by CT or MRI. Meta-analyses and meta-regressions were performed to determine the overall effect size (ES) and the dose-dependent relationship of exercise and caloric restriction on visceral fat. Heterogeneity, risk of bias and the certainty of evidence were also assessed.

RESULTS

Forty randomised controlled trials involving 2190 participants were included. Overall, exercise (ES -0.28 (-0.37 to -0.19); p<0.001; I2=25%) and caloric restriction (ES -0.53 (-0.71 to -0.35); p<0.001; I2=33%) reduced visceral fat compared with the controls. Exercise demonstrated a dose-response effect of -0.15 ((-0.23 to -0.07); p<0.001) per 1000 calories deficit per week, whereas the effect of caloric restriction was not dose-dependent (ES 0.03 (-0.12 to 0.18); p=0.64). Most of the studies showed a moderate risk of bias.

CONCLUSIONS

These findings support the dose-dependent effects of exercise to reduce visceral fat in overweight and obese adults. Caloric restriction did not demonstrate a dose-response relationship, although this may be attributed to the smaller number of studies available for analysis, compared with exercise studies.

PROSPERO REGISTRATION NUMBER

CRD42020210096.

Linking Physical Activity to Breast Cancer Risk via Inflammation, Part 1: The Effect of Physical Activity on Inflammation

The protective effect of physical activity on breast cancer incidence may partially be mediated by inflammation. Systematic searches of Medline, EMBASE, and SPORTDiscus were performed to identify intervention studies, Mendelian randomization studies, and prospective cohort studies that examined the effects of physical activity on circulating inflammatory biomarkers in adult women. Meta-analyses were performed to generate effect estimates. Risk of bias was assessed, and the Grading of Recommendations Assessment, Development, and Evaluation system was used to determine the overall quality of the evidence. Thirty-five intervention studies and one observational study met the criteria for inclusion. Meta-analyses of randomized controlled trials (RCT) indicated that, compared with control groups, exercise interventions reduced levels of C-reactive protein (CRP) [standardized mean difference (SMD) = -0.27, 95% confidence interval (CI) = -0.62 to 0.08), tumor necrosis factor alpha (TNFα, SMD = -0.63, 95% CI = -1.04 to -0.22), interleukin-6 (IL6, SMD = -0.55, 95% CI = -0.97 to -0.13) and leptin (SMD = -0.50, 95% CI = -1.10 to 0.09). Owing to heterogeneity in effect estimates and imprecision, evidence strength was graded as low (CRP, leptin) or moderate (TNFα and IL6). High-quality evidence indicated that exercise did not change adiponectin levels (SMD = 0.01, 95% CI = -0.14 to 0.17). These findings provide support for the biological plausibility of the first part of the physical activity-inflammation-breast cancer pathway.

Moderate to Vigorous-intensity Continuous Training versus High-intensity Interval Training for improving VO2max in women: A systematic review and meta-analysis

Traditional continuous training and high-intensity interval training (HIIT) can increase maximal oxygen uptake (V̇O_2max). However, there is conflicting evidence regarding which form of training demonstrates the greatest improvements to V̇O_2max, and data in women is sparse. We conducted a systematic review and meta-analyses to assess whether moderate to vigorous-intensity continuous training (MVICT) or HIIT was superior at improving V̇O_2max in women. Randomised controlled and parallel studies examined the influence of MVICT and/or HIIT on V̇O_2max in women. There was no statistical difference in V̇O_2max improvements after training between women in the MVICT and HIIT cohorts (mean difference [MD]: -0.42, 95%CI: -1.43 to 0.60, p>0.05). Both MVICT and HIIT increased V̇O_2max from baseline (MD: 3.20, 95% CI: 2.73 to 3.67 and MD: 3.16, 95% CI 2.09 to 4.24, respectively, p<0.001). Greater improvements in V̇O_2max were observed in women who participated in more training sessions in both training formats. Long-HIIT was superior to short-HIIT protocols at increasing V̇O_2max. Although MVICT and long-HIIT sessions elicited greater increases in V̇O_2max in younger women compared to short-HIIT protocols, these differences were negligible in older women. Our findings suggest MVICT and HIIT are equally effective strategies for improving V̇O_2max and indicate an effect of age on its response to training in women.

Cardiorespiratory Fitness and Bone Turnover Markers in Adults With Metabolic Syndrome: The Mediator Role of Inflammation

The relationship between inflammatory markers and bone turnover in adults is well known, and a negative association between cardiorespiratory fitness (CRF) and inflammatory markers has also been described. Hence, we tested whether the association between CRF and bone turnover markers is mediated by inflammatory markers in adults with metabolic syndrome. A total of 81 adults (58.5 ± 5.0 years, 62.7% women) were included in the analysis. CRF was measured by the 6-min walking test. Serum interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor alpha, high-sensitivity c-reactive protein (hsCRP) and vascular endothelial growth factor, collagen type I cross-linked C-telopeptide, procollagen type I N-terminal propeptide (P1NP), and total osteocalcin were assessed using a sensitive ELISA kit. Body composition was assessed by dual-energy X-ray absorptiometry. Partial correlation was used to test the relationship between CRF, inflammatory markers, and bone turnover markers, controlling for sex, lean mass, and fat mass. Boot-strapped mediation procedures were performed, and indirect effects with confidence intervals not including zero were interpreted as statistically significant. CRF was positively correlated with P1NP levels (r = .228, p = .044) and osteocalcin levels (r = .296, p = .009). Furthermore, CRF was positively correlated with IL-1β levels (r = .340, p = .002) and negatively correlated with hsCRP levels (r = -.335, p = .003), whereas IL-1β levels were positively correlated with P1NP levels (r = .245, p = .030), and hsCRP levels were negatively correlated with P1NP levels (r = -.319, p = .004). Finally, the association between CRF and P1NP levels was totally mediated by hsCRP (percentage of mediation = 39.9). Therefore, CRF benefits on bone formation could be dependent on hsCRP concentrations in this population.

Reverse Periodization for Improving Sports Performance: A Systematic Review

Background

Reverse periodization is commonly touted as a salient planning strategy to improve sport performance in athletes, but benefits have not been clearly described.

Objectives

We sought to identify the main characteristics of reverse periodization, and the influence of training volume and periodization models on enhancing physiological measures and sports performance.

Design

Systematic review.

Methods

The electronic databases Scopus, PubMed and Web of Science were searched using a comprehensive list of relevant terms.

Results

A total of 925 studies were identified, and after removal of duplicates and studies based on title and abstract screening, 17 studies remained, and 11 finally included in the systematic review. There was a total of 200 athletes in the included studies. Reverse periodization does not provide superior performance improvements in swimming, running, muscular endurance, maximum strength, or maximal oxygen uptake, compared to traditional or block periodization. The quality of evidence levels for the reverse periodization studies was 1b (individual randomized controlled trial) for two investigations, 2b (individual cohort study) for the remaining studies and a mean of 4.9 points in the PEDro scale (range 0–7).

Conclusions

It appears that reverse periodization is no more effective than other forms of periodization in improving sports performance. More comparative studies on this alternative version of periodization are required to verify its effectiveness and utility across a range of endurance sports.

The Effects of Standardised versus Individualised Aerobic Exercise Prescription on Fitness-Fatness Index in Sedentary Adults: A Randomised Controlled Trial

A poor Fitness Fatness Index (FFI) is associated with type 2 diabetes incidence, other chronic conditions (Alzheimer's, cancer, and cardiovascular disease) and all-cause mortality. Recent investigations have proposed that an individualised exercise prescription based on ventilatory thresholds is more effective than a standardised prescription in improving cardiorespiratory fitness (CRF), a key mediator of FFI. Thus, the aim of the current study was to determine the effectiveness of individualised versus standardised exercise prescription on FFI in sedentary adults. Thirty-eight sedentary individuals were randomised to 12-weeks of: (1) individualised exercise training using ventilatory thresholds (n = 19) or (2) standardised exercise training using a percentage of heart rate reserve (n = 19). A convenience sample was also recruited as a control group (n=8). Participants completed CRF exercise training three days per week, for 12-weeks on a motorised treadmill. FFI was calculated as CRF in metabolic equivalents (METs), divided by fatness determined by waist to height ratio (WtHR). A graded exercise test was used to measure CRF, and anthropometric measures (height and waist circumference) were assessed to ascertain WtHR. There was a difference in FFI change between study groups, whilst controlling for baseline FFI, F (2, 42) = 19.382 p < .001, partial η2 = 0.480. The magnitude of FFI increase from baseline was significantly higher in the individualised (+15%) compared to the standardised (+10%) (p = 0.028) and control group (+4%) (p = <.001). The main finding of the present study is that individualised exercise prescription had the greatest effect on improving FFI in sedentary adults compared to a standardised prescription. Therefore, an individualised based exercise prescription should be considered a viable and practical method of improving FFI in sedentary adults.

Effects of 8-week increment aerobic exercise program on bone metabolism and body composition in young non-athletes

PURPOSE

The effects of aerobic exercise on bone metabolism are still unclear. Thus, the main goal of this study was to explore if there was an effect of the short-term aerobic exercise program on the bone remodeling process and if there were sex differences in the effect of the training program on bone metabolism.

METHODS

Twenty-one participants (men and women) aged 20-23 performed an 8-week aerobic exercise program three times per week in 1-h sessions with increases in the exercise load every 2 weeks. Bone density, bone mineral content and concentration of markers of bone metabolism: osteocalcin, C-terminal procollagen type I peptide, pyridinoline, parathyroid hormone, osteoprotegerin, and the receptor activator of nuclear kappa B ligand by ELISA were measured at the start and at the end of the study, while changes in body composition were assessed by a bioelectric impedance analysis method 6 times during the study.

RESULTS

The aerobic exercise program increased the concentration of osteocalcin (11.34 vs 14.24 ng/ml), pyridinoline (67.51 vs 73.99 nmol/l), and the receptor activator of nuclear kappa B ligand (95.122 vs 158.15 pg/ml). A statistically significant increase in bone density at neck mean (1.122 vs 1.176 g/cm³) and in bone mineral content at dual femur (33.485 vs 33.700 g) was found in women, while there was no statistically significant change at any site in men.

CONCLUSION

8 weeks of the aerobic exercise program with increment in intensity increased some of bone remodeling biomarkers and showed different effects for men and women.

Effects of swimming training on myocardial protection in rats

Swimming is important for promoting and maintaining health, as it can increase the efficiency of the cardiovascular system and decrease the occurrence of cardiovascular diseases. The objective of the present study was to examine whether swimming training could decrease myocardial injury in rats caused by myocardial ischemia/reperfusion (I/R). Sprague-Dawley rats were randomized into four groups, namely the Sham, coronary artery occlusion, swimming training and ischemic preconditioning (IPC) groups. Myocardial I/R was induced in anesthetized male Sprague-Dawley rats by a 40-min occlusion followed by a 3-h reperfusion of the left anterior descending coronary artery. The rats were sacrificed after surgery and their hearts were examined. The results demonstrated that the number of TUNEL-positive nuclei and degree of caspase-3 activation were both significantly increased in the myocardium following myocardial I/R in rats, indicating increased cardiomyocyte apoptosis. On the other hand, swimming training decreased the serum levels of creatine phosphokinase, lactate dehydrogenase and cardiac troponin I, and was associated with reduced histological damage and myocardial infarct size. Furthermore, swimming training also reduced TNF-α levels, caspase-3 activation and enhanced Bcl-2 activation, which decreased the number of apoptotic cells in the myocardium. The findings of the present study showed that swimming training and IPC could similarly decrease myocardial injury following myocardial I/R, and may therefore be used as exercise training to effectively prevent myocardial injury.

Leisure but Not Occupational Physical Activity and Sedentary Behavior Associated With Better Health

OBJECTIVE

This study explores relations between occupational and leisure-time physical activity (OPA, LTPA) and sedentary behavior (OSB, LTSB) and several health outcomes.

METHODS

A total 114 full-time workers had their body composition, waist circumference, height, weight, resting heart rate, and resting blood pressure measured. ActivPal monitor measured physical activity behaviors. Stress, mood, and pain were measured with ecological momentary assessment. General linear models were used to examine the relationship between high and low OPA, LTPA, OSB, and LTSB with each health outcome while controlling for covariates.

RESULTS

The high LTPA group had lower body mass index (BMI) (P = 0.04) and better mood (P = 0.007) than the low LTPA group. The high LTSB group had higher systolic blood pressure (P = 0.001), higher diastolic blood pressure (P = 0.01), higher BMI (P = 0.027), higher body fat percentage (P = 0.003), higher waist circumference (P = 0.01), and worse mood (P = 0.032) than the low LTSB group. No differences were found between OPA and OSB groups.

CONCLUSIONS

These findings suggest there may be differential relations between PA and SB accumulated during leisure versus occupational time.

The effect of exercise intensity on chronic inflammation: A systematic review and meta-analysis

OBJECTIVES

Chronic inflammation is independently associated with the incidence and progression of chronic disease. Exercise has been found to reduce chronic inflammation, however the role of exercise intensity (work rate) is unknown. This review aimed to determine the pooled effect of higher- compared to lower-intensity aerobic and resistance exercise on chronic inflammation in adults.

DESIGN

Systematic review and meta-analysis.

METHODS

Five electronic databases were searched. Intervention trials that assessed the effect of ≥2 different exercise intensities on peripheral markers of chronic inflammation [c-reactive protein (CRP), interleukin (IL)-6, tumour necrosis factor (TNF)-α and IL-10] in adults were included. Random-effect meta-analyses were conducted to calculate the mean difference in change scores between groups [effect size (ES)]. Sub-group analyses were performed to explore the influence of age, chronic disease, body mass index and intervention duration on inflammation heterogeneity.

RESULTS

Of 3952 studies identified, 27 were included. There were no significant effects of exercise intensity on IL-6 (ES=-0.039, 95%CI=-0.353-0.275; p=0.806), TNF-α (ES=0.296, 95%CI=-0.184-0.777; p=0.227) and IL-10 (ES=0.007, 95%CI=-0.904-0.919; p=0.987). A significant pooled ES was observed for higher- versus lower-intensity exercise on CRP concentrations, in studies of middle-aged adults (ES=-0.412, 95%CI=-0.821- -0.004, p=0.048) or interventions >9 weeks in duration (ES=-0.520, 95%CI=-0.882--0.159, p=0.005).

CONCLUSIONS

Exercise intensity did not influence chronic inflammatory response. However, sub-analyses suggest that higher-intensity training may be more efficacious than lower-intensity for middle-aged adults, or when longer duration interventions are implemented (>9 weeks), in the most commonly-reported analyte (CRP).

The Effect of Aerobic and Resistance Training and Combined Exercise Modalities on Subcutaneous Abdominal Fat: A Systematic Review and Meta-analysis of Randomized Clinical Trials

Subcutaneous abdominal adipose tissue (SAT), is the largest fat depot and major provider of free fatty acids to the liver. Abdominal fat is indirectly (via increased levels of low-grade inflammation) correlated with many of the adverse health effects of obesity. Although exercise is one of the most prominent components of obesity management, its effects on SAT are still unclear. The aim of this study was to investigate the independent effects of aerobic training (AT) and resistance training (RT) modalities and combined exercise modalities on SAT in adults. PubMed, SCOPUS, and Google Scholar were searched to find relevant publications up to November 2018. The effect sizes were represented as weighted mean difference (WMD) and 95% CIs. Between-study heterogeneity was examined using the I2 test. Overall, 43 identified trials that enrolled 3552 subjects (2684 women) were included. After removal of outliers, combining effect sizes indicated a significant effect of AT (WMD: -13.05 cm2; 95% CI: -18.52, -7.57; P < 0.001), RT (WMD: -5.39 cm2; 95% CI: -9.66, -1.12; P = 0.01), and combined exercise training (CExT; WMD: -28.82 cm2; 95% CI: -30.83, -26.81; P < 0.001) on SAT relative to control groups. Pooled effect sizes demonstrated a significant effect of AT on SAT compared with a CExT group (WMD: 11.07 cm2; 95% CI: 1.81, 20.33; P = 0.01). However, when comparing the AT and RT groups, no significant difference was seen in SAT (WMD: -0.73 cm2; 95% CI: -4.50, 3.04; P = 0.70). Meta-analysis of relevant trials indicated that AT, RT, and CExT lead to SAT reduction. Aerobic exercise was shown to produce greater efficacy in decreasing SAT.

Endurance Training vs. Circuit Resistance Training: Effects on Lipid Profile and Anthropometric/Body Composition Status in Healthy Young Adult Women

Background: Endurance training (ET) and resistance training (RT) are known to be effective in improving anthropometric/body composition and lipid panel indicators, but there is an evident lack of studies on differential effects of these two forms of physical exercise (PE). This study aimed to evaluate the differential effects of 8-week ET and RT among young adult women. Methods: Participants were women (n = 57; age: 23 ± 3 years; initial body height: 165 ± 6 cm; body mass: 66.79 ± 7.23 kg; BMI: 24.37 ± 2.57 kg/m²) divided into the ET group (n = 20), RT group (n = 19), and non-exercising control group (n = 18). All participants were tested for cardiovascular risk factors (CRF), including total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, glucose, and anthropometric/body composition (body mass, body mass index, skinfold measures, body fat %) at the beginning and at the end of the study. Over the 8 weeks, the ET group trained three times/week on a treadmill while the RT group participated in equal number of circuit weight training sessions. Both types of training were planned according to participants’ pre-study fitness status. Results: A two-factor analysis of variance for repeated measurements (“group” × “measurement”) revealed significant main effects for “measurement” in CRF. The “group × measurement” interaction was significant for CRF. The post-hoc analysis indicated significant improvements in CRF for RT and ET. No significant differential effects between RT and ET were evidenced. Conclusions: The results of this study evidence improvements of CRF in young adult women as a result of 8-week ET and RT. The lack of differential training-effects may be attributed to the fact that all participants underwent pre-study screening of their fitness status, which resulted in application of accurate training loads.

Effect of High-Intensity Interval Training on Total, Abdominal and Visceral Fat Mass: A Meta-Analysis

BACKGROUND

High-intensity interval training (HIIT) is promoted as a time-efficient strategy to improve body composition.

OBJECTIVE

The aim of this meta-analysis was to assess the efficacy of HIIT in reducing total, abdominal, and visceral fat mass in normal-weight and overweight/obese adults.

METHODS

Electronic databases were searched to identify all related articles on HIIT and fat mass. Stratified analysis was performed using the nature of HIIT (cycling versus running, target intensity), sex and/or body weight, and the methods of measuring body composition. Heterogeneity was also determined RESULTS: A total of 39 studies involving 617 subjects were included (mean age 38.8 years ± 14.4, 52% females). HIIT significantly reduced total (p = 0.003), abdominal (p = 0.007), and visceral (p = 0.018) fat mass, with no differences between the sexes. A comparison showed that running was more effective than cycling in reducing total and visceral fat mass. High-intensity (above 90% peak heart rate) training was more successful in reducing whole body adiposity, while lower intensities had a greater effect on changes in abdominal and visceral fat mass. Our analysis also indicated that only computed tomography scan or magnetic resonance imaging showed significant abdominal and/or visceral fat-mass loss after HIIT interventions.

CONCLUSION

HIIT is a time-efficient strategy to decrease fat-mass deposits, including those of abdominal and visceral fat mass. There was some evidence of the greater effectiveness of HIIT running versus cycling, but owing to the wide variety of protocols used and the lack of full details about cycling training, further comparisons need to be made. Large, multicenter, prospective studies are required to establish the best HIIT protocols for reducing fat mass according to subject characteristics.

Effects of Aerobic Exercise Alone on Lipids in Healthy East Asians: A Systematic Review and Meta-Analysis

AIM

The purpose of the current work was to review the effects of regular aerobic exercise on serum lipid and lipoprotein levels in East Asians using meta-analysis.

METHODS

The randomized controlled trials analyzed involved healthy adults who were East Asians with a mean age ≥40 years, an exercise group that only performed regular aerobic exercise, and a control group that did not carry out exercise-related intervention; the trials indicated mean high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), or triglyceride (TG). The mean difference (MD) was defined as the difference (mean value at post-intervention in the exercise group－mean value at baseline in the exercise group)－(mean value at post-intervention in the control group－mean value at baseline in the control group) in HDL-C, LDL-C, TC, and TG and was calculated for each trial. The weighted MD was calculated with a random-effects model.

RESULTS

The meta-analysis examined 994 subjects in 25 studies. The weighted MD in HDL-C, TC, and TG improved significantly (HDL-C, 2.2 mg/dL; TC, －5.8 mg/dL; TG, －13.7 mg/dL). The weighted MD in HDL-C and TC contained significant heterogeneity (HDL-C, I²＝45.1%; TC, I²＝56.2%). When trials were limited to those involving moderate-intensity exercise (55%-69% of the maximum heart rate) or an exercise volume ≥150 min/week, the weighted MD in HDL-C, LDL-C, TC, and TG improved significantly and did not contain significant heterogeneity.

CONCLUSIONS

The findings suggest that the ideal form of exercise to improve lipid and lipoprotein levels in East Asians is exercise of moderate-intensity and in a volume ≥150 min/week.

Effects of dancing compared to walking on cardiovascular risk and functional capacity of older women: A randomized controlled trial

INTRODUCTION

Aging is characterized by reductions in lean mass simultaneously to increases in visceral adipose tissue, elevating cardiovascular risk (CVR) and physical dependence. Dancing has been recommended for improving fall-risk and CVR, however, comparisons with traditional exercises are limited. This study aimed to compare the effects of dancing with walking on CVR and functionality of older women.

METHODS

Thirty sedentary women (65 ± 5 years, BMI 27 ± 4 kg/m²) were randomized into three groups (n = 10/group): dancing, walking or stretching (active control). All interventions lasted 8 weeks (60 min sessions): dancing/walking 3×/week, stretching 1×/week. Dancing: several styles, no partner. Walking: treadmill, 60% peak oxygen consumption (VO₂peak). Stretching: large muscle groups, no discomfort. Before and after interventions assessments: VO₂peak (primary outcome), total cholesterol, HDL-C, LDL-C, glucose, insulin, CRP, TNF-α, waist and hip circumferences, visceral adipose tissue (VAT), muscle thickness, maximal muscle strength/power, static and dynamic balance, gait ability, flexibility, chair-raise and level of physical activity (PA).

STATISTICS

generalized estimating equations, post-hoc LSD (p < 0.05), SPSS 22.0.

RESULTS

(Mean-CI): (before vs after): group vs time interaction showed increases in VO₂peak (mL·kg^-1·min^-1) for dancing 23.3 (20.8-25.8) vs 25.6 (23.4-27.8), and walking 23.4 (21.3-25.5) vs 27.0 (25.4-28.6), with no differences for stretching 23.5 (21.3-25.7) vs 23.0 (21.0-24.9). Lower body muscle power and static balance also improved for dancing and walking, but not for stretching. Main time effect showed improvements in CRP, TNF-α, LDL-C, HDL-C, VAT, waist, hip, chair raise, flexibility and level of daily PA for all groups.

CONCLUSION

Dancing induced similar increases in VO₂peak, lower body muscle power and static balance as walking, while the stretching group remained unchanged. Pooled effects showed improvements in body composition, lipid and inflammatory profile, which are supported by increased PA levels.

TRIAL REGISTRATION

NCT03262714.

In-season eccentric-overload training in elite soccer players: Effects on body composition, strength and sprint performance

The aim of this study was to describe the changes in body composition, strength and sprint performance in response to an entire competitive season of football training supplemented with 2 inertial eccentric-overload training sessions a week in young male professional soccer players. Whole body and regional composition (assessed using dual-energy X-ray absorptiometry), power output in half-squat and 40-m sprinting performance were evaluated in fourteen players. The eccentric-overload training consisted of training sessions a week of 1–2 sets of 10 exercises of upper-body and core (Day 1) and lower-body (Day 2), during the entire competitive season (27 weeks). Whole body fat mass decreased (-6.3 ± 3.6%, ES = -0.99 ± 0.54) substantially while lean mass increased (2.5 ± 0.8%, ES = 0.25 ± 0.09), with some regional differences. There was a substantial increase in half-squat power output (from 3% to 14%, ES from 0.45 to 1.73) and sprint performance (from 1.1% to 1.8%, ES from -0.33 to -0.44), however performance changes were not correlated with changes in body composition. A combined soccer and eccentric-overload training program was able to promote positive changes in body composition and physical factors relevant to both on-field performance and injury prevention in elite soccer players.

The Effect of a 12-Week Health Training Program on Selected Anthropometric and Biochemical Variables in Middle-Aged Women

Regular moderate physical activity positively affects health, fitness, and body composition; it regulates the pro- and anti-inflammatory cytokines levels. Vitamin D plays an important regulatory role; its adequate levels correlate with low values of inflammation markers and an increase in muscle strength and fitness in exercising people. The study's aim was to evaluate changes in somatic variables, oxidative stress, and inflammation markers, as well as blood calcidiol concentration in middle-aged healthy women after 12 weeks of aerobics classes—endurance exercises, including choreographic sequences, aiming to improve fitness and motor coordination. The training led to a significant reduction of body mass and fat tissue; it induced an increase in lean body mass. After the 12-week training program, plasma antioxidant status increased (0.65 ± 0.21, p < 0.01) and the concentration of lipid peroxidation products decreased (0.07 ± 0.02, p < 0.001). A significant increase in plasma antioxidant status associated with training could have reduced the level of proinflammatory interleukin as indicated by a positive correlation between these variables (r_s = 0.64, p < 0.05). The study proved that a 12-week health training program in physically inactive middle-aged women might provide improvements in their anthropometric parameters and selected biochemical indicators.

Benefits of different intensity of aerobic exercise in modulating body composition among obese young adults: a pilot randomized controlled trial

BACKGROUND

The aim of present study was to compare the effects of different aerobic exercise intensities and energy expenditures on the body composition of sedentary obese college students in Taiwan.

METHODS

Forty-eight obese participants [body mass index (BMI) ≥ 27 kg/m², age 18-26 years] were randomized into four equal groups (n = 12): light-intensity training group (LITG), 40%-50% heart rate reserve (HRR); middle-intensity training group (MITG), 50%-70% HRR; high-intensity training group (HITG), 70%-80% HRR; and control group (CG). The aerobic exercise training program was conducted for 60 min per day on a treadmill 3 days per week for 12 weeks. All participant anthropometric data, blood biochemical parameters, and health-related physical fitness components were measured at baseline and after 12 weeks.

RESULTS

At baseline, the anthropometric indices did not differ significantly among the four groups (p > 0.05). After 12-week exercise intervention, the HITG and MITG had significantly more changes in body weight, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) than the LITG. The changes in BMI and body fat percentage differed among all four groups (p < 0.05).

CONCLUSIONS

A 12-week high-intensity exercise intervention with high energy expenditure can considerably reduce body weight, body fat, WC, WHR, and WHtR, whereas a light-intensity exercise intervention can significantly reduce body weight and body fat.

TRIAL REGISTRATION

Current Controlled Trials TPECTR09831410900 , registered on 24^th Dec 2009.

Effects of Exercise Training on Fat Loss and Lean Mass Gain in Mexican-American and Korean Premenopausal Women

We investigated the effect of exercise training on body composition change in women. Nineteen Mexican-American and 18 Korean premenopausal overweight/obese women were randomized into one of the following groups: control, low-intensity training group (LI), and high-intensity training group (HI). Subjects completed 12 weeks of training at 50-56% maximal oxygen consumption (LI) or 65-70% maximal oxygen consumption (HI). Body composition components were measured at baseline and after training using dual-energy X-ray absorptiometry for Mexican-Americans, while whole-body composition was measured by the direct segmental multifrequency bioelectrical impedance analysis and abdominal fat was measured by single-slice computed tomography for Koreans. Data were analyzed using mixed-model repeated measures independent of age, ethnicity, and body mass index (BMI). Exercise training showed a significant effect on BMI, fat percentage, fat mass, lean mass, and visceral adipose tissue area. HI significantly decreased fat mass and fat percentage but increased lean mass (all P < 0.05). LI significantly reduced BMI, fat mass, fat percentage, and visceral adipose tissue area but increased lean mass (all P < 0.05). Exercise training had a beneficial effect on reducing BMI, fat percentage, fat mass, and visceral adipose tissue area but had no effect on increasing lean mass for Mexican-American and Korean premenopausal overweight/obese women.

The incidence of training responsiveness to cardiorespiratory fitness and cardiometabolic measurements following individualized and standardized exercise prescription: study protocol for a randomized controlled trial

BACKGROUND

There is individual variability to cardiorespiratory fitness (CRF) training, but the underlying cause is not well understood. Traditionally, a standardized approach to exercise prescription has utilized relative percentages of maximal heart rate, heart rate reserve (HRR), maximal oxygen uptake (VO2max), or VO2 reserve to establish exercise intensity. However, this model fails to take into consideration individual metabolic responses to exercise and may attribute to the variability in training responses. It has been proposed that an individualized approach would take into consideration metabolic responses to exercises to increase responsiveness to training.

METHODS

In this randomized control trial, participants will undergo a 12-week exercise intervention using individualized (ventilatory thresholds) and standardized (HRR) methods to prescribe CRF training intensity. Following the intervention, participants will be categorized as responders or non-responders based on changes in maximal aerobic abilities. Participants who are non-responders will complete a second 12-week intervention in a crossover design to determine whether they can become responders with a differing exercise prescription. There are four main research outcomes: (1) determine the cohort-specific technical error to use in the categorization of response rate; (2) determine if an individualized intensity prescription is superior to a standard approach in regards to VO2max and cardiometabolic risk factors; (3) investigate the time course changes throughout 12 weeks of CRF training between the two intervention groups; and (4) determine if non-responders can become responders if the exercise prescription is modified.

DISCUSSION

The findings from this research will provide evidence on the effectiveness of individualized exercise prescription related to training responsiveness of VO2max and cardiometabolic risk factors compared to a standardized approach and further our understanding of individual exercise responses. If the individualized approach proposed is deemed effective, it may change the way exercise specialists prescribe exercise intensity to enhance training responsiveness.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT02868710 . Registered on 15 August 2016.

Effects of Moderators on Physical Training Programs: A Bayesian Approach

Vetter, RE, Yu, H, and Foose, AK. Effects of moderators on physical training programs: a Bayesian approach. J Strength Cond Res 31(7): 1868-1878, 2017-Creating an optimal physical training program is an important focus in sport and exercise research. The purpose of this research was to examine how different moderators (age, ability level, training weeks, training frequencies, and intensity) impacted the physiological outcomes of specific exercise training programs (muscular strength, speed, power, and cardiorespiratory) using the Bayesian method. A Bayesian approach uses flexible frameworks to determine the pattern of outcomes. This Bayesian analysis combined data generated by 34 previous studies from 1984 to 2015 to improve estimates of effects; these studies rendered 312 cases. The analyses for age were strong in cardiorespiratory and speed but less in power and muscular strength. Ability level was not a predictor of outcomes in each of the 4 areas. Training weeks contributed to power and cardiorespiratory, but not for speed, whereas for strength the effect size (ES) increased only up to the 16th week. Training frequency was a nonsignificant predictor of ES; most of the included studies within this analysis used only training frequencies of 2 or 3 days. Training intensity clearly contributed to the ES. The pattern of influence for intensity level in strength was greatest between 55 and 80%, in power it increased at 65% and continued in a positive linear pattern, in cardiorespiratory it increased up to 65% and then plateaued, and for speed no inferences could be made.

Effect of exercise training on C reactive protein: a systematic review and meta-analysis of randomised and non-randomised controlled trials

PURPOSE

C-reactive protein (CRP) is a marker of chronic systemic inflammation frequently used in cardiovascular disease risk assessment. The purpose of this meta-analysis was to provide a quantitative estimate of the magnitude of change in CRP following participation in physical exercise interventions.

METHODS

All studies included in the meta-analysis were peer reviewed and published in English. Human participants were assigned to a non-exercise comparison group or exercise training group, with the intervention lasting ≥2 weeks. CRP levels were measured at baseline, during and/or after completion of the exercise training programme. Random-effects models were used to aggregate a mean effect size (ES), 95% CIs and potential moderators.

RESULTS

83 randomised and non-randomised controlled trials met the inclusion criteria and resulted in 143 effects (n=3769). The mean ES of 0.26 (95% CI 0.18 to 0.34, p<0.001) indicated a decrease in CRP following exercise training. A decrease in body mass index (BMI; β=1.20, SE=0.25, p<0.0001) and %Fat (β=0.76, SE=0.21, p=0.0002) were associated with a decrease in CRP, independently accounting for 11.1% and 6.6% of the variation in response, respectively. Exercise training led to a greater reduction in CRP when accompanied by a decrease in BMI (ES=0.38, 95% CI 0.26 to 0.50); however, a significant improvement in CRP occurred in the absence of weight loss (ES=0.19, 95% CI 0.10 to 0.28; both p<0.001).

CONCLUSIONS

These results suggest that engaging in exercise training is associated with a decrease in CRP levels regardless of the age or sex of the individual; however, greater improvements in CRP level occur with a decrease in BMI or %Fat.

Effects of exercise on c-reactive protein in healthy patients and in patients with heart disease: A meta-analysis

Decreases in circulating hsCRP have been associated with increased physical activity and exercise training, although the ability of exercise interventions to reduce hsCRP and which individuals benefit the most remains unclear. This meta-analysis evaluates the ability of exercise to reduce hsCRP levels in healthy individuals and in individuals with heart disease. A systematic review and meta-analysis was conducted that included exercise interventions trials from 1995 to 2012. Forty-three studies were included in the final analysis for a total of 3575 participants. Exercise interventions significantly reduced hsCRP (standardized mean difference -0.53 mg/L; 95% CI, -0.74 to -0.33). Results of sub-analysis revealed no significant difference in reductions in hsCRP between healthy adults and those with heart disease (p = .20). Heterogeneity between studies could not be attributed to age, gender, intervention length, intervention type, or inclusion of diet modification. Exercise interventions reduced hsCRP levels in adults irrespective of the presence of heart disease.​.

Inflammatory Marker Changes in Postmenopausal Women after a Year-long Exercise Intervention Comparing High Versus Moderate Volumes

This randomized dose comparison trial examined if higher exercise volume decreased inflammatory biomarkers, associated with postmenopausal breast cancer risk, more than moderate exercise volume. The Breast Cancer and Exercise Trial in Alberta was a two-center, two-armed randomized trial in 400 inactive, healthy, postmenopausal women, aged 50 to 74 years, with a body mass index of 22 to 40 kg/m(2). Participants were randomized to high (300 minutes/week) or moderate (150 minutes/week) volumes of aerobic exercise while maintaining usual diet. Fasting blood concentrations of C-reactive protein (CRP), IL6, and TNFα were measured at baseline, 6 and 12 months. Intention-to-treat (ITT) analysis was performed using linear mixed models adjusted for baseline biomarker concentrations. ITT analyses of 386 (97%) participants showed no statistically significant group differences for changes in biomarker levels at 6 and 12 months. In addition, we did not observe any modification of this effect by baseline characteristics of participants. In post hoc analyses based on self-selected exercise level (measured in minutes/week), CRP decreased by 22.45% for participants who exercised >246 minutes/week (highest quintile) and increased by 0.07% for those who exercised <110 minutes/week (lowest quintile, Ptrend = 0.04), adjusted for baseline covariates. When this analysis was restricted to include exercise time in the target heart rate zone only, statistically significant trends were observed for both CRP (P < 0.01) and IL6 (P = 0.04). Prescribing 300 minutes/week of moderate-to-vigorous aerobic exercise did not improve inflammatory markers compared with 150 minutes/week in postmenopausal women. Decreases in CRP were observed with higher self-selected exercise volume.

Dose-response association between leisure time physical activity and work ability: Cross-sectional study among 3000 workers

INTRODUCTION

Regular physical activity is important for longevity and health, but knowledge about the optimal dose of physical activity for maintaining good work ability is unknown. This study investigates the association between intensity and duration of physical activity during leisure time and work ability in relation to physical demands of the job.

METHODS

From the 2010 round of the Danish Work Environment Cohort Study, currently employed wage earners with physically demanding work (n = 2952) replied to questions about work, lifestyle and health. Excellent (100 points), very good (75 points), good (50 points), fair (25 points) and poor (0 points) work ability in relation to the physical demands of the job was experienced by 18%, 40%, 30%, 10% and 2% of the respondents, respectively.

RESULTS

General linear models that controlled for gender, age, physical and psychosocial work factors, lifestyle and chronic disease showed that the duration of high-intensity physical activity during leisure was positively associated with work ability, in a dose-response fashion (p < 0.001). Those performing ⩾ 5 hours of high-intensity physical activity per week had on average 8 points higher work ability than those not performing such activities. The duration of low-intensity leisure-time physical activity was not associated with work ability (p = 0.5668).

CONCLUSIONS

The duration of high-intensity physical activity during leisure time is associated in a dose-response fashion with work ability, in workers with physically demanding jobs.

Effects of Exercise Training on Cardiorespiratory Fitness and Biomarkers of Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Guidelines recommend exercise for cardiovascular health, although evidence from trials linking exercise to cardiovascular health through intermediate biomarkers remains inconsistent. We performed a meta-analysis of randomized controlled trials to quantify the impact of exercise on cardiorespiratory fitness and a variety of conventional and novel cardiometabolic biomarkers in adults without cardiovascular disease.

METHODS AND RESULTS

Two researchers selected 160 randomized controlled trials (7487 participants) based on literature searches of Medline, Embase, and Cochrane Central (January 1965 to March 2014). Data were extracted using a standardized protocol. A random-effects meta-analysis and systematic review was conducted to evaluate the effects of exercise interventions on cardiorespiratory fitness and circulating biomarkers. Exercise significantly raised absolute and relative cardiorespiratory fitness. Lipid profiles were improved in exercise groups, with lower levels of triglycerides and higher levels of high-density lipoprotein cholesterol and apolipoprotein A1. Lower levels of fasting insulin, homeostatic model assessment-insulin resistance, and glycosylated hemoglobin A1c were found in exercise groups. Compared with controls, exercise groups had higher levels of interleukin-18 and lower levels of leptin, fibrinogen, and angiotensin II. In addition, we found that the exercise effects were modified by age, sex, and health status such that people aged <50 years, men, and people with type 2 diabetes, hypertension, dyslipidemia, or metabolic syndrome appeared to benefit more.

CONCLUSIONS

This meta-analysis showed that exercise significantly improved cardiorespiratory fitness and some cardiometabolic biomarkers. The effects of exercise were modified by age, sex, and health status. Findings from this study have significant implications for future design of targeted lifestyle interventions.