Brief intense interval exercise activates AMPK and p38 MAPK signaling and increases the expression of PGC-1α in human skeletal muscle

Reduced-exertion high-intensity interval training (REHIT): a feasible approach for improving health and fitness?

In recent years, research investigating the dose-response to sprint interval training (SIT) has provided evidence that the number and duration of repetitions in a SIT session can be reduced whilst preserving the beneficial health-related adaptations. Together this research has led to the development of protocols involving minimal doses of SIT: regularly performing just two or three 20-30 s all-out sprints in a 10 min training session has been shown to elicit beneficial metabolic and cardiovascular adaptations. These SIT protocols, which we originally termed "reduced-exertion high-intensity interval training" (or REHIT), have the potential to remove many of the common barriers associated with other SIT protocols, as well as with HIT and aerobic exercise. Here, we critically review the evidence on the efficacy, feasibility and acceptability, and effectiveness of REHIT for improving health and fitness.

Effects of different types of exercise intensity on improving health-related physical fitness in children and adolescents: a systematic review

A substantial body of empirical evidence reveals that physical activity is associated with a wide range of positive physical and mental health outcomes. However, an absence of comprehensive syntheses is observed concerning the varying effects of different exercise intensities on the improvement of physical health among children and adolescents. The aim of this review is to systematically investigate the effects of different exercise intensities on the physical fitness of children and adolescents, to analyses the optimal exercise intensities for improving physical fitness, and to provide a relevant theoretical basis for optimizing school physical education curricula. A systematic search strategy was used in this study in four online databases (PubMed, Scopus, EBSCO and Web of Science). Intervention studies that met the inclusion criteria underwent a thorough screening process, and their methodological quality was assessed utilizing the PEDro scale. The selected literature was systematically analyzed and evaluated through induction, summary, analysis, and evaluation. These findings indicate that high-intensity exercise training exerts significant positive effects on body composition, cardiopulmonary function and muscle fitness in children and adolescents. Therefore, we suggest that schools should focus on high-intensity sports in their physical education curriculum, which can further improve the student's PHYSICAL FITNESS.

Acute physiological responses of blood flow restriction between high-intensity interval repetitions in trained cyclists

Blood flow restriction (BFR) is increasingly being used to enhance aerobic performance in endurance athletes. This study examined physiological responses to BFR applied in recovery phases within a high-intensity interval training (HIIT) session in trained cyclists. Eleven competitive road cyclists (mean ± SD, age: 28 ± 7 years, body mass: 69 ± 6 kg, peak oxygen uptake: 65 ± 9 mL · kg-1 · min-1) completed two randomised crossover conditions: HIIT with (BFR) and without (CON) BFR applied during recovery phases. HIIT consisted of six 30-s cycling bouts at an intensity equivalent to 85% of maximal 30-s power (523 ± 93 W), interspersed with 4.5-min recovery. BFR (200 mmHg, 12 cm cuff width) was applied for 2-min in the early recovery phase between each interval. Pulmonary gas exchange (V̇O2, V̇CO2, and V̇E), tissue oxygen saturation index (TSI), heart rate (HR), and serum vascular endothelial growth factor concentration (VEGF) were measured. Compared to CON, BFR increased V̇CO2 and V̇E during work bouts (both p < 0.05, dz < 0.5), but there was no effect on V̇O2, TSI, or HR (p > 0.05). In early recovery, BFR decreased TSI, V̇O2, V̇CO2, and V̇E (all p < 0.05, dz > 0.8) versus CON, with no change in HR (p > 0.05). In late recovery, when BFR was released, V̇O2, V̇CO2, V̇E, and HR increased, but TSI decreased versus CON (all p < 0.05, dz > 0.8). There was a greater increase in VEGF at 3-h post-exercise in BFR compared to CON (p < 0.05, dz > 0.8). Incorporating BFR into HIIT recovery phases altered physiological responses compared to exercise alone.

An 8-Week study on the effects of high and Moderate-Intensity interval exercises on mitochondrial MOTS-C changes and their relation to metabolic markers in male diabetic sand rats

Mitochondrial dysfunction is a significant feature of type 2 diabetes. MOTS-C, a peptide derived from mitochondria, has positive effects on metabolism and exercise capacity. This study explored the impact of high and moderate-intensity interval exercises on mitochondrial MOTS-C alterations and their correlation with metabolic markers in male diabetic sand rats. Thirty male sand rats were divided into six groups: control, MIIT, DM + HIIT, DM + MIIT, DM, and HIIT (5 rats each). Diabetes was induced using a high-fat diet (HFD) combined with streptozotocin (STZ). The Wistar sand rats in exercise groups underwent 8 weeks of interval training of varying intensities. Post sample collection, protein expressions of PCG-1a, AMPK, and GLUT4 were assessed through Western blot analysis, while MOTS-C protein expression was determined using ELISA. Both exercise intensity and diabetes significantly affected the levels of PCG-1a, MOTS-C, GLUT4 proteins, and insulin resistance (p < 0.001). The combined effect of diabetes status and exercise intensity on these levels was also significant (p < 0.001). However, the diabetes effect varied when comparing high-intensity to moderate-intensity exercise. The moderate-intensity exercise group with diabetes showed higher levels of PCG-1a, MOTS-C, and GLUT4 proteins and reduced insulin resistance levels (p < 0.001). Exercise intensity (p = 0.022) and diabetes (p = 0.008) significantly influenced AMPK protein levels. The interplay between diabetes status and exercise intensity on AMPK protein levels was noteworthy, with the moderate-intensity diabetes group exhibiting higher AMPK levels than the high-intensity diabetes group (p < 0.001). In conclusion, exercise elevates the levels of PCG-1a, MOTS-C, GLUT4, and AMPK proteins, regulating insulin resistance in diabetic sand rats. Given the AMPK-MOTS-C mitochondrial pathway's mechanisms, interval exercises might enhance the metabolic rates and general health of diabetic rodents.

Knockdown of PROX1 promotes milk fatty acid synthesis by targeting PPARGC1A in dairy goat mammary gland

Goat milk is rich in various fatty acids that are beneficial to human health. Chromatin immunoprecipitation followed by sequencing (ChIP-seq) and RNA-seq analyses of goat mammary glands at different lactation stages revealed a novel lactation regulatory factor, Prospero homeobox 1 (PROX1). However, the mechanism whereby PROX1 regulates lipid metabolism in dairy goats remains unclear. We found that PROX1 exhibits the highest expression level during peak lactation period. PROX1 knockdown enhanced the expression of genes related to de novo fatty acid synthesis (e.g., SREBP1 and FASN) and triacylglycerol (TAG) synthesis (e.g., DGAT1 and GPAM) in goat mammary epithelial cells (GMECs). Consistently, intracellular TAG and lipid droplet contents were significantly increased in PROX1 knockdown cells and reduced in PROX1 overexpression cells, and we observed similar results in PROX1 knockout mice. Following PROX1 overexpression, RNA-seq showed a significant upregulation of peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PPARGC1A) expression. Further, PPARGC1A knockdown attenuated the inhibitory effects of PROX1 on TAG contents and lipid-droplet formation in GMECs. Moreover, we found that PROX1 promoted PPARGC1A transcription via the PROX1 binding sites (PBSs) located in the PPARGC1A promoter. These results suggest a novel target for manipulating the goat milk-fat composition and improving the quality of goat milk.

AMPK and PGC-α following maximal and supramaximal exercise in men and women: a randomized cross-over study

We tested the hypothesis that AMPK activation and peroxisome proliferator gamma coactivator 1 alpha (PGC-1α) expression are not augmented as exercise intensity (power output) increases from maximal to supramaximal intensities and conducted an exploratory analysis comparing AMPK activation and PGC-1α expression in males and females. Seventeen (n = 9 males; n = 8 females) recreationally active, healthy, young individuals volunteered to participate in the current study. Participants completed work matched interval exercise at 100% (Max) and 133% (Supra) of peak work rate (WRpeak). Intervals were 1 min in duration and participants were prescribed 6 and 8 intervals of Max and Supra, respectively, to equate external work across protocols. PGC-1α mRNA expression and activation of AMPK (p-ACC) were examined in muscle biopsy samples. Interval WR (watts; W), intensity (%WRpeak) and average HR (bpm), blood lactate (mmol/L) and rating of perceived exertion were all higher (all p < 0.05) in Supra. Fatigue was greater (p < 0.05) in Supra. PGC-1α mRNA expression significantly increased after exercise in Max (p < 0.01) and Supra (p < 0.01), but was not significantly different (p = 0.71) between intensities. A main effect of time (Pre - 0 h) (p < 0.01) was observed for p-ACC; however, no effect of intensity (p = 0.08) or interaction (p = 0.97) was observed. No significant effects of time (p = 0.05) intensity (p = 0.42), or interaction (p = 0.97) were observed for p-AMPK (Thr172). Exploratory sex analysis demonstrated a main effect of sex for p-ACC (greater p-ACC in males; p < 0.05) but not for p-AMPK or PGC-1α expression. Our results confirm that AMPK-PGC-1α signalling is not augmented following supramaximal exercise and provide novel data demonstrating a decrease in AMPK activation (p-ACC) in females compared to men. Trial registration: https://doi.org/10.17605/OSF.IO/U7PX9.

Aerobic exercise interventions for promoting cardiovascular health and mobility after stroke: a systematic review with Bayesian network meta-analysis

OBJECTIVE

To determine the superiority of aerobic exercise (AE) interventions on key outcomes of stroke recovery, including cardiorespiratory fitness (V̇O2peak, primary outcome), systolic blood pressure (SBP) and mobility (6 min Walk Test (6MWT) distance and 10 m Usual Gait Speed) after stroke.

DATA SOURCES

MEDLINE, EMBASE, Web of Science, CINAHL, CENTRAL, SPORTDiscus, PsycINFO and AMED Allied and Complementary Medicine were searched from inception to February 2023.

ELIGIBILITY CRITERIA

Randomised controlled trials were included that compared the effects of any AE interventions (low-intensity, moderate-intensity, high-intensity continuous training (HICT), high-intensity interval training (HIIT)) to no exercise, usual care or other AE interventions in individuals poststroke.

ANALYSES

Systematic review with Bayesian network meta-analysis (NMA) methodology was employed. Surface under the cumulative ranking curve (SUCRA) values were used to rank interventions. The Grading of Recommendations, Assessment, Development and Evaluation minimally contextualised framework for NMA was followed.

RESULTS

There were 28 studies (n=1298) included in the NMA for V̇O2peak, 11 (n=648) for SBP, 28 (n=1494) for 6MWT and 18 (n=775) for the 10 m Usual Gait Speed. The greatest effect on V̇O2peak, 6MWT and 10 m Usual Gait Speed was observed after HIIT and HICT. No differences between interventions were found for SBP. SUCRA values identified HIIT as the superior AE intervention for all outcomes of interest. HIIT was the most effective intervention for improving V̇O2peak (2.9 mL/kg/min (95% credible interval 0.8 to 5.0) moderate certainty) compared with usual care.

CONCLUSION

This NMA suggests that higher-intensity AE is superior to traditional low-intensity to moderate-intensity AE for improving outcomes after stroke.

Advancing cancer cachexia diagnosis with -omics technology and exercise as molecular medicine

Muscle atrophy exacerbates disease outcomes and increases mortality, whereas the preservation of skeletal muscle mass and function play pivotal roles in ensuring long-term health and overall quality-of-life. Muscle atrophy represents a significant clinical challenge, involving the continued loss of muscle mass and strength, which frequently accompany the development of numerous types of cancer. Cancer cachexia is a highly prevalent multifactorial syndrome, and although cachexia is one of the main causes of cancer-related deaths, there are still no approved management strategies for the disease. The etiology of this condition is based on the upregulation of systemic inflammation factors and catabolic stimuli, resulting in the inhibition of protein synthesis and enhancement of protein degradation. Numerous necessary cellular processes are disrupted by cachectic pathology, which mediate intracellular signalling pathways resulting in the net loss of muscle and organelles. However, the exact underpinning molecular mechanisms of how these changes are orchestrated are incompletely understood. Much work is still required, but structured exercise has the capacity to counteract numerous detrimental effects linked to cancer cachexia. Primarily through the stimulation of muscle protein synthesis, enhancement of mitochondrial function, and the release of myokines. As a result, muscle mass and strength increase, leading to improved mobility, and quality-of-life. This review summarises existing knowledge of the complex molecular networks that regulate cancer cachexia and exercise, highlighting the molecular interplay between the two for potential therapeutic intervention. Finally, the utility of mass spectrometry-based proteomics is considered as a way of establishing early diagnostic biomarkers of cachectic patients.

Association of aerobic and muscle-strengthening physical activity with all-cause and cardiovascular disease mortality among adults with type 2 diabetes: A prospective cohort of US adults

OBJECTIVE

To investigate the relationship of moderate physical activity (MPA), vigorous physical activity (VPA), and muscle strengthening activity (MSA), independently and jointly, with all-cause, cardiovascular disease (CVD), and non-CVD mortality in individuals with type 2 diabetes (T2D).

MATERIAL AND METHODS

This cohort study included 47,538 adults with T2D and 561,963 adults without T2D from the National Health Interview Survey 1997-2018 who provided data on self-reported physical activity (PA). Mortality data were obtained from the National Death Index through 2019. Cox regression was used to estimate hazard ratio (HR) and 95% confidence interval (CI).

RESULTS

In analyses mutually adjusted, versus no MPA adults with T2D, performing the recommendations of MPA (150-299 min/week) associated with lower all-cause mortality (HR, 0.72; 95% CI, 0.66-0.78), CVD mortality (HR, 0.68; 95% CI, 0.58-0.79), and non-CVD mortality (HR, 0.72; 95% CI, 0.65-0.79). Similar benefits were observed in those meeting recommendations for VPA and MSA. Higher levels of PA beyond current recommendations may provide a few additional benefits without adverse effects on mortality risk, regardless of diabetes onset age, duration of diabetes, and medication status. The joint analysis indicates that combining MSA with aerobic PA could further lower mortality risk, and lowest all-cause mortality was observed among individuals engaging in either 75-150 min/week of VPA and 1 time/week of MSA (HR, 0.30; 95% CI, 0.13-0.70) or 150-299 min/week of MPA and 1 time/week of MSA (HR, 0.33; 95% CI, 0.20-0.55).

CONCLUSION

Our study supports the current PA guidelines and suggests that there may be limited benefits gained from exercising beyond recommended levels in adults with T2D, combining recommended levels of aerobic and resistance exercises could yield the greatest benefits.

Effects of aerobic combined with resistance exercise on cardiorespiratory fitness and cardiometabolic health in breast cancer survivors: A Systematic Review, meta-analysis and meta-regression

Background

Cardiotoxicity from chemotherapy is a serious risk to the quality of survival of breast cancer survivors (BCS), and aerobic combined with resistance exercise (CE) has the potential to combat this cardiac damage. However, there is a lack of high-quality studies to assess the specific effects of CE. This study aimed to investigate the effects of CE on cardiopulmonary function (CRF) and cardiometabolic health in BCS.

Methods

A comprehensively searched of the 4 databases (PubMed, Embase, Web of Science, Cochrane Library) from the database construction until March 1, 2023. The included studies were randomized controlled trials (RCTs) reporting the effects of CE on CRF and cardiometabolic health in BCS. The quality of the literature was assessed by two independent reviewers using the Cochrane Collaboration Risk of Bias Tool. Weight means difference (WMD), or standardized mean difference (SMD), were combined using random or fixed effects models. Subgroup and meta-regression explored heterogeneity as well as covariate effects.

Results

40 studies were included in the meta-analysis, with 2849 participants. Results showed that CE significantly increased maximal oxygen uptake (VO2max) (WMD:4.55; 95% CI:2.84, 6.26; I2 = 91.90%, P < 0.001) and reduced body weight (BW) (WMD: 1.61; 95% CI: 2.44, -0.78; I2 = 38.60%, P = 0.032) and body mass index (BMI) (WMD: 0.86; 95% CI: 1.43, -0.29; I2 = 70.50%, P < 0.001) in BCS. Subgroup analysis showed that BMI (WMD: 1.15; 95% CI: 1.89, -0.41; I2 = 76.90%, P < 0.001) and VO2max (WMD:4.21; 95% CI:2.40, 6.02; I2 = 96.4%, P < 0.001) were more effective with supervision. Meta-regression analysis showed that sample size had a significant moderating effect on BW (Coeff: 0.03, 95% CI: 0.00, 0.06).

Conclusions

CE significantly increases CRF in BCS and improves most cardiometabolic health-related outcomes. In addition, there will be a need for many larger RCTs to explore the effects of CE on inflammatory biomarkers in BCS.

Effect of high-intensity interval training on cardiorespiratory in children and adolescents with overweight or obesity: a meta-analysis of randomized controlled trials

Objective

This meta-analysis aimed to examine the effect of high-intensity interval training on cardiorespiratory fitness in children and adolescents with overweight or obesity, and to explore the optimal dose of high-intensity interval training to improve cardiorespiratory fitness in children and adolescents with overweight or obesity.

Methods

Randomized controlled trials on the effects of HIIT on cardiorespiratory fitness in children and adolescents with overweight or obesity were retrieved from six electronic databases, including PubMed, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP. The quality assessment of the included studies was conducted following the revised quality evaluation method based on the PRISMA principles. Keywords for literature search mainly include high-intensity interval, cardiorespiratory fitness, overweight, obese, children, and adolescent, etc.

Results

(1) A total of 18 studies, comprising 581 participants (288 in the intervention group and 293 in the control group), were included and all of them were of moderate to high quality. (2) HIIT had a positive effect on the cardiorespiratory fitness levels of in children and adolescents with overweight or obesity (SMD = 0.91; 95% CI: 0.66, 1.15; p < 0.00001). (3) The improvement in cardiorespiratory fitness was more significant when the HIIT intervention lasted for more than 10 weeks (SMD = 1.04; 95% CI: 0.74, 1.34; p < 0.00001), was conducted 3 times per week, with 2 to 8 sets per session (SMD = 1.13; 95% CI: 0.71, 1.55; p < 0.00001), and maintained a ratio of approximately 1:1 between exercise and rest intervals (SMD = 1.11; 95% CI: 0.73, 1.50; p < 0.00001).

Conclusion and recommendations

(1) Long-term HIIT can improve cardiorespiratory fitness in children and adolescents with overweight or obesity. (2) To achieve significant improvements in cardiorespiratory fitness in a short period, children and adolescents with overweight or obesity can engage in HIIT programs lasting for more than 10 weeks, conducted 3 times per week, with 2 to 8 sets per session, and a ratio of approximately 1:1 between exercise and rest intervals.

Systematic Review Registration

Identifier: INPLASY202350033.

Aged gastrocnemius muscle of mice positively responds to a late onset adapted physical training

Introduction: A regular physical training is known to contribute to preserve muscle mass and strength, maintaining structure and function of neural and vascular compartments and preventing muscle insulin resistance and inflammation. However, physical activity is progressively reduced during aging causing mobility limitations and poor quality of life. Although physical exercise for rehabilitation purposes (e.g., after fractures or cardiovascular events) or simply aiming to counteract the development of sarcopenia is frequently advised by physicians, nevertheless few data are available on the targets and the global effects on the muscle organ of adapted exercise especially if started at old age. Methods: To contribute answering this question for medical translational purposes, the proteomic profile of the gastrocnemius muscle was analyzed in 24-month-old mice undergoing adapted physical training on a treadmill for 12 weeks or kept under a sedentary lifestyle condition. Proteomic data were implemented by morphological and morphometrical ultrastructural evaluations. Results and Discussion: Data demonstrate that muscles can respond to adapted physical training started at old age, positively modulating their morphology and the proteomic profile fostering protective and saving mechanisms either involving the extracellular compartment as well as muscle cell components and pathways (i.e., mitochondrial processes, cytoplasmic translation pathways, chaperone-dependent protein refolding, regulation of skeletal muscle contraction). Therefore, this study provides important insights on the targets of adapted physical training, which can be regarded as suitable benchmarks for future in vivo studies further exploring the effects of this type of physical activity by functional/metabolic approaches.

Physiological and skeletal muscle responses to high-intensity interval exercise in Thoroughbred horses

Introduction

The purpose of this study was to determine whether acute high-intensity interval exercise or sprint interval exercise induces greater physiological and skeletal muscle responses compared to moderate-intensity continuous exercise in horses.

Methods

In a randomized crossover design, eight trained Thoroughbred horses performed three treadmill exercise protocols consisting of moderate-intensity continuous exercise (6 min at 70% VO2max; MICT), high-intensity interval exercise (6 × 30 s at 100% VO2max; HIIT), and sprint interval exercise (6 × 15 s at 120% VO2max; SIT). Arterial blood samples were collected to measure blood gas variables and plasma lactate concentration. Biopsy samples were obtained from the gluteus medius muscle before, immediately after, 4 h, and 24 h after exercise for biochemical analysis, western blotting and real-time RT-PCR. Effects of time and exercise protocol were analyzed using mixed models (p < 0.05).

Results

Heart rate and plasma lactate concentration at the end of exercise were higher in HIIT and SIT than those in MICT (heart rate, HIIT vs. MICT, p = 0.0005; SIT vs. MICT, p = 0.0015; lactate, HIIT vs. MICT, p = 0.0014; SIT vs. MICT, p = 0.0003). Arterial O2 saturation and arterial pH in HIIT and SIT were lower compared with MICT (SaO2, HIIT vs. MICT, p = 0.0035; SIT vs. MICT, p = 0.0265; pH, HIIT vs. MICT, p = 0.0011; SIT vs. MICT, p = 0.0023). Muscle glycogen content decreased significantly in HIIT (p = 0.0004) and SIT (p = 0.0016) immediately after exercise, but not in MICT (p = 0.19). Phosphorylation of AMP-activated protein kinase (AMPK) in HIIT showed a significant increase immediately after exercise (p = 0.014), but the increase was not significant in MICT (p = 0.13) and SIT (p = 0.39). At 4 h after exercise, peroxisome proliferator-activated receptor γ co-activator-1α mRNA increased in HIIT (p = 0.0027) and SIT (p = 0.0019) and vascular endothelial growth factor mRNA increased in SIT (p = 0.0002).

Discussion

Despite an equal run distance, HIIT and SIT cause more severe arterial hypoxemia and lactic acidosis compared with MICT. In addition, HIIT activates the AMPK signaling cascade, and HIIT and SIT elevate mitochondrial biogenesis and angiogenesis, whereas MICT did not induce any significant changes to these signaling pathways.

Cooling of male rat skeletal muscle during endurance-like contraction attenuates contraction-induced PGC-1α mRNA expression

This study aimed to determine effects of cooling on contraction-induced peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) and vascular endothelial growth factor (VEGF) gene expression, phosphorylations of its related protein kinases, and metabolic responses. Male rats were separated into two groups; room temperature (RT) or ice-treated (COLD) on the right tibialis anterior (TA). The TA was contracted isometrically using nerve electrical stimulation (1-s stimulation × 30 contractions, with 1-s intervals, for 10 sets with 1-min intervals). The TA was treated before the contraction and during 1-min intervals with an ice pack for the COLD group and a water pack at RT for the RT group. The muscle temperature of the COLD group decreased to 19.42 ± 0.44°C (p < 0.0001, -36.4%) compared with the RT group after the experimental protocol. An increase in mRNA expression level of PGC-1α, not VEGF, after muscle contractions was significantly lower in the COLD group than in the RT group (p < 0.0001, -63.0%). An increase in phosphorylated AMP-activated kinase (AMPK) (p = 0.0037, -28.8%) and a decrease in glycogen concentration (p = 0.0231, +106.3%) after muscle contraction were also significantly inhibited by cooling. Collectively, muscle cooling attenuated the post-contraction increases in PGC-1α mRNA expression coinciding with decreases in AMPK phosphorylation and glycogen degradation.

Applied high-intensity interval cardio yoga improves cardiometabolic fitness, energetic contributions, and metabolic flexibility in healthy adults

Purpose: Currently, there is no interventional approach to increase the intensity of Surya Namaskar a popular hatha yoga sequence used worldwide. Therefore, this study investigated how tempo-based high-intensity interval cardio yoga (HIICY) and traditional interval hatha yoga (TIHY) affects cardiometabolic fitness in active adults. Methods: Twenty physically active male and female individuals were randomly separated into HIICY (5 males, 5 females, 1.5 s tempo) and TIHY (5 males, 5 females, 3 s tempo) groups. The intervention included twelve exercise sessions for 4 weeks in both groups. Participants conducted a ramp test to determine their maximal oxygen uptake (V ˙ O2max), maximal velocity at V ˙ O2max (vV ˙ O2max), and maximal heart rate (HRmax). Afterward, they performed a 10-min high-intensity cardio yoga test (HICYT) to determine heart rate (HRpeak and HRmean), oxygen uptake (V ˙ O2peak and V ˙ O2mean), respiratory exchange ratio (RER), blood lactate concentrations (La- peak and ∆La-), fat and carbohydrate oxidations (FATox, CHOox), and energetic contributions (oxidative; W Oxi, glycolytic; W Gly, and phosphagen; W PCr, total energy demand; W Total). Results: V ˙ O2max and vV ˙ O2max showed time and group × time interactions (p < 0.01, p < 0.0001, p < 0.001, respectively). V ˙ O2max after HIICY was significantly higher than in pre-testing and following TIHY (p < 0.001, p < 0.0001, respectively). V ˙ O2peak, V ˙ O2mean, RER, HRpeak, and HRmean during the 10-min HICYT showed significant time effects (p < 0.05). ∆La- indicated a group × time interaction (p < 0.05). Group x time interaction effects for FATox at the fourth and sixth minute were observed (p < 0.05, respectively). Absolute (kJ) and relative (%) W Oxi, W Gly, and W Total showed time and group × time interaction effects (p < 0.05, p < 0.01, respectively). Furthermore, %W Gly was reduced following HIICY (p < 0.05). Additionally, V ˙ O2max and vV ˙ O2max were highly correlated with W Oxi in kJ (r = 0.91, 0.80, respectively). Moderate to high correlations were observed among CHOox, FATox, and absolute V ˙ O2max (r = 0.76, 0.62, respectively). Conclusion: A 4-week period of HIICY improved cardiometabolic fitness, oxidative capacity, and metabolic flexibility compared with TIHY, in physically active adults. Therefore, HIICY is suitable as HY-specific HIIT and time-efficient approach for relatively healthy individuals.

Effects of acute moderate-intensity aerobic exercise on cognitive function in E-athletes: A randomized controlled trial

BACKGROUND

E-sports require athletes to have high-speed reflexes and excellent memory skills. Whereas a single session of aerobic exercise has been shown to improve cognitive function, this paper aims is to investigate the effects of acute moderate-intensity aerobic exercise on the cognitive function of e-sports players and its time-course characteristics.

METHODS

Thirty-four E-athletes were divided into 2 groups according to a random number table method, and 2 trials in a quiet physical fitness gym. The duration of each trial was approximately 1 hour. In the first trial: exercise group (64-76% of maximum heart rate for 30 minutes power cycling) and control group, cognitive function was tested, and results were automatically recorded before, immediately after, and 30 minutes after exercise using the human benchmark website (https://humanbenchmark.com). The second trial crossed and swapped the interventions of the 2 groups, and the other test protocols were the same as the first.

RESULTS

In both trials, the exercise intervention group showed significant improvements in speed accuracy (P < .001, Cohen's d = 1.406, 95% CI: 0.717-2.072; P = .005, Cohen's d = 0.782, 95% CI: 0.227-1.319), visual memory (P < .001, Cohen's d = 1.416, 95% CI: 0.725-2.086; P = .015, Cohen's d = 0.662, 95% CI: 0.127-1.181), and reaction time (P < .001, Cohen's d = 1.265, 95% CI: 0.610-1.898; P<.001, Cohen's d = 0.979, 95% CI: 0.386-1.551) immediately after exercise compared to baseline. The exercise intervention group also showed significant improvement in speed accuracy 30 minutes after exercise compared to baseline (P = .002 Cohen's d = 0.869, 95% CI: 0.298-1.421; P = .009, Cohen's d = 0.722, 95% CI: 0.177-1.249). In the first trial, the exercise intervention group showed significant improvements in visual memory and reaction time immediately after exercise compared to the control group (P = .013, Cohen's d = 0.904, 95% CI: 0.190-1.605; P = .027, Cohen's d = 0.796, 95% CI: 0.090-1.490). The exercise intervention group also showed significant improvement in reaction time 30 minutes after exercise compared to baseline (P = .009, Cohen's d = 0.719, 95% CI: 0.174-1.246). There was no effect of exercise on sequence memory or the chimp test in both trials (P > .05). Sequence effect analysis showed no influence on the order of the exercise intervention in both trials (P = .912; P = .111; P = .226).

CONCLUSION

Acute moderate-intensity aerobic exercise significantly enhanced the speed accuracy, visual reaction time, and instantaneous memory of eSports players, and the effect could be extended up to 30 minutes after exercise.

Impacts of altered exercise volume, intensity, and duration on the activation of AMPK and CaMKII and increases in PGC-1α mRNA

The purpose of this review is to explore and discuss the impacts of augmented training volume, intensity, and duration on the phosphorylation/activation of key signaling protein - AMPK, CaMKII and PGC-1α - involved in the initiation of mitochondrial biogenesis. Specifically, we explore the impacts of augmented exercise protocols on AMP/ADP and Ca²⁺ signaling and changes in post exercise PGC - 1α gene expression. Although AMP/ADP concentrations appear to increase with increasing intensity and during extended durations of higher intensity exercise AMPK activation results are varied with some results supporting and intensity/duration effect and others not. Similarly, CaMKII activation and signaling results following exercise of different intensities and durations are inconsistent. The PGC-1α literature is equally inconsistent with only some studies demonstrating an effect of intensity on post exercise mRNA expression. We present a novel meta-analysis that suggests that the inconsistency in the PGC-1α literature may be due to sample size and statistical power limitations owing to the effect of intensity on PGC-1α expression being small. There is little data available regarding the impact of exercise duration on PGC-1α expression. We highlight the need for future well designed, adequately statistically powered, studies to clarify our understanding of the effects of volume, intensity, and duration on the induction of mitochondrial biogenesis by exercise.

Does Lactate-Guided Threshold Interval Training within a High-Volume Low-Intensity Approach Represent the "Next Step" in the Evolution of Distance Running Training?

The aim of the present study was to describe a novel training model based on lactate-guided threshold interval training (LGTIT) within a high-volume, low-intensity approach, which characterizes the training pattern in some world-class middle- and long-distance runners and to review the potential physiological mechanisms explaining its effectiveness. This training model consists of performing three to four LGTIT sessions and one VO_2max intensity session weekly. In addition, low intensity running is performed up to an overall volume of 150-180 km/week. During LGTIT sessions, the training pace is dictated by a blood lactate concentration target (i.e., internal rather than external training load), typically ranging from 2 to 4.5 mmol·L^-1, measured every one to three repetitions. That intensity may allow for a more rapid recovery through a lower central and peripheral fatigue between high-intensity sessions compared with that of greater intensities and, therefore, a greater weekly volume of these specific workouts. The interval character of LGTIT allows for the achievement of high absolute training speeds and, thus, maximizing the number of motor units recruited, despite a relatively low metabolic intensity (i.e., threshold zone). This model may increase the mitochondrial proliferation through the optimization of both calcium and adenosine monophosphate activated protein kinase (AMPK) signaling pathways.

Skeletal Muscle Mitochondrial Dysfunction in Chronic Obstructive Pulmonary Disease: Underlying Mechanisms and Physical Therapy Perspectives

Skeletal muscle dysfunction (SMD) is a prevalent extrapulmonary complication and a significant independent prognostic factor in patients with chronic obstructive pulmonary disease (COPD). Mitochondrial dysfunction is one of the core factors that damage structure and function in COPD skeletal muscle and is closely related to smoke exposure, hypoxia, and insufficient physical activity. The currently known phenotypes of mitochondrial dysfunction are reduced mitochondrial content and biogenesis, impaired activity of mitochondrial respiratory chain complexes, and increased mitochondrial reactive oxygen species production. Significant progress has been made in research on physical therapy (PT), which has broad prospects for treating the abovementioned potential mitochondrial-function changes in COPD skeletal muscle. In terms of specific types of PT, exercise therapy can directly act on mitochondria and improve COPD SMD by increasing mitochondrial density, regulating mitochondrial biogenesis, upregulating mitochondrial respiratory function, and reducing oxidative stress. However, improvements in mitochondrial-dysfunction phenotype in COPD skeletal muscle due to different exercise strategies are not entirely consistent. Therefore, based on the elucidation of this phenotype, in this study, we analyzed the effect of exercise on mitochondrial dysfunction in COPD skeletal muscle and the regulatory mechanism thereof. We also provided a theoretical basis for exercise programs to rehabilitate this condition.

The Effects of Sprint Interval Training on Physical Performance: A Systematic Review and Meta-Analysis

ABSTRACT

Hall, AJ, Aspe, RR, Craig, TP, Kavaliauskas, M, Babraj, J, and Swinton, PA. The effects of sprint interval training on physical performance: a systematic review and meta-analysis. J Strength Cond Res 37(2): 457-481, 2023-The present study aimed to synthesize findings from published research and through meta-analysis quantify the effect of sprint interval training (SIT) and potential moderators on physical performance outcomes (categorized as aerobic, anaerobic, mixed aerobic-anaerobic, or muscular force) with healthy adults, in addition to assessing the methodological quality of included studies and the existence of small study effects. Fifty-five studies were included (50% moderate methodological quality, 42% low methodological quality), with 58% comprising an intervention duration of ≤4 weeks and an array of different training protocols. Bayesian's meta-analysis of standardized mean differences (SMD) identified a medium effect of improved physical performance with SIT (ES 0.5 = 0.52; 95% credible intervals [CrI]: 0.42-0.62). Moderator analyses identified overlap between outcome types with the largest effects estimated for anaerobic outcomes (ES 0.5 = 0.61; 95% CrI: 0.48-0.75). Moderator effects were identified for intervention duration, sprint length, and number of sprints performed per session, with larger effects obtained for greater values of each moderator. A substantive number of very large effect sizes (41 SMDs > 2) were identified with additional evidence of extensive small study effects. This meta-analysis demonstrates that short-term SIT interventions are effective for developing moderate improvements in physical performance outcomes. However, extensive small study effects, likely influenced by researchers analyzing many outcomes, suggest potential overestimation of reported effects. Future research should analyze fewer a priori selected outcomes and investigate models to progress SIT interventions for longer-term performance improvements.

The effect of Tabata-style functional high-intensity interval training on cardiometabolic health and physical activity in female university students

Introduction: The increasing prevalence of metabolic syndrome and physical inactivity enhances exposure to cardiometabolic risk factors in university students. High-intensity interval training (HIIT) improved cardiometabolic health in clinical adults but the evidence in the university setting is limited. Furthermore, few studies examined the effect of low-volume HIIT on habitual physical activity (PA). Therefore, the primary aim of this study was to evaluate the efficacy of 12-week Tabata-style functional HIIT for improving multiple cardiometabolic health outcomes and habitual PA. We also investigated whether changes in habitual PA over the intervention period had an impact on exercise-induced health outcomes. Methods: 122 female freshmen were randomized into the Tabata group (n = 60) and the control (n = 62). The Tabata training protocol involved 8 × 20 s maximal repeated functional exercises followed by 10 s rest with a frequency of 3 times per week for 12 weeks. Body composition, maximal oxygen uptake (VO_2max), blood pressure (BP), blood lipids, fasting glucose and insulin, C-reactive protein and PA were objectively measured using standardized methods. Dietary intake was measured using a valid food frequency questionnaire. All variables were measured pre- and post-intervention. Results: Mixed linear modelling results showed that there were large intervention effects on VO_2max (p < 0.001, d = 2.53, 95% CI: 2.03 to 3.00 for relative VO_2max; p < 0.001, d = 2.24, 95% CI: 1.76 to 2.68 for absolute VO_2max), resting heart rate (p < 0.001, d = -1.82, 95% CI: -2.23 to -1.37), systolic BP (p < 0.001, d = -1.24, 95% CI: -1.63 to -0.84), moderate-to-vigorous intensity physical activity (MVPA) (p < 0.001, d = 2.31, 95% CI: 1.83 to 2.77), total PA (p < 0.001, d = 1.98, 95% CI: 1.53 to 2.41); moderate effects on %BF (p < 0.001, d = -1.15, 95% CI: -1.53 to -0.75), FM (p < 0.001, d = -1.08, 95% CI: -1.46 to -0.69), high-density lipoprotein (HDL) (p < 0.001, d = 1.04, 95% CI: 0.65 to 1.42), total cholesterol (p = 0.001, d = -0.64, 95% CI: -1.00 to -0.26); small effects on BMI (p = 0.011, d = -0.48, 95% CI: -0.84 to 0.11), WC (p = 0.043, d = -0.37, 95% CI: -0.74 to -0.01), low-density lipoprotein (p = 0.003, d = -0.57, 95% CI: -0.93 to -0.19), HOMA-IR (p = 0.026, d = -0.42, 95% CI: -0.78 to -0.05) and fasting insulin (p = 0.035, d = -0.40, 95% CI: -0.76 to -0.03). Regression analysis showed that only the percentage change of HDL was associated with the change of MVPA (b = 0.326, p = 0.015) and TPA (b = 0.480, p = 0.001). Conclusion: From the findings of the study we can conclude that 12-week low-volume Tabata-style functional HIIT was highly effective for university female students to improve cardiorespiratory fitness, body fat, some cardiometabolic health outcomes and habitual PA.

Skeletal muscle mechanisms contributing to improved glycemic control following intense interval exercise and training

High-intensity and sprint interval training (HIIT and SIT, respectively) enhance insulin sensitivity and glycemic control in both healthy adults and those with cardiometabolic diseases. The beneficial effects of intense interval training on glycemic control include both improvements seen in the hours to days following a single session of HIIT/SIT and those which accrue with chronic training. Skeletal muscle is the largest site of insulin-stimulated glucose uptake and plays an integral role in the beneficial effects of exercise on glycemic control. Here we summarize the skeletal muscle responses that contribute to improved glycemic control during and following a single session of interval exercise and evaluate the relationship between skeletal muscle remodelling and improved insulin sensitivity following HIIT/SIT training interventions. Recent evidence suggests that targeting skeletal muscle mechanisms via nutritional interventions around exercise, particularly with carbohydrate manipulation, can enhance the acute glycemic benefits of HIIT. There is also some evidence of sex-based differences in the glycemic benefits of intense interval exercise, with blunted responses observed after training in females relative to males. Differences in skeletal muscle metabolism between males and females may contribute to sex differences in insulin sensitivity following HIIT/SIT, but well-controlled studies evaluating purported muscle mechanisms alongside measurement of insulin sensitivity are needed. Given the greater representation of males in muscle physiology literature, there is also a need for more research involving female-only cohorts to enhance our basic understanding of how intense interval training influences muscle insulin sensitivity in females across the lifespan.

Structural functionality of skeletal muscle mitochondria and its correlation with metabolic diseases

The skeletal muscle is one of the largest organs in the mammalian body. Its remarkable ability to swiftly shift its substrate selection allows other organs like the brain to choose their preferred substrate first. Healthy skeletal muscle has a high level of metabolic flexibility, which is reduced in several metabolic diseases, including obesity and Type 2 diabetes (T2D). Skeletal muscle health is highly dependent on optimally functioning mitochondria that exist in a highly integrated network with the sarcoplasmic reticulum and sarcolemma. The three major mitochondrial processes: biogenesis, dynamics, and mitophagy, taken together, determine the quality of the mitochondrial network in the muscle. Since muscle health is primarily dependent on mitochondrial status, the mitochondrial processes are very tightly regulated in the skeletal muscle via transcription factors like peroxisome proliferator-activated receptor-γ coactivator-1α, peroxisome proliferator-activated receptors, estrogen-related receptors, nuclear respiratory factor, and Transcription factor A, mitochondrial. Physiological stimuli that enhance muscle energy expenditure, like cold and exercise, also promote a healthy mitochondrial phenotype and muscle health. In contrast, conditions like metabolic disorders, muscle dystrophies, and aging impair the mitochondrial phenotype, which is associated with poor muscle health. Further, exercise training is known to improve muscle health in aged individuals or during the early stages of metabolic disorders. This might suggest that conditions enhancing mitochondrial health can promote muscle health. Therefore, in this review, we take a critical overview of current knowledge about skeletal muscle mitochondria and the regulation of their quality. Also, we have discussed the molecular derailments that happen during various pathophysiological conditions and whether it is an effect or a cause.

Systematic Review and Meta-Analysis of Circulating Irisin Levels Following Endurance Training: Results of Continuous and Interval Training

Background

Irisin has been suggested as a helpful hormone for adverse metabolic conditions. However, the interaction between acute endurance exercises and irisin is still unclear. The purpose of this systematic review and meta-analysis was to determine the acute effect of endurance training, either continuous or interval training, on circulating irisin in healthy adults.

Methods

Literature search was conducted in Web of Science, PubMed, Scopus and CINAHL until September 2022. Clinical trials measuring irisin levels following a single session of interval or continuous endurance training in healthy adults were eligible. Cohen’s d effect size (95% confidence level), subgroup analyses and univariate meta-regression were calculated using a random-effects model. The procedures described by PRISMA were followed and the protocol was prospectively registered with PROSPERO (CRD 42021240971).

Results

Data of the 16 included studies comprising 412 individuals showed a significant increase following one session of continuous endurance training (d = 0.33, 95% CI: 0.20 to 0.46 , p < 0.001), while interval training did not change circulating irisin (d = 0.16, 95% CI: −0.12 to 0.44 , p = 0.202). Both subgroup and univariate meta-regression analyses showed non-significant differences in the change of circulating irisin comparing blood measurement, exercise mode or previous level of physical activity of the participants and circulating irisin at baseline, duration, or intensity of the exercise, respectively.

Conclusion

Continuous method for endurance training increases circulating irisin in healthy adults, while studies measuring circulating irisin following interval training in healthy adults are still limited to be conclusive.

Effects of two workload-matched high intensity interval training protocols on regulatory factors associated with mitochondrial biogenesis in the soleus muscle of diabetic rats

Aims: High intensity interval training (HIIT) improves mitochondrial characteristics. This study compared the impact of two workload-matched high intensity interval training (HIIT) protocols with different work:recovery ratios on regulatory factors related to mitochondrial biogenesis in the soleus muscle of diabetic rats.

Materials and methods: Twenty-four Wistar rats were randomly divided into four equal-sized groups: non-diabetic control, diabetic control (DC), diabetic with long recovery exercise [4–5 × 2-min running at 80%–90% of the maximum speed reached with 2-min of recovery at 40% of the maximum speed reached (DHIIT1:1)], and diabetic with short recovery exercise (5–6 × 2-min running at 80%–90% of the maximum speed reached with 1-min of recovery at 30% of the maximum speed reached [DHIIT2:1]). Both HIIT protocols were completed five times/week for 4 weeks while maintaining equal running distances in each session.

Results: Gene and protein expressions of PGC-1α, p53, and citrate synthase of the muscles increased significantly following DHIIT1:1 and DHIIT2:1 compared to DC (p ˂ 0.05). Most parameters, except for PGC-1α protein (p = 0.597), were significantly higher in DHIIT2:1 than in DHIIT1:1 (p ˂ 0.05). Both DHIIT groups showed significant increases in maximum speed with larger increases in DHIIT2:1 compared with DHIIT1:1.

Conclusion: Our findings indicate that both HIIT protocols can potently up-regulate gene and protein expression of PGC-1α, p53, and CS. However, DHIIT2:1 has superior effects compared with DHIIT1:1 in improving mitochondrial adaptive responses in diabetic rats.

Fast regulation of the NF-κB signalling pathway in human skeletal muscle revealed by high-intensity exercise and ischaemia at exhaustion: Role of oxygenation and metabolite accumulation

The NF-κB signalling pathway plays a critical role in inflammation, immunity, cell proliferation, apoptosis, and muscle metabolism. NF-κB is activated by extracellular signals and intracellular changes in Ca2+, Pi, H+, metabolites and reactive oxygen and nitrogen species (RONS). However, it remains unknown how NF-κB signalling is activated during exercise and how metabolite accumulation and PO2 influence this process. Eleven active men performed incremental exercise to exhaustion (IE) in normoxia and hypoxia (PIO2:73 mmHg). Immediately after IE, the circulation of one leg was instantaneously occluded (300 mmHg). Muscle biopsies from m. vastus lateralis were taken before (Pre), and 10s (Post, occluded leg) and 60s after exercise from the occluded (Oc1m) and free circulation (FC1m) legs simultaneously together with femoral vein blood samples. NF-κB signalling was activated by exercise to exhaustion, with similar responses in normoxia and acute hypoxia, as reflected by the increase of p105, p50, IKKα, IκBβ and glutathione reductase (GR) protein levels, and the activation of the main kinases implicated, particularly IKKα and CaMKII δD, while IKKβ remained unchanged. Postexercise ischaemia maintained and stimulated further NF-κB signalling by impeding muscle reoxygenation. These changes were quickly reverted at the end of exercise when the muscles recovered with open circulation. Finally, we have shown that Thioredoxin 1 (Trx1) protein expression was reduced immediately after IE and after 1 min of occlusion while the protein expression levels of glutathione peroxidase 1 (Gpx1) and thioredoxin reductase 1 (TrxR1) remained unchanged. These novel data demonstrate that exercising to exhaustion activates NF-κB signalling in human skeletal muscle and regulates the expression levels of antioxidant enzymes in human skeletal muscle. The fast regulation of NF-κB at exercise cessation has implications for the interpretation of published studies and the design of new experiments.

Effects of high-intensity interval training with hyperbaric oxygen

Hyperbaric Oxygen (HBO₂) has been proposed as a pre-conditioning method to enhance exercise performance. Most prior studies testing this effect have been limited by inadequate methodologies. Its potential efficacy and mechanism of action remain unknown. We hypothesized that HBO₂ could enhance aerobic capacity by inducing mitochondrial biogenesis via redox signaling in skeletal muscle. HBO₂ was administered in combination with high-intensity interval training (HIIT), a potent redox stimulus known to induce mitochondrial biogenesis. Aerobic capacity was tested during acute hypobaric hypoxia seeking to shift the limiting site of whole body V̇O2 from convection to diffusion, more closely isolating any effect of improved oxidative capacity. Healthy volunteers were screened with sea-level (SL) V̇O₂peak testing. Seventeen subjects were enrolled (10 men, 7 women, ages 26.5±1.3 years, BMI 24.6±0.6 kg m⁻², V̇O₂peak SL = 43.4±2.1). Each completed 6 HIIT sessions over 2 weeks randomized to breathing normobaric air, “HIIT+Air” (PiO₂ = 0.21 ATM) or HBO₂ (PiO₂ = 1.4 ATM) during training, “HIIT+HBO₂” group. Training workloads were individualized based on V̇O₂peak SL test. Vastus Lateralis (VL) muscle biopsies were performed before and after HIIT in both groups. Baseline and post-training V̇O₂peak tests were conducted in a hypobaric chamber at PiO2 = 0.12 ATM. HIIT significantly increased V̇O₂peak in both groups: HIIT+HBO₂ 31.4±1.5 to 35.2±1.2 ml kg⁻¹·min⁻¹ and HIIT+Air 29.0±3.1 to 33.2±2.5 ml kg⁻¹·min⁻¹ (p = 0.005) without an additional effect of HBO₂ (p = 0.9 for interaction of HIIT x HBO₂). Subjects randomized to HIIT+HBO₂ displayed higher skeletal muscle mRNA levels of PPARGC1A, a regulator of mitochondrial biogenesis, and HK2 and SLC2A4, regulators of glucose utilization and storage. All other tested markers of mitochondrial biogenesis showed no additional effect of HBO₂ to HIIT. When combined with HIIT, short-term modest HBO₂ (1.4 ATA) has does not increase whole-body V̇O₂peak during acute hypobaric hypoxia. (ClinicalTrials.gov Identifier: NCT02356900; https://clinicaltrials.gov/ct2/show/NCT02356900).

The effect of high-intensity interval training (HIIT) on protein expression in Flexor Hallucis Longus (FHL) and soleus (SOL) in rats with type 2 diabetes

Purpose

In people with diabetes, one of the problems for patients is muscle wasting and inhibition of the protein synthesis pathway. This study aimed to evaluate the effects of HIIT on protein expression in two skeletal muscles, flexor hallucis longus (FHL) and soleus (SOL) in rats with type 2 diabetes mellitus (T2DM).

Materials and methods

Diabetes initially was induced by streptozotocin (STZ) and nicotinamide. Rats with type 2 diabetes were randomly and equally divided into control (n = 6) and HIIT groups (n = 6). After 8 weeks of training, the content of total and phosphorylated proteins of serine/threonine-protein kinases (AKT1), mammalian target of rapamycin (mTOR), P70 ribosomal protein S6 kinase 1 (P70S6K1), and 4E (eIF4E)-binding protein 1 (4E-BP1) in FHL and SOL muscles were measured by Western blotting. While body weight and blood glucose were also controlled.

Results

In the HIIT training group, compared to the control group, a significant increase in the content of AKT1 (0.003) and mTOR (0.001) proteins was observed in the FHL muscle. Also, after 8 weeks of HIIT training, protein 4E-BP1 (0.001) was increased in SOL muscle. However, there was no significant change in other proteins in FHL and SOL muscle.

Conclusions

In rats with type 2 diabetes appear to HIIT leading to more protein expression of fast-twitch muscles than slow-twitch muscles. thus likely HIIT exercises can be an important approach to increase protein synthesis and prevent muscle atrophy in people with type 2 diabetes.

'Fit for surgery': The relationship between cardiorespiratory fitness and postoperative outcomes

New Findings

What is the topic of this review?

The relationships and physiological mechanisms underlying the clinical benefits of cardiorespiratory fitness (CRF) in patients undergoing major intra‐abdominal surgery.

What advances does it highlight?

Elevated CRF reduces postoperative morbidity/mortality, thus highlighting the importance of CRF as an independent risk factor. The vascular protection afforded by exercise prehabilitation can further improve surgical risk stratification and postoperative outcomes.

Abstract

Surgery accounts for 7.7% of all deaths globally and the number of procedures is increasing annually. A patient's ‘fitness for surgery’ describes the ability to tolerate a physiological insult, fundamental to risk assessment and care planning. We have evolved as obligate aerobes that rely on oxygen (O₂). Systemic O₂ consumption can be measured via cardiopulmonary exercise testing (CPET) providing objective metrics of cardiorespiratory fitness (CRF). Impaired CRF is an independent risk factor for mortality and morbidity. The perioperative period is associated with increased O₂ demand, which if not met leads to O₂ deficit, the magnitude and duration of which dictates organ failure and ultimately death. CRF is by far the greatest modifiable risk factor, and optimal exercise interventions are currently under investigation in patient prehabilitation programmes. However, current practice demonstrates potential for up to 60% of patients, who undergo preoperative CPET, to have their fitness incorrectly stratified. To optimise this work we must improve the detection of CRF and reduce potential for interpretive error that may misinform risk classification and subsequent patient care, better quantify risk by expressing the power of CRF to predict mortality and morbidity compared to traditional cardiovascular risk factors, and improve patient interventions with the capacity to further enhance vascular adaptation. Thus, a better understanding of CRF, used to determine fitness for surgery, will enable both clinicians and exercise physiologists to further refine patient care and management to improve survival.

Time course and fibre type-dependent nature of calcium-handling protein responses to sprint interval exercise in human skeletal muscle

KEY POINTS

Sprint interval training (SIT) has been shown to cause fragmentation of the sarcoplasmic reticulum calcium-release channel, ryanodine receptor 1 (RyR1) 24 hours post-exercise, which may act as a signal for mitochondrial biogenesis. In this study, we examined the time course of RyR1 fragmentation in human whole muscle and pooled type I and type II skeletal muscle fibres following a single session of SIT. Full-length RyR1 protein content was significantly lower than pre-exercise by 6 h post-SIT in whole muscle, and fragmentation was detectable in type II but not type I fibres, though to a lesser extent than in whole muscle. The peak in PGC1A mRNA expression occurred earlier than RyR1 fragmentation. The increased temporal resolution and fibre type-specific responses for RyR1 fragmentation provide insights into its importance to mitochondrial biogenesis in humans.

ABSTRACT

Sprint interval training (SIT) causes fragmentation of the skeletal muscle sarcoplasmic reticulum Ca²⁺ release channel, ryanodine receptor 1 (RyR1), 24h post-exercise, potentially signaling mitochondrial biogenesis by increasing cytosolic [Ca²⁺ ]. Yet, the time course and skeletal muscle fibre type-specific patterns of RyR1 fragmentation following a session of SIT remain unknown. Ten participants (n = 4 females; n = 6 males) performed a session of SIT (6 × 30 s "all-out" with 4.5 min rest after each sprint) with vastus lateralis muscle biopsy samples collected before and 3, 6, and 24h after exercise. In whole muscle, full-length RyR1 protein content was significantly reduced 6 h (mean [SD]; -38 [38]%; p<0.05) and 24 h post-SIT (-30 [48]%; p<0.05) compared to pre-exercise. Examining each participant's largest response in pooled samples, full-length RyR1 protein content was reduced in type II (-26 [30]%; p<0.05) but not type I fibres (-11 [40]%; p>0.05). 3h post-SIT, there was also a decrease in SERCA1 in type II fibres (-23 [17]%; p<0.05) and SERCA2a in type I fibres (-19 [21]%; p<0.05), despite no time effect for either protein in whole muscle samples (p>0.05). PGC1A mRNA content was elevated 3h and 6h post-SIT (5.3- and 3.7-fold change from pre, respectively; p<0.05 for both), but peak PGC1A mRNA expression was not significantly correlated with peak RyR1 fragmentation (r² = 0.10; p>0.05). In summary, altered Ca²⁺ -handling protein expression, which occurs primarily in type II muscle fibres, may influence signals for mitochondrial biogenesis as early as 3-6 h post-SIT in humans. Abstract figure legend Western blotting was performed on whole muscle and pooled type I and II muscle fibre preparations derived from human vastus lateralis muscle biopsy samples collected before and after a single session of sprint interval training (SIT). Full-length ryanodine receptor 1 (RyR1) protein content was reduced 6 and 24 h post-exercise in whole muscle samples compared to baseline, despite a heterogeneous time course among individuals. This RyR1 fragmentation proceeded and outlasted the increase in peroxisome proliferator-activated γ receptor coactivator 1α (PGC1A) mRNA expression. When examining the time point of each individual's peak response, RyR1 fragmentation was evident in type II, but not type I, muscle fibres. These findings suggest that, in humans, mitochondrial biogenesis could be influenced by RyR1 fragmentation 3-6 h post-SIT in a fibre type-dependent manner. Created with BioRender.com. This article is protected by copyright. All rights reserved.

High Intensity Interval Training: A Potential Method for Treating Sarcopenia

Sarcopenia, an age-related disease characterized by loss of muscle strength and muscle mass, has attracted the attention of medical experts due to its severe morbidity, low living quality, high expenditure of health care, and mortality. Traditionally, persistent aerobic exercise (PAE) is considered as a valid way to attenuate muscular atrophy. However, nowadays, high intensity interval training (HIIT) has emerged as a more effective and time-efficient method to replace traditional exercise modes. HIIT displays comprehensive effects on exercise capacity and skeletal muscle metabolism, and it provides a time-out for the recovery of cardiopulmonary and muscular functions without causing severe adverse effects. Studies demonstrated that compared with PAE, HIIT showed similar or even higher effects in improving muscle strength, enhancing physical performances and increasing muscle mass of elder people. Therefore, HIIT might become a promising way to cope with the age-related loss of muscle mass and muscle function. However, it is worth mentioning that no study of HIIT was conducted directly on sarcopenia patients, which is attributed to the suspicious of safety and validity. In this review, we will assess the effects of different training parameters on muscle and sarcopenia, summarize previous papers which compared the effects of HIIT and PAE in improving muscle quality and function, and evaluate the potential of HIIT to replace the status of PAE in treating old people with muscle atrophy and low modality; and point out drawbacks of temporary experiments. Our aim is to discuss the feasibility of HIIT to treat sarcopenia and provide a reference for clinical scientists who want to utilize HIIT as a new way to cope with sarcopenia.

Exercise Snacks: A Novel Strategy to Improve Cardiometabolic Health

We define exercise snacks as isolated ≤1-min bouts of vigorous exercise performed periodically throughout the day. We hypothesize that exercise snacks are a feasible, well-tolerated, and time-efficient approach to improve cardiorespiratory fitness and reduce the negative impact of sedentary behavior on cardiometabolic health. Efficacy has been demonstrated in small proof-of-concept studies. Additional research should investigate this novel physical activity strategy.

Bioelectrical Impedance Vector Analysis of Young Elite Team Handball Players

Team handball is a highly dynamic sport where physical demands differ between categories and roles. Thus, physical characteristics are fundamental for the final performance. This study aims to (a) characterize a sample of young male and female elite team handball players with a non-athletic reference population; (b) to generate their 50%, 75%, and 95% percentiles of the bioelectrical variables. The study included 55 young elite team handball players (Males, n = 37, age = 17.0 ± 1.2 yrs, height = 185.8 ± 7.3 cm, weight = 82.0 ± 11.0 kg, body mass index (BMI) = 23.7 ± 2.5; Females, n = 18, age = 17.8 ± 0.9 yrs, height = 171.2 ± 6.4 cm, weight = 67.4 ± 7.2 kg, BMI = 23.0 ± 2.0). Height and bioelectrical variables were assessed in a state of euhydration and standard conditions. Bioelectrical impedance vector analysis (BIVA) was used to characterize the bioelectrical vector (BIA vector) distribution pattern for each group. Compared to the reference values, BIA vector showed statistically significant differences in males U17 (n = 19, T2 = 51.0, p < 0.0001), males U19 (n = 18, T2 = 82.0, p < 0.0001) and females U19 (n = 18, T2 = 85.8, p < 0.0001). Male groups were also bioelectrically different (T2 = 13.7, p = 0.0036). BIVA showed specific bioelectrical characteristics in young male and female elite handball players. This study provides an original data set of bioelectrical impedance reference values of young male and female elite team handball players. Our result might help to interpret individual bioimpedance vectors and define target regions for young handball players.

Factors Influencing AMPK Activation During Cycling Exercise: A Pooled Analysis and Meta-Regression

BACKGROUND

The 5' adenosine monophosphate (AMP)-activated protein kinase (AMPK) is a cellular energy sensor that is activated by increases in the cellular AMP/adenosine diphosphate:adenosine triphosphate (ADP:ATP) ratios and plays a key role in metabolic adaptations to endurance training. The degree of AMPK activation during exercise can be influenced by many factors that impact on cellular energetics, including exercise intensity, exercise duration, muscle glycogen, fitness level, and nutrient availability. However, the relative importance of these factors for inducing AMPK activation remains unclear, and robust relationships between exercise-related variables and indices of AMPK activation have not been established.

OBJECTIVES

The purpose of this analysis was to (1) investigate correlations between factors influencing AMPK activation and the magnitude of change in AMPK activity during cycling exercise, (2) investigate correlations between commonly reported measures of AMPK activation (AMPK-α2 activity, phosphorylated (p)-AMPK, and p-acetyl coenzyme A carboxylase (p-ACC), and (3) formulate linear regression models to determine the most important factors for AMPK activation during exercise.

METHODS

Data were pooled from 89 studies, including 982 participants (93.8% male, maximal oxygen consumption [[Formula: see text]] 51.9 ± 7.8 mL kg^-1 min^-1). Pearson's correlation analysis was performed to determine relationships between effect sizes for each of the primary outcome markers (AMPK-α2 activity, p-AMPK, p-ACC) and factors purported to influence AMPK signaling (muscle glycogen, carbohydrate ingestion, exercise duration and intensity, fitness level, and muscle metabolites). General linear mixed-effect models were used to examine which factors influenced AMPK activation.

RESULTS

Significant correlations (r = 0.19-0.55, p < .05) with AMPK activity were found between end-exercise muscle glycogen, exercise intensity, and muscle metabolites phosphocreatine, creatine, and free ADP. All markers of AMPK activation were significantly correlated, with the strongest relationship between AMPK-α2 activity and p-AMPK (r = 0.56, p < 0.001). The most important predictors of AMPK activation were the muscle metabolites and exercise intensity.

CONCLUSION

Muscle glycogen, fitness level, exercise intensity, and exercise duration each influence AMPK activity during exercise when all other factors are held constant. However, disrupting cellular energy charge is the most influential factor for AMPK activation during endurance exercise.

FTO-mediated demethylation of GADD45B promotes myogenesis through the activation of p38 MAPK pathway

N6-methyladenosine (m⁶A) modification plays a critical role in mammalian development. However, the role of m⁶A in the skeletal muscle development remains largely unknown. Here, we report a global m⁶A modification pattern of goat skeletal muscle at two key development stages and identified that the m⁶A modification regulated the expression of the growth arrest and DNA damage-inducible 45B (GADD45B) gene, which is involved in myogenic differentiation. We showed that GADD45B expression increased during myoblast differentiation, whereas the downregulation of GADD45B inhibits myogenic differentiation and mitochondrial biogenesis. Moreover, the expression of GADD45B regulates the expression of myogenic regulatory factors and peroxisome proliferator-activated receptor gamma coactivator 1 alpha by activating the p38 mitogen-activated protein kinase (MAPK) pathway. Conversely, the inactivation of p38 MAPK abolished the GADD45B-mediated myogenic differentiation. Furthermore, we found that the knockdown of fat mass and obesity-associated protein (FTO) increases GADD45B m⁶A modification and decreases the stability of GADD45B mRNA, which impairs myogenic differentiation. Our results indicate that the FTO-mediated m⁶A modification in GADD45B mRNA drives skeletal muscle differentiation by activating the p38 MAPK pathway, which provides a molecular mechanism for the regulation of myogenesis via RNA methylation.

Effects of High-Intensity Interval Training and Moderate-Intensity Continuous Training on Cardiometabolic Risk Factors in Overweight and Obesity Children and Adolescents: A Meta-Analysis of Randomized Controlled Trials

Background: The purpose of this review was to compare the effectiveness of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on cardiometabolic risk factors of obese children and adolescents. Methods: Relevant studies published in PubMed, MEDLINE and Web of Science databases were searched. Only randomized controlled trials (RCTs) that examined the effect of HIIT and MICT on children and adolescents with obesity were included. Meta-analyses were conducted to determine the effect of HIIT on cardiometabolic risk factors using STATA software and potential moderators were explored (i.e., study duration, training modalities, work/rest ratio and work duration time). Results: Twelve RCTs involving 325 participants were included in the meta-analysis. HIIT showed more positive effects on maximal oxygen uptake (VO_2max; SMD = 0.87, 95% CI: 0.39 to 1.35, p = 0.000) and systolic blood pressure (SBP; SMD = −0.64, 95% CI: −1.05 to −0.22, p = 0.003) than MICT. However, when compared with MICT, HIIT caused no significant differences in body weight, body mass index, body fat percentage, diastolic blood pressure and glycolipid metabolism markers. Furthermore, subgroup analysis showed that the effects of HIIT on VO_2max and SBP were significantly different regarding protocol factors, such as modality, duration, training time, training settings, work/rest ratio and work duration. Conclusions: HIIT has a positive role in promoting cardiometabolic risk factors in obese children and adolescents. Moreover, when compared with MICT, HIIT had a more significant effect on improving cardiorespiratory fitness and systolic blood pressure. The factors of HIIT protocol had an important influence on the intervention effects of childhood obesity.

The Prediction of Running Velocity during the 30-15 Intermittent Fitness Test Using Accelerometry-Derived Metrics and Physiological Parameters: A Machine Learning Approach

Measuring exercise variables is one of the most important points to consider to maximize physiological adaptations. High-intensity interval training (HIIT) is a useful method to improve both cardiovascular and neuromuscular performance. The 30–15_IFT is a field test reflecting the effort elicited by HIIT, and the final velocity reached in the test is used to set the intensity of HIIT during the training session. In order to have a valid measure of the velocity during training, devices such as GPS can be used. However, in several situations (e.g., indoor setting), such devices do not provide reliable measures. The aim of the study was to predict exact running velocity during the 30–15_IFT using accelerometry-derived metrics (i.e., Player Load and Average Net Force) and heart rate (HR) through a machine learning (ML) approach (i.e., Support Vector Machine) with a leave-one-subject-out cross-validation. The SVM approach showed the highest performance to predict running velocity (r = 0.91) when compared to univariate approaches using PL (r = 0.62), AvNetForce (r = 0.73) and HR only (r = 0.87). In conclusion, the presented multivariate ML approach is able to predict running velocity better than univariate ones, and the model is generalizable across subjects.

Skeletal Muscle Ribosome and Mitochondrial Biogenesis in Response to Different Exercise Training Modalities

Skeletal muscle adaptations to resistance and endurance training include increased ribosome and mitochondrial biogenesis, respectively. Such adaptations are believed to contribute to the notable increases in hypertrophy and aerobic capacity observed with each exercise mode. Data from multiple studies suggest the existence of a competition between ribosome and mitochondrial biogenesis, in which the first adaptation is prioritized with resistance training while the latter is prioritized with endurance training. In addition, reports have shown an interference effect when both exercise modes are performed concurrently. This prioritization/interference may be due to the interplay between the 5’ AMP-activated protein kinase (AMPK) and mechanistic target of rapamycin complex 1 (mTORC1) signaling cascades and/or the high skeletal muscle energy requirements for the synthesis and maintenance of cellular organelles. Negative associations between ribosomal DNA and mitochondrial DNA copy number in human blood cells also provide evidence of potential competition in skeletal muscle. However, several lines of evidence suggest that ribosome and mitochondrial biogenesis can occur simultaneously in response to different types of exercise and that the AMPK-mTORC1 interaction is more complex than initially thought. The purpose of this review is to provide in-depth discussions of these topics. We discuss whether a curious competition between mitochondrial and ribosome biogenesis exists and show the available evidence both in favor and against it. Finally, we provide future research avenues in this area of exercise physiology.

A Narrative Review on the Role of AMPK on De Novo Lipogenesis in Non-Alcoholic Fatty Liver Disease: Evidence from Human Studies

5′AMP-activated protein kinase (AMPK) is known as metabolic sensor in mammalian cells that becomes activated by an increasing adenosine monophosphate (AMP)/adenosine triphosphate (ATP) ratio. The heterotrimeric AMPK protein comprises three subunits, each of which has multiple phosphorylation sites, playing an important role in the regulation of essential molecular pathways. By phosphorylation of downstream proteins and modulation of gene transcription AMPK functions as a master switch of energy homeostasis in tissues with high metabolic turnover, such as the liver, skeletal muscle, and adipose tissue. Regulation of AMPK under conditions of chronic caloric oversupply emerged as substantial research target to get deeper insight into the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Evidence supporting the role of AMPK in NAFLD is mainly derived from preclinical cell culture and animal studies. Dysbalanced de novo lipogenesis has been identified as one of the key processes in NAFLD pathogenesis. Thus, the scope of this review is to provide an integrative overview of evidence, in particular from clinical studies and human samples, on the role of AMPK in the regulation of primarily de novo lipogenesis in human NAFLD.

Acute effects of high-intensity interval training and moderate-intensity continuous exercise on BDNF and irisin levels and neurocognitive performance in late middle-aged and older adults

The purposes of the present study were (1) to explore and compare the acute effects of high-intensity interval training (HIIT) and moderate-intensity continuous exercise (MICE) on neurocognitive performance and molecular biomarkers in late middle-aged and older adults, and (2) to examine the relationships of HIIT/MICE exercise-induced neurocognitive changes with changes in circulating irisin and BDNF levels elicited by different acute exercise modes. Using a within-subject design, twenty-one participants completed an acute bout of 30 min of HIIT, MICE, or a non-exercise-intervention (REST) session in a counterbalanced order. The neuropsychological [i.e., accuracy rate (AR) and reaction time (RT)] and neurophysiological [i.e., event-related potential (ERP) P3 latency and amplitude] indices were simultaneously measured when the participants performed a working memory task at baseline and after an intervention mode. Blood samples were also taken before and after the intervention mode. The results showed that, although ARs were significantly increased only via the MICE intervention mode, the acute HIIT and MICE interventions improved RT performance and increased ERP P3 amplitudes in the late middle-aged and older adults under consideration. Serum BDNF levels were significantly increased with the acute HIIT and MICE interventions, and significant irisin level increases were only observed following the HIIT intervention. However, changes in the levels of Irisin and BDNF pre- and post-intervention were not correlated with changes in neurocognitive performance, with the exception of the correlation between the changes in irisin levels and RTs with acute exercise in the MICE intervention mode. The present findings suggested similar beneficial effects on neurocognitive performance (i.e., RTs and ERP P3 amplitudes) and peripheral BDNF levels following MICE and HIIT interventions in the middle-aged and older adults. In terms of ARs and irisin, the two acute exercise modes appear to induce divergent effects. Irisin may play a potential facilitating role in the neuropsychological (e.g., RT) performance of working memory in such a group. However, the mechanisms remain to be determined.

α-Hydroxyisocaproic Acid Decreases Protein Synthesis but Attenuates TNFα/IFNγ Co-Exposure-Induced Protein Degradation and Myotube Atrophy via Suppression of iNOS and IL-6 in Murine C2C12 Myotube

There is ongoing debate as to whether or not α-hydroxyisocaproic acid (HICA) positively regulates skeletal muscle protein synthesis resulting in the gain or maintenance of skeletal muscle. We investigated the effects of HICA on mouse C2C12 myotubes under normal conditions and during cachexia induced by co-exposure to TNFα and IFNγ. The phosphorylation of AMPK or ERK1/2 was significantly altered 30 min after HICA treatment under normal conditions. The basal protein synthesis rates measured by a deuterium-labeling method were significantly lowered by the HICA treatment under normal and cachexic conditions. Conversely, myotube atrophy induced by TNFα/IFNγ co-exposure was significantly improved by the HICA pretreatment, and this improvement was accompanied by the inhibition of iNOS expression and IL-6 production. Moreover, HICA also suppressed the TNFα/IFNγ co-exposure-induced secretion of 3-methylhistidine. These results demonstrated that HICA decreases basal protein synthesis under normal or cachexic conditions; however, HICA might attenuate skeletal muscle atrophy via maintaining a low level of protein degradation under cachexic conditions.

Exercise and health: historical perspectives and new insights

Since ancient times, the health benefits of regular physical activity/exercise have been recognized and the classic studies of Morris and Paffenbarger provided the epidemiological evidence in support of such an association. Cardiorespiratory fitness, often measured by maximal oxygen uptake, and habitual physical activity levels are inversely related to mortality. Thus, studies exploring the biological bases of the health benefits of exercise have largely focused on the cardiovascular system and skeletal muscle (mass and metabolism), although there is increasing evidence that multiple tissues and organ systems are influenced by regular exercise. Communication between contracting skeletal muscle and multiple organs has been implicated in exercise benefits, as indeed has other interorgan "cross-talk." The application of molecular biology techniques and "omics" approaches to questions in exercise biology has opened new lines of investigation to better understand the beneficial effects of exercise and, in so doing, inform the optimization of exercise regimens and the identification of novel therapeutic strategies to enhance health and well-being.

Swimming Exercise Promotes Post-injury Axon Regeneration and Functional Restoration through AMPK

Restoration of lost function following a nervous system injury is limited in adulthood as the regenerative capacity of nervous system declines with age. Pharmacological approaches have not been very successful in alleviating the consequences of nervous system injury. On the contrary, physical activity and rehabilitation interventions are often beneficial to improve the health conditions in the patients with neuronal injuries. Using touch neuron circuit of Caenorhabditis elegans, we investigated the role of physical exercise in the improvement of functional restoration after axotomy. We found that a swimming session of 90 min following the axotomy of posterior lateral microtubule (PLM) neuron can improve functional recovery in larval and adult stage animals. In older age, multiple exercise sessions were required to enhance the functional recovery. Genetic analysis of axon regeneration mutants showed that exercise-mediated enhancement of functional recovery depends on the ability of axon to regenerate. Exercise promotes early initiation of regrowth, self-fusion of proximal and distal ends, as well as postregrowth enhancement of function. We further found that the swimming exercise promotes axon regeneration through the activity of cellular energy sensor AAK-2/AMPK in both muscle and neuron. Our study established a paradigm where systemic effects of exercise on functional regeneration could be addressed at the single neuron level.

Treatment with sera from Water Polo athletes activates AMPKα and ACC proteins In HepG2 hepatoma cell line

Purpose

Physical activity and professional physical activity such as water polo (WP) sport, has numerous beneficial effects to fight metabolism-related disorders through several mechanisms, including the promotion of liver metabolic adaptations, and the modulation of cytokine production. The aim of this study was to investigate the effects of different types of physical activity on AMPKα and ACC, two proteins involved in liver metabolism; therefore, we treated the hepatoma cell line Hep G2 with sera from elite WP athletes and amateur (basket) players. As control, we used serum from both sedentary and obese subjects.

Methods

Help G2 cells were treated with 5% of human sera from the different subjects; after 24 h and 48 h, HepG2 cell viability was verified through MTT assay and activation status of AMPKα and ACC through western blotting. Cytokine’s serum levels were measured through ELISA assay.

Results

After 72 h, the treatment of HepG2 cells with sera from the different subjects produced no effect on cell viability. Furthermore, after 48 h of treatment, both AMPKα and ACC phosphorylation statistically increases in HepG2 cells treated with sera from WP athletes. Furthermore, IL-4, IL-6 and IL-10 levels resulted statistically increased in WP athlete’s sera than in sedentary subjects.

Conclusion

The specific activation of AMPKα and ACC by WP sera confirms that professional sport activity carried out by WP athletes can be considered as a physiological activator of these two proteins also in HepG2 liver cells. In addition, the increase of anti-inflammatory cytokines in WP sera confirms the ample evidence for multiple anti-inflammatory activities carried out by WP discipline.

High-intensity exercise training improves perioperative risk stratification in the high-risk patient

Exercise prehabilitation prior to major surgery can improve cardiorespiratory fitness (CRF) and clinical outcome. However, in patients deemed “high‐‐risk” for surgery, the feasibility, optimum training modality and its intensity, duration, and frequency are yet to be defined. We assessed the cardiorespiratory fitness of a 70‐year‐old female patient requiring major thoraco‐abdominal surgery for reconstruction of her esophagus. Cardiopulmonary exercise testing (CPET) on a cycle ergometer was used to determine CRF. A baseline CPET confirmed poor CRF and placed her in a high surgical risk group. This was followed by 16 weeks of unsupervised, home‐based, moderate‐intensity steady‐state (MISS) training followed by 10 weeks of high‐intensity interval training (HIIT) under the combined supervision of an exercise physiologist and clinician in hospital. Following MISS training, CPET metrics failed to improve: peak oxygen uptake decreased (14.7–13.7 ml O₂·kg⁻¹·min⁻¹; −7%) together with peak power (73–70 W; −4%) and anaerobic threshold (AT) increased (7.8–8.3 ml O₂·kg⁻¹·min⁻¹; +6%). However, HIIT resulted in impressive improvement in CRF. Peak oxygen uptake (13.7–18.6 ml O₂·kg⁻¹·min⁻¹; +36%), AT (8.3–10.5 ml O₂·kg⁻¹·min⁻¹; +27%), peak power (70–102 W; +46%), minute ventilation (35.8–57.7 L·min⁻¹; +61%), and peak heart rate (100–133 b·min⁻¹; +33%) all increased. Ventilatory equivalents for carbon dioxide at AT (V˙E/V˙CO₂‐AT) improved (30–28; −7%). The improvement in CRF resulted in surgical reclassification from high to low risk. In conclusion, preoperative HIIT training can confer a marked improvement in CRF in an elderly surgical patient and is associated with a corresponding reduction in perioperative risk.

Effect of high-intensity interval training on cardiometabolic risk factors in childhood obesity: a meta-analysis

INTRODUCTION

This systematic review with meta-analysis aimed to quantify the effectiveness of high-intensity interval training (HIIT) on the cardiometabolic health of obese children and adolescents.

EVIDENCE ACQUISITION

Relevant articles were sourced from PubMed, Embase, the Web of Science, EBSCO, the Cochrane Library and China National Knowledge Infrastructure (CNKI). Randomized controlled trials were included if they employed participants aged 7-19 years. Outcomes included fasting glucose (FG), fasting insulin (FI), homeostasis model assessment-insulin resistance (HOMA-IR), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), triacylglycerol (TG), total cholesterol (TC), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at baseline and postintervention and compared with those in the control group. Data analysis and synthesis were completed by Revman 5.3 software and Stata 12.0 software (StataCorp LLC., College Station, TX, USA).

EVIDENCE SYNTHESIS

Eight trials involving 379 participants were identified. HIIT significantly decreased the FI, HOMA-IR, TC, TG, LDL-c and SBP in participants with obesity. With regard to changes in blood glucose and lipids, participants who underwent HIIT showed great improvement in FI (mean difference: -3.09 µU/mL, 95% confidence interval [CI] -3.71 to -2.46, P<0.0001), HOMA-IR (mean difference: -0.64, 95% CI -0.82 to -0.46, P<0.0001), TG (mean difference: -0.21 mmol/L, 95% CI -0.31 to -0.10, P<0.0001) and LDL-c (mean difference: -0.35 mmol/L, 95% CI -0.48 to -0.22, P<0.001) than the control group. Similar results were found for SBP (mean difference: -3.61 mmHg, 95% CI -5.85 to -1.37, P=0.002). However, no significant differences in changes in FG, HDL-c and DBP were observed between HIIT and control groups.

CONCLUSIONS

HIIT can produce a positive effect on cardiometabolic risk factors in obese children and adolescents. HIIT may be an alternative and effective training method for managing childhood obesity.

Interval-induced metabolic perturbation determines tissue fluid shifts into skeletal muscle

Intense interval exercise has proven to be as effective as traditional endurance exercise in improving maximal oxygen uptake. Shared by these two exercise regimes is an acute reduction in plasma volume, which is a suggested stimulus behind exercise-induced increases in blood volume and maximal oxygen uptake. This study aimed to link exercise-induced metabolic perturbation with volume shifts into skeletal muscle tissue. Ten healthy subjects (mean age 33 ± 8 years, 5 males and 5 females) performed three 30 s all-out sprints on a cycle ergometer. Upon cessation of exercise magnetic resonance imaging, ³¹ Phosphorus magnetic resonance spectroscopy and blood samples were used to measure changes in muscle volume, intramuscular energy metabolites and plasma volume. Compared to pre-exercise, muscle volume increased from 1147.1 ± 35.6 ml to 1283.3 ± 11.0 ml 8 min post-exercise. At 30 min post-exercise, muscle volume was still higher than pre-exercise (1147.1 ± 35.6 vs. 1222.2 ± 6.8 ml). Plasma volume decreased by 16 ± 3% immediately post-exercise and recovered back to - 5 ± 6% after 30 min. Principal component analysis of exercise performance, muscle and plasma volume changes as well as changes in intramuscular energy metabolites showed generally strong correlations between metabolic and physiological variables. The strongest predictor for the volume shifts of muscle and plasma was the magnitude of glucose-6-phosphate accumulation post-exercise. Interval training leads to large metabolic and hemodynamic perturbations with accumulation of glucose-6-phosphate as a possible key event in the fluid flux between the vascular compartment and muscle tissue.

Single Ingestion of Trehalose Enhances Prolonged Exercise Performance by Effective Use of Glucose and Lipid in Healthy Men

Trehalose increases blood glucose levels slowly and induces a slight insulin response. The present study aimed to study the effect of trehalose on prolonged exercise performance. The participants were 12 healthy men (age: 21.3 ± 0.9 y). After an overnight fast (12 h), they first exercised with a constant load (intensity: 40% V˙O₂peak) for 60 min using a bicycle ergometer. They continued to exercise with a constant load (40% V˙O₂peak) for 30 min between four sets of the 30-s Wingate test. After the 1st set, each participant ingested 500 mL water (control), 8% glucose, or 8% trehalose in three trials. These three trials were at least one week apart and were conducted in a double-blind and randomized crossover manner. Blood was collected for seven biochemical parameters at 12 time points during the experiment. The area under the curve of adrenaline after ingestion of trehalose was significantly lower than that for water and tended to be lower than that for glucose in the later stage of the exercise. Lower secretion of adrenaline after a single dose of 8% trehalose during prolonged exercise reflected the preservation of carbohydrates in the body in the later stage of the exercise. In conclusion, a single ingestion of trehalose helped to maintain prolonged exercise performance.