Deciphering V̇ O2,max: limits of the genetic approach

Estimating maximum oxygen uptake of fishes during swimming and following exhaustive chase - different results, biological bases and applications

The maximum rate at which animals take up oxygen from their environment (ṀO2,max) is a crucial aspect of their physiology and ecology. In fishes, ṀO2,max is commonly quantified by measuring oxygen uptake either during incremental swimming tests or during recovery from an exhaustive chase. In this Commentary, we compile recent studies that apply both techniques to the same fish and show that the two methods typically yield different mean estimates of ṀO2,max for a group of individuals. Furthermore, within a group of fish, estimates of ṀO2,max determined during swimming are poorly correlated with estimates determined during recovery from chasing (i.e. an individual's ṀO2,max is not repeatable across methods). One explanation for the lack of agreement is that these methods measure different physiological states, each with their own behavioural, anatomical and biochemical determinants. We propose that these methods are not directly interchangeable but, rather, each is suited to address different questions in fish biology. We suggest that researchers select the method that reflects the biological contexts of their study, and we advocate for the use of accurate terminology that acknowledges the technique used to elevate ṀO2 (e.g. peak ṀO2,swim or peak ṀO2,recovery). If the study's objective is to estimate the 'true' ṀO2,max of an individual or species, we recommend that pilot studies compare methods, preferably using repeated-measures designs. We hope that these recommendations contribute new insights into the causes and consequences of variation in ṀO2,max within and among fish species.

Understanding the variation in exercise responses to guide personalized physical activity prescriptions

Understanding the factors that contribute to exercise response variation is the first step in achieving the goal of developing personalized exercise prescriptions. This review discusses the key molecular and other mechanistic factors, both extrinsic and intrinsic, that influence exercise responses and health outcomes. Extrinsic characteristics include the timing and dose of exercise, circadian rhythms, sleep habits, dietary interactions, and medication use, whereas intrinsic factors such as sex, age, hormonal status, race/ethnicity, and genetics are also integral. The molecular transducers of exercise (i.e., genomic/epigenomic, proteomic/post-translational, transcriptomic, metabolic/metabolomic, and lipidomic elements) are considered with respect to variability in physiological and health outcomes. Finally, this review highlights the current challenges that impede our ability to develop effective personalized exercise prescriptions. The Molecular Transducers of Physical Activity Consortium (MoTrPAC) aims to fill significant gaps in the understanding of exercise response variability, yet further investigations are needed to address additional health outcomes across all populations.

Physical activity phenotypes and mortality in older adults: a novel distributional data analysis of accelerometry in the NHANES

Physical activity is deemed critical to successful ageing. Despite evidence and progress, there is still a need to determine more precisely the direction, magnitude, intensity, and volume of physical activity that should be performed on a daily basis to effectively promote the health of individuals. This study aimed to assess the clinical validity of new physical activity phenotypes derived from a novel distributional functional analysis of accelerometer data in older adults. A random sample of participants aged between 65 and 80 years with valid accelerometer data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 was used. Five major clinical phenotypes were identified, which provided a greater sensitivity for predicting 5-year mortality and survival outcomes than age alone, and our results confirm the importance of moderate-to-vigorous physical activity. The new clinical physical activity phenotypes are a promising tool for improving patient prognosis and for directing to more targeted intervention planning, according to the principles of precision medicine. The use of distributional representations shows clear advantages over more traditional metrics to explore the effects of the full spectrum of the physical activity continuum on human health.

Effects of worksite exercise intervention (PRODET®) on well-being at work and capability in performing work-related sedentary tasks: A pilot study

BACKGROUND: Companies have tried to carry out interventions in order to mitigate the risks associated with losses in productivity and the health of employees. OBJECTIVE: This intervention trial evaluated the effect of a supervised exercise intervention based on aerobic capacity and strength on well-being at work and capability in performing work tasks. METHODOLOGY: The sample was composed of 67 participants (N = 67, mean age 34.31 years) and investigated a 12-week group physical exercise program in the workplace, two days per week for 50 minutes, which was supervised and based on aerobic endurance and strength. The 67 subjects were working-age office workers, deemed sedentary and randomized into an intervention (N = 40) or control (N = 27) group. Among them, 33 were men (N = 33; 49.25%) and 34 were women (N = 34, 50.75%). Outcomes were assessed pre- and post-test in both groups. The Mann-Whitney U and Chi-Square tests were performed to compare the characteristics of the intervention and control group. η2 = z/(n-1) was calculated as effect size rates. RESULTS: The program showed statistically significant effects on strength endurance (P = 0.020, η2 = 0.08), the loss of fat percentage (P = 0.015, η2 = 0.09), lower limb power (P = 0.020, η2 = 0.08) and QoL (P = 0.0001, η2 = 0.39 for the physical health outcome, and P = 0.0001, η2 = 0.35 for the outcome of total scores of mental health). CONCLUSIONS: The intervention had an impact on the endurance, fat percentage loss and QoL of the workers whose occupations were based on sedentary tasks.

Interindividual variation in maximum aerobic metabolism varies with gill morphology and myocardial bioenergetics

This study asked whether interindividual variation in maximum and standard aerobic metabolic rates of the Gulf killifish, Fundulus grandis, correlate with gill morphology and cardiac mitochondrial bioenergetics, traits reflecting critical steps in the O2 transport cascade from the environment to the tissues. Maximum metabolic rate (MMR) was positively related to body mass, total gill filament length, and myocardial oxygen consumption during maximum oxidative phosphorylation (multiple R2=0.836). Standard metabolic rate (SMR) was positively related to body mass, total gill filament length, and myocardial oxygen consumption during maximum electron transport system activity (multiple R2=0.717). After controlling for body mass, individuals with longer gill filaments, summed over all gill arches, or greater cardiac respiratory capacity had higher whole-animal metabolic rates. The overall model fit and the explanatory power of individual predictor variables were better for MMR than for SMR, suggesting that gill morphology and myocardial bioenergetics are more important in determining active rather than resting metabolism. After accounting for body mass, heart ventricle mass was not related to variation in MMR or SMR, indicating that the quality of the heart (i.e., the capacity for mitochondrial metabolism) was more influential than heart size. Finally, the myocardial oxygen consumption required to offset the dissipation of the transmembrane proton gradient in the absence of ATP synthesis was not correlated with either MMR or SMR. The results support the idea that interindividual variation in aerobic metabolism, particularly maximum metabolic rate, is associated with variation in specific steps in the O2 transport cascade.

Variability in the Aerobic Fitness-Related Dependence on Respiratory Processes During Muscle Work Is Associated With the ACE-I/D Genotype

Background

The efficiency of aerobic energy provision to working skeletal muscle is affected by aerobic fitness and a prominent insertion/deletion polymorphism in the angiotensin-converting enzyme (ACE-I/D) gene for the major modulator of tissue perfusion. We assessed whether variability in the fitness state is dependent on the contribution of multiple aspects of oxygen transport to the development of muscle power, and the respective control coefficients, are associated with the ACE-I/D genotype.

Methods

Twenty-five women and 19 men completed a ramp test of cycling exercise to exhaustion during which serial steps of oxygen transport [oxygen uptake (L O₂ min⁻¹) (VO₂), minute ventilation in (L min⁻¹) (VE), cardiac output in equivalents of L min⁻¹ (Q), arterial oxygen saturation (SpO₂), muscle oxygen saturation (SmO₂), and total hemoglobin concentration (g dL⁻¹) (THb) in Musculus vastus lateralis and Musculus gastrocnemius, respiration exchange ratio (RER)], blood lactate and glucose concentration, were continuously monitored. The contribution/reliance of power output (PO) on the parameters of oxygen transport was estimated based on the slopes in Pearson's moment correlations (|r| > 0.65, p < 0.05) vs. power values over the work phase of the ramp test, and for respective fractional changes per time (defining control coefficients) over the rest, work, and recovery phase of the ramp test. Associations of variability in slopes and control coefficients with the genotype and aerobic fitness were evaluated with ANOVA.

Results

All parameters characterizing aspects of the pathway of oxygen, except THb, presented strong linear relationships [(|r| > 0.70) to PO]. Metabolic efficiency was 30% higher in the aerobically fit subjects [peak oxygen uptake (mL O₂ min⁻¹) (VO₂peak) ≥ 50 ml min⁻¹ kg⁻¹], and energy expenditure at rest was associated with the fitness state × ACE-I/D genotype, being highest in the fit non-carriers of the ACE D-allele. For VO₂, VE, and RER the power-related slopes of linear relationships during work demonstrated an association with aerobic fitness, being 30–40% steeper in the aerobically fit than unfit subjects. For VE the power-related slope also demonstrated an association with the ACE-I/D genotype. For increasing deficit in muscle oxygen saturation (DSmO₂) in Musculus vastus lateralis (DSmO₂ Vas), the power-related slope was associated with the interaction between aerobic fitness × ACE-I/D genotype.

Conclusion

Local and systemic aspects of aerobic energy provision stand under influence of the fitness state and ACE-I/D genotype. This especially concerns the association with the index of the muscle's mitochondrial respiration (SmO₂) which compares to the genetic influences of endurance training.

Associations Between Cardiorespiratory Fitness, Cardiovascular Risk, and Cognition Are Mediated by Structural Brain Health in Midlife

Background

Evidence in older adults suggests that higher cardiorespiratory fitness and lower cardiovascular risk are associated with greater cognition. However, given that changes in the brain that lead to cognitive decline begin decades before the onset of symptoms, understanding the mechanisms by which modifiable cardiovascular factors are associated with brain health in midlife is critical and can lead to the development of strategies to promote and maintain brain health as we age.

Methods and Results

In 501 middle‐aged (aged 40–65 years) adult participants of the BBHI (Barcelona Brain Health Initiative), we found differential associations among cardiorespiratory fitness, cardiovascular risk, and cognition and cortical thickness. Higher cardiorespiratory fitness was significantly associated with better visuospatial abilities and frontal loading abstract problem solving (β=3.16, P=0.049) in the older middle‐aged group (aged 55–65 years). In contrast, cardiovascular risk was negatively associated with better visuospatial reasoning and problem‐solving abilities (β=−0.046, P=0.002), flexibility (β=−0.054, P<0.001), processing speed (β=−0.115, P<0.001), and memory (β=−0.120, P<0.001). Cortical thickness in frontal regions mediated the relationship between cardiorespiratory fitness and cognition, whereas cortical thickness in a disperse network spanning multiple cortical regions across both hemispheres mediated the relationship between cardiovascular risk and cognition.

Conclusions

The relationships between modifiable cardiovascular factors, cardiorespiratory fitness, and cardiovascular risk, and cognition are present in healthy middle‐aged adults. These relationships are also mediated by brain structure highlighting a potential mechanistic pathway through which higher cardiorespiratory fitness and lower cardiovascular risk can positively impact cognitive function in midlife.

Biological and methodological factors affecting V ̇ O 2 max response variability to endurance training and the influence of exercise intensity prescription

NEW FINDINGS

What is the topic of this review? Biological and methodological factors associated with the variable changes in cardiorespiratory fitness in response to endurance training. What advances does it highlight? Several biological and methodological factors exist that each contribute, to a given extent, to response variability. Notably, prescribing exercise intensity relative to physiological thresholds reportedly increases cardiorespiratory fitness response rates compared to when prescribed relative to maximum physiological values. As threshold-based approaches elicit more homogeneous acute physiological responses among individuals, when repeated over time, these uniform responses may manifest as more homogeneous chronic adaptations thereby reducing response variability.

ABSTRACT

Changes in cardiorespiratory fitness (CRF) in response to endurance training (ET) exhibit large variations, possibly due to a multitude of biological and methodological factors. It is acknowledged that ∼20% of individuals may not achieve meaningful increases in CRF in response to ET. Genetics, the most potent biological contributor, has been shown to explain ∼50% of response variability, whilst age, sex and baseline CRF appear to explain a smaller proportion. Methodological factors represent the characteristics of the ET itself, including the type, volume and intensity of exercise, as well as the method used to prescribe and control exercise intensity. Notably, methodological factors are modifiable and, upon manipulation, alter response rates to ET, eliciting increases in CRF regardless of an individual's biological predisposition. Particularly, prescribing exercise intensity relative to a physiological threshold (e.g., ventilatory threshold) is shown to increase CRF response rates compared to when intensity is anchored relative to a maximum physiological value (e.g., maximum heart rate). It is, however, uncertain whether the increased response rates are primarily attributable to reduced response variability, greater mean changes in CRF or both. Future research is warranted to elucidate whether more homogeneous chronic adaptations manifest over time among individuals, as a result of exposure to more homogeneous exercise stimuli elicited by threshold-based practices.

Genome wide association study of response to interval and continuous exercise training: the Predict-HIIT study

BACKGROUND

Low cardiorespiratory fitness (V̇O_2peak) is highly associated with chronic disease and mortality from all causes. Whilst exercise training is recommended in health guidelines to improve V̇O_2peak, there is considerable inter-individual variability in the V̇O_2peak response to the same dose of exercise. Understanding how genetic factors contribute to V̇O_2peak training response may improve personalisation of exercise programs. The aim of this study was to identify genetic variants that are associated with the magnitude of V̇O₂peak response following exercise training.

METHODS

Participant change in objectively measured V̇O₂peak from 18 different interventions was obtained from a multi-centre study (Predict-HIIT). A genome-wide association study was completed (n = 507), and a polygenic predictor score (PPS) was developed using alleles from single nucleotide polymorphisms (SNPs) significantly associated (P < 1 × 10^-5) with the magnitude of V̇O₂peak response. Findings were tested in an independent validation study (n = 39) and compared to previous research.

RESULTS

No variants at the genome-wide significance level were found after adjusting for key covariates (baseline V̇O₂peak_, individual study, principal components which were significantly associated with the trait). A Quantile-Quantile plot indicates there was minor inflation in the study. Twelve novel loci showed a trend of association with V̇O₂peak response that reached suggestive significance (P < 1 × 10^-5). The strongest association was found near the membrane associated guanylate kinase, WW and PDZ domain containing 2 (MAGI2) gene (rs6959961, P = 2.61 × 10^-7). A PPS created from the 12 lead SNPs was unable to predict V̇O₂peak response in a tenfold cross validation, or in an independent (n = 39) validation study (P > 0.1). Significant correlations were found for beta coefficients of variants in the Predict-HIIT (P < 1 × 10^-4) and the validation study (P <  × 10^-6), indicating that general effects of the loci exist, and that with a higher statistical power, more significant genetic associations may become apparent.

CONCLUSIONS

Ongoing research and validation of current and previous findings is needed to determine if genetics does play a large role in V̇O₂peak response variance, and whether genomic predictors for V̇O₂peak response trainability can inform evidence-based clinical practice. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR), Trial Id: ACTRN12618000501246, Date Registered: 06/04/2018, http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374601&isReview=true .

Repeatability of training-induced skeletal muscle adaptations in active young males

OBJECTIVES

Measurements of protein content, enzymatic activity, and/or capillarization are frequently utilized as markers of skeletal muscle adaptation following exercise training. Whether changes in these markers of muscle adaptation are repeatable when individuals are repeatedly exposed to the same training stimulus is unknown. The purpose of this study was to test the repeatability of skeletal muscle adaptations to two identical training periods.

METHODS

Ten active young males (age: 22 ± 2 years; VO₂max: 57 ± 7 ml/kg/min) were exposed to two identical four-week periods of supervised high-intensity interval running (4 × 4 min at 90-95% of HRmax interspersed with 3-min at 70-75% HRmax) separated by a 3-month wash-out period. Vastus lateralis biopsies were obtained before and after each training period for the measurement of protein content, enzyme activity, and capillary density.

RESULTS

Training-induced changes in citrate synthase (CS) maximal activity, protein content (PGC-1α, OXPHOS, and LDH-A), and capillary density were not repeatable within individuals (r = -0.52-0.15; ICCs: -0.42-0.04; CVs: 11-67%). Several OXPHOS complex subunits also demonstrated dissimilar group-level adaptations (period × time interaction effects, p < 0.05) with large differences (η_p² > 0.4) between training periods. A large (η_p² = 0.65) increase in capillary density was apparent irrespective of training period (main effect of time, p = 0.05).

CONCLUSIONS

An individual (or a group of individuals) may exhibit dissimilar skeletal muscle adaptations when re-exposed to the same training stimulus. Our findings challenge the utility of classifying of individuals as high/low responders using measurements of mitochondrial protein content, CS activity and/or capillary density following a single training period.

Towards a personalised approach in exercise-based cardiovascular rehabilitation: How can translational research help? A 'call to action' from the Section on Secondary Prevention and Cardiac Rehabilitation of the European Association of Preventive Cardiology

The benefit of regular physical activity and exercise training for the prevention of cardiovascular and metabolic diseases is undisputed. Many molecular mechanisms mediating exercise effects have been deciphered. Personalised exercise prescription can help patients in achieving their individual greatest benefit from an exercise-based cardiovascular rehabilitation programme. Yet, we still struggle to provide truly personalised exercise prescriptions to our patients. In this position paper, we address novel basic and translational research concepts that can help us understand the principles underlying the inter-individual differences in the response to exercise, and identify early on who would most likely benefit from which exercise intervention. This includes hereditary, non-hereditary and sex-specific concepts. Recent insights have helped us to take on a more holistic view, integrating exercise-mediated molecular mechanisms with those influenced by metabolism and immunity. Unfortunately, while the outline is recognisable, many details are still lacking to turn the understanding of a concept into a roadmap ready to be used in clinical routine. This position paper therefore also investigates perspectives on how the advent of 'big data' and the use of animal models could help unravel inter-individual responses to exercise parameters and thus influence hypothesis-building for translational research in exercise-based cardiovascular rehabilitation.