Exercise Training as a Treatment for Cardiometabolic Risk in Sedentary Adults: Are Physical Activity Guidelines the Best Way to Improve Cardiometabolic Health? The FIT-AGEING Randomized Controlled Trial

Impact of a daily legume-based meal on blood and anthropometric parameters in a group of omnivorous adults: A pilot study

This pilot study aimed to assess the impact of substituting a traditional lunch for a vegetarian legume-based meal on blood and anthropometric parameters in a group of omnivorous adults. A one-group comparison, quasi-experimental dietary intervention was designed. A vegetarian legume-based meal was offered for 8 consecutive weeks (weekdays) to non-vegetarian individuals (n = 26), (28 years [P25 = 20.0, P75 = 35.5]; 21.9 kg/m2 [P25 = 21.3, P75 = 24.8]). Sociodemographic data, health status and lifestyle-related information were recorded. Three-day food records were used to collect food intake at baseline and at the end of the intervention. Anthropometric parameters were recorded and fasting blood analyses were performed following standard procedures. Wilcoxon signed-rank test was used for statistical comparisons. A p-value <0.05 was considered statistically significant. Participants showed a median intake of 79.8 g of cooked legumes per meal, meaning 13 (50.0%) subjects met the Portuguese daily legume intake recommendations during the intervention days. There were no statistically significant differences in anthropometric parameters. Transferrin concentration increased after 8 weeks (+12.5 mg/dL; p = 0.001). Total cholesterol concentration reduced after 8 weeks (-6 mg/dL; p = 0.041), as well as low-density lipoprotein (LDL) cholesterol (-7 mg/dL; p = 0.003). Triglycerides (+9 mg/dL; p = 0.046), fasting glucose (+2 mg/dL; p = 0.037) and HbA1c (+0.1 mg/dL; p = 0.010) concentration increased after the 2-month legume-based trial. Results suggest a cholesterol-lowering potential of legume-rich diets. However, unfavourable results regarding the impact on glucose metabolism-related biomarkers and triglyceride levels were observed. The study's limitations in design and sample size emphasise the importance of conducting further research with larger cohorts to attain more conclusive findings.

The effects of combined exercise training on glucose metabolism and inflammatory markers in sedentary adults: a systematic review and meta-analysis

This systematic review and meta-analysis aimed to determine the magnitude of the effect of combined exercise training on glucose metabolism markers, adipokines, and inflammatory cytokines in non-diabetic sedentary adults. PubMed, Web of Science, Scopus, Cochrane Library electronic databases and reference lists of included studies were explored for randomized controlled trials (RCTs) that included physically inactive adults and provided combined training interventions (aerobic plus resistance exercise). Effects on fasting glucose and insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), HbA1c, adiponectin, leptin, IL-6, TNF-α, and C-reactive protein (CRP) in exercise vs control groups were analyzed using random effects meta-analysis. The Cochrane Risk of Bias Tool for Randomized Trials 2.0 (RoB 2) was used to assess the risk of bias. A total of 24 RCTs were included in the quantitative analysis. Combined exercise training significantly decrease fasting glucose (standardized mean difference, SMD: - 0.474, 95% CI [- 0.829, - 0.120], p = 0.009, 35 study arms), fasting insulin (SMD: - 1.024, 95% CI [- 1.502, - 0.545], p < 0.001, 27 study arms), HOMA-IR (SMD: - 0.946, 95% CI [- 1.450, - 0.442], p < 0.001, 23 study arms), TNF-α (SMD: - 0.972, 95% CI [- 1.361, - 0.582], p < 0.001, 10 study arms), and CRP (SMD: - 0.507, 95% CI [- 0.818, - 0.196], p = 0.001, 14 study arms). No significant effects were observed for HbA1c, adiponectin, leptin, and IL-6 levels. Random effects meta-regression models by age, sex, and intervention length were not able to explain any of the variation in the effect size of HOMA-IR. Findings from this systematic review and meta-analysis suggest that combined exercise training improves some glucose metabolism markers and inflammatory parameters in sedentary adults without diabetes.

Physical exercise improves memory in sedentary middle-aged adults: Are these exercise-induced benefits associated with S-Klotho and 1,25-dihydroxivitamin D? The FIT-AGEING randomized controlled trial

We aimed to investigate the effect of three types of exercise interventions on memory (i.e., immediate memory (IM), long-term memory (LTM), and recognition). We also investigated whether exercise-induced changes in circulating S-Klotho and 1,25-dihydroxivitamin D (1,25(OH)2 D) levels were related to those observed in memory in healthy middle-aged sedentary adults. A 12-week randomized controlled trial was performed with a parallel-group design. Seventy-four participants (45-65 years old: 53% women) were randomly assigned to (1) no exercise (control) group, (2) concurrent training based on the international physical activity recommendations (PAR) group, (3) high-intensity interval training (HIIT) group, or (4) HIIT plus whole-body electromyostimulation (HIIT-EMS) group. Memory outcomes were assessed using the Wechsler Memory Scale-third edition. S-Klotho plasma levels were determined according to a solid-phase sandwich enzyme-linked immunosorbent assay kit while 1,25(OH)2 D plasma levels were measured using a DiaSorin-Liaison immunochemiluminometric analyzer. IM-Verbal Paired Associates (IM-VPA) and IM-Logical Memory (IM-LM) were improved in both the HIIT and HIIT-EMS groups compared with the control group (all p ≤ 0.045). Exercise-induced changes in S-Klotho plasma levels were positively associated with those observed in IM, LTM, and recognition (all p ≤ 0.007), whereas exercise-induced changes in 1,25(OH)2 D plasma levels were directly related to changes in IM and LTM (all p ≤ 0.048). In conclusion, a 12-week HIIT intervention with or without WB-EMS seems to be the most effective exercise program to improve IM. The significant and positive associations between exercise-induced changes in S-Klotho and 1,25(OH)2 D levels with those observed in memory outcomes suggest that these factors may be potentially related to exercise-induced improvements of memory in middle-aged adults.

Effects of combined training during the COVID-19 pandemic on metabolic health and quality of life in sedentary workers: A randomized controlled study

This study aimed to analyze the effects of a combined training (CT) program performed during the first national lockdown due to the COVID-19 pandemic on body composition, metabolic profile, quality of life and stress in sedentary workers, and examines whether changes in the metabolic profile are associated with changes in health-related outcomes which are modifiable by exercise. We evaluated 31 sedentary workers (48.26 ± 7.89 years old). Participants were randomly assigned to a CT group (i.e., performed 16 weeks of exercise) or to a non-exercise control group. The CT program consisted of 16-week of resistance and aerobic exercise. Body composition, glycemic and lipidic profiles, cardiorespiratory fitness (CRF), health-related quality of life and stress levels were assessed pre- and post-intervention. After the intervention period, the CT group demonstrated significantly lower waist and hip circumference (p < 0.05) values than the control group. The control group significantly increased the fasting glucose and HOMA-IR after 16 weeks follow-up (+4.74 mg/dL, p = 0.029; and +0.41 units, p = 0.010, respectively), whiles no significant changes were observed in the CT group in the same parameters (+3.33 mg/dL, p = 0.176; and +0.04 units, p = 0.628, respectively). No changes were observed in the lipid profile for either group (p > 0.05). A significant positive relationship was detected between the change in BMI with the changes in insulin and HOMA-IR (r = 0.643, p = 0.024; and r = 0.605, p = 0.037, respectively). In addition, the changes in CRF were negatively associated with the changes in total cholesterol (r = -0.578, p = 0.049). We observed differences between groups on perceived stress levels and physical, psychological, and environmental domains of quality of life, with the CT group showing better results. Moreover, the CT group improved perceived life satisfaction (+3.17 points, p = 0.038). The findings of the present study suggest that the participants who remained physically active during the first pandemic-related lockdown were able to mitigate the deleterious effects associated with a sedentary lifestyle.

Ruiz J, Nestares T, Carneiro-Barrera A. Multidisciplinary Prehabilitation and Postoperative Rehabilitation for Avoiding Complications in Patients Undergoing Resection of Colon Cancer: Rationale, Design, and Methodology of the ONCOFIT Study

ONCOFIT is a randomized clinical trial with a two-arm parallel design aimed at determining the influence of a multidisciplinary Prehabilitation and Postoperative Program (PPP) on post-surgery complications in patients undergoing resection of colon cancer. This intervention will include supervised physical exercise, dietary behavior change, and psychological support comparing its influence to the standard care. Primary and secondary endpoints will be assessed at baseline, at preoperative conditions, at the end of the PPP intervention (after 12 weeks) and 1-year post-surgery, and will include: post-surgery complications (primary endpoint); prolonged hospital length of stay; readmissions and emergency department call within 1-year after surgery; functional capacity; patient reported outcome measures targeted; anthropometry and body composition; clinical/tumor parameters; physical activity levels and sedentariness; dietary habits; other unhealthy habits; sleep quality; and fecal microbiota diversity and composition. Considering the feasibility of the present intervention in a real-life scenario, ONCOFIT will contribute to the standardization of a cost-effective strategy for preventing and improving health-related consequences in patients undergoing resection of colon cancer with an important clinical and economic impact, not only in the scientific community, but also in clinical practice.

Associations between Objectively Determined Physical Activity and Cardiometabolic Health in Adult Women: A Systematic Review and Meta-Analysis

The purpose of this systematic review and meta-analysis was to qualitatively synthesize and quantitatively assess the evidence of the relationship between objectively determined volumes of physical activity (PA) and cardiometabolic health in women. Four databases (PubMed, Web of Science, Scopus, and the Cochrane library) were searched and, finally, 24 eligible studies were included, with a total of 2105 women from eight countries. A correlational meta-analysis shows that moderate-to-vigorous intensity physical activity (MVPA) was favorably associated with high-density lipoprotein (r = 0.16; 95% CI: 0.06, 0.25; p = 0.002); however, there was limited evidence for the effects of most of the other cardiometabolic biomarkers recorded from steps, total physical activity, light- and moderate-intensity physical activity and MVPA. It is most compelling and consistent that being more physically active is beneficial to the metabolic syndrome. Overall, PA levels are low in adult women, suggesting that increasing the total volume of PA is more important than emphasizing the intensity and duration of PA. The findings also indicate that, according to the confounding effects of body composition and cardiorespiratory fitness, meeting the minimal level of 150 min of moderate-intensity physical activity recommended is not enough to obtain a significant improvement in cardiometabolic indicators. Nonetheless, the high heterogeneity between studies inhibits robust conclusions.

Different exercise training modalities similarly improve heart rate variability in sedentary middle-aged adults: the FIT-AGEING randomized controlled trial

PURPOSE

This study aimed to investigate the influence of different exercise training modalities on heart rate variability (HRV) in sedentary middle-aged adults; and to study whether changes in health-related outcomes (i.e., body composition and cardiometabolic risk) are associated with those hypothetical HRV changes in sedentary middle-aged adults.

METHODS

A total of 66 middle-aged adults (53.6 ± 4.4 years old; 50% women) were enrolled in the FIT-AGEING study. We conducted a 12-week randomized controlled trial. The participants were randomly assigned to 4 groups: (a) a control group (no exercise); (b) a physical activity recommendation from the World Health Organization group (PAR); (c) a high-intensity interval training group (HIIT); and (d) a high-intensity interval training group adding whole-body electromyostimulation (HIIT + EMS).

RESULTS

All exercise training modalities induced changes in HRV parameters (all P ≤ 0.001) without statistical differences between them (all P > 0.05). We found associations between changes in body composition and cardiometabolic risk and exercise-related changes in HRV.

CONCLUSION

Our results suggest that different exercise interventions (i.e., PAR, HIIT and HIIT + EMS) induced an enhancement of HRV in sedentary middle-aged adults. Our findings support the notion that exercise-related changes in HRV are associated with changes in body composition and cardiometabolic risk after the intervention program CLINICAL TRIAL REGISTRY: NCT03334357 (ClinicalTrials.gov). November 7, 2017 retrospectively registered.

Effect of Different Exercise Training Modalities on Fasting Levels of Oxylipins and Endocannabinoids in Middle-Aged Sedentary Adults: A Randomized Controlled Trial

This study aimed to investigate the effects of different exercise training programs on fasting plasma levels of oxylipins, endocannabinoids (eCBs), and eCBs-like molecules in middle-aged sedentary adults. A 12-week randomized controlled trial was conducted using a parallel group design. Sixty-five middle-aged adults (40-65 years old) were randomly assigned to: (a) no exercise (control group), (b) concurrent training based on international physical activity recommendations (PAR group), (c) high-intensity interval training (HIIT group), and (d) HIIT together with whole-body electromyostimulation (HIIT + EMS group). Plasma levels of oxylipins, eCBs, and eCBs-like molecules were determined in plasma samples before and after the intervention using targeted lipidomics. Body composition was assessed through dual-energy X-ray absorptiometry, and dietary intake through a food frequency questionnaire and three nonconsecutive 24-hr recalls. The physical activity recommendations, HIIT, and HIIT-EMS groups showed decreased plasma levels of omega-6 and omega-3-derived oxylipins, and eCBs and eCBs-like molecules after 12 weeks (all Δ ≤ -0.12; all p < .05). Importantly, after Bonferroni post hoc corrections, the differences in plasma levels of omega-6 and omega-3 oxylipins were not statistically significant compared with the control group (all p > .05). However, after post hoc corrections, plasma levels of anandamide and oleoylethanolamide were increased in the physical activity recommendations group compared with the control group (anandamide: Δ = 0.05 vs. -0.09; oleoylethanolamide: Δ = -0.12 vs. 0.013, all p ≤ .049). In conclusion, this study reports that a 12-week exercise training intervention, independent of the modality applied, does not modify fasting plasma levels of omega-6 and omega-3 oxylipins, eCBs, and eCBs-like molecules in middle-aged sedentary adults.

A Novel Intensity-Based Approach to Increasing Prefrontal Cerebral Oxygenation by Walking Exercise

Regional cerebral blood flow (rCBF) increases after moderately intense exercise and is significantly correlated with cognitive function. However, no intensity-based physiological indicator for enhancing rCBF during low- to-moderate-intensity exercise has been proposed. The purpose of this study was to develop a physiological indicator housed in a wearable device to determine whether low-to-moderate intensity walking can increase rCBF. A cross-sectional study with four parallel arms was performed. Each of 114 participants was randomly assigned to either the moderate, low-to-moderate, low, or very low walking intensity groups. A novel dynamic cardiac force meter (CFM) was used to quantify walking intensity. Heart rate and hemoencephalography (HEG) were measured during each phase of the session. Compared to baseline, HEG significantly increased in both the submaximal exercise and recovery phases in members of the low-to-moderate intensity group but not the very low intensity group. Low-to-moderate intensity walking improves prefrontal cerebral blood oxygenation. The present results demonstrate the usefulness of a dynamic CFM housed in a wearable device for quantifying the intensity of walking exercise aimed at increasing prefrontal blood oxygenation. The results of the study may help guide further development of exercise strategies for brain disease patients and the ageing population.

Effect of a short-term whole-body high-intensity interval training on fitness, morphological, and functional parameters in untrained individuals

BACKGROUND

High-intensity interval training protocols using the body weight (WBHIIT) as resistance could be an interesting and inexpensive alternative due to the absence of equipment required (low cost) and the possibility to be performed in a wide range of locations. Therefore, the purpose of the present study was to analyze the effects of a short-term WBHIIT protocol on muscle thickness (MT), muscular endurance (ME), one maximum repetition test (1RM), and maximum oxygen uptake (VO2max) of untrained individuals.

METHODS

Fifty healthy men (28.2 ± 6.7 years, 77.5 ± 26.2 kg, 171 ± 10 cm, 23.2 ± 8.2 % Fat) were randomized into WB-HIIT (n = 25) or control (CON, n = 25) group. The WB-HIIT performed 9 exercises (40-second stimulus in all out intensity/ 20-second of passive recovery) divided into 3 blocks with 2 sets each for 6 weeks (three times a week).

RESULTS

Only WB-HIIT resulted in a significant increase in MT, ME, 1RM, and VO2max (all p < 0.05) outcomes and were significantly greater compared to CON (all p < 0.05).

CONCLUSIONS

Our results demonstrate that a WB-HIIT program can be a time-efficient strategy to promote changes on fitness, morphological and functional parameters in previously untrained sedentary individuals.

The effect of endurance and endurance-strength training on body composition and cardiometabolic markers in abdominally obese women: a randomised trial

Studies comparing the effect of endurance and endurance-strength training on cardiometabolic markers provided inconsistent results. Therefore, the study aimed to compare the effect of endurance and endurance-strength training on body composition and cardiometabolic parameters in abdominally obese women. In this randomised trial, 101 subjects were included and divided into endurance (n = 52) and endurance-strength (n = 49) training. During the 12-week intervention, participants performed supervised one-hour training three times a week. Body composition, blood pressure (BP), markers of glucose and lipid homeostasis, and myoglobin levels were measured before and after the intervention. In total, 85 subjects completed the trial. Both interventions decreased fat mass and visceral adipose tissue and increased free fat mass, appendicular lean mass index and lean mass index. Neither endurance training nor endurance-strength training affected glucose and lipid metabolism. However, only endurance training significantly decreased paraoxonase and myoglobin levels. Both training programmes significantly decreased BP, with a more reduction of diastolic BP noted in the endurance group. In conclusion, both training programmes had a favourable effect on body composition but did not improve glucose and lipid homeostasis. Besides, endurance training decreased paraoxonase activity and myoglobin levels and was more effective in reducing BP.The study was registered with the German Clinical Trials Register (DRKS) within the number: DRKS00019832 (retrospective registration), date of registration: 26/02/2020.

Effect of a 12-Week Concurrent Training Intervention on Cardiometabolic Health in Obese Men: A Pilot Study

The present study aimed to investigate the effects of a 12-week concurrent training intervention on cardiometabolic health in obese men. Twelve obese men (42.5 ± 5.3 years old) participated in the current 12−week randomized controlled trial with a parallel group design. The participants were randomly assigned to a concurrent training group or to a no-exercise control group. Anthropometry and body composition assessment were determined by electrical bio-impedance. Blood samples were obtained and a cardiometabolic risk Z-Score was calculated. Energy metabolism-related parameters [i.e., resting metabolic rate (RMR), respiratory quotient (RQ), and substrate oxidation in both resting conditions and during exercise] were determined by indirect calorimetry. Echocardiographic studies were performed using an ultrasound system equipped with a transducer to measure cardiac function. A significant decrease of weight (Δ = −4.21 kg; i.e., primary outcome), body mass index (Δ = −1.32 kg/m²), fat mass (FM; Δ = −3.27 kg), blood pressure (BP; Δ = −10.81 mmHg), and cardiometabolic risk Z-Score (Δ = −0.39) was observed in the exercise group compared with the control group (all P < 0.05), while no significant changes were noted in waist circumference (WC), lean mass (LM), bone mineral content, glycemic and lipid profiles, liver function, nor in energy metabolism-related parameters (all P > 0.1). Moreover, a significant increment of left ventricular (LV) end diastolic diameter (Δ = −4.35 mm) was observed in the exercise group compared with the control group (P = 0.02). A 12-week concurrent training intervention is an effective strategy to induce weight and fat loss with simultaneous reductions of BP and cardiometabolic risk, and improving cardiac function in obese men.

Influence of Health Related Fitness on the Morphofunctional Condition of Second Mature Aged Women

To analyze the influence of health-related fitness on the condition of second mature aged women. Participants: 65 women divided into two groups. Group 1-40 women, (43.33 ± 0.93) years old and group 2-25 women (44.40 ± 0.93) years old. The participants trained for 8 months, three times a week for 1 h. Group 1 trained dance aerobics (Monday), strength fitness (Wednesday) and stretching (Friday). Group 2 trained only stretching. The body length and mass, handgrip strength test, vital capacity, blood pressure, heart rate, Stange and Genchi tests, and motion amplitude in joints were evaluated before and after the program. The significance of the differences between the groups was evaluated by Student's criterion (t) and Rosenbaum (Q). The different intensity of the health-related effect was confirmed at the end of the program. Physiometric indicators significantly increased in group 1. The complex physical activity led to a decrease in heart rate. The results of the Stange and Genchi tests significantly increased. Goniometric indicators of group 2 increased. The comparative analysis of the participants indicators confirms the generalized and higher health-related effect of the complex fitness program. The effect of such a program showed an increase of the adaptive potential, a significant increase in the functional capabilities of women, and the optimization of the studied indicators. With the same time expenditure for health-related fitness, the complex program has a more multifaceted effect in comparison with stretching.