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The acute versus chronic response to exercise
Abstract
There is strong and consistent evidence that a single exercise session can acutely reduce triglycerides and increase high-density lipoprotein (HDL) cholesterol (HDL-C), reduce blood pressure, and improve insulin sensitivity and glucose homeostasis. Such observations suggest that at least some of the effects on atherosclerotic cardiovascular disease (ASCVD) risk factors attributed to exercise training may be the result of recent exercise.
These acute and chronic exercise effects cannot be considered in isolation. Exercise training increases the capacity for exercise, thereby permitting more vigorous and/or more prolonged individual exercise sessions and a more significant acute effect. The intensity, duration, and energy expenditure required to produce these acute exercise effects are not clearly defined. The acute effect of exercise on triglycerides and HDL-C appears to increase with overall energy expenditure possibly because the effect maybe mediated by reductions in intramuscular triglycerides. Prolonged exercise appears necessary for an acute effect of exercise on low-density lipoprotein (LDL) cholesterol (LDL-C) levels. The acute effect of exercise on blood pressure is a low threshold phenomenon and has been observed after energy expenditures requiring only 40% maximal capacity. The acute effect of exercise on glucose metabolism appears to require exercise near 70% maximal, but this issue has not been carefully examined.
Exercise has definite acute effects on blood lipids, blood pressure, and glucose homeostasis. Exercise also has acute effects on other factors related to atherosclerosis such as immunological function, vascular reactivity, and hemostasis. Considerable additional research is required to define the threshold of exercise required to produce these putatively beneficial effects.
... This modulation of lipid profiles helps to prevent the accumulation of plaque in the arteries, thereby reducing the risk of heart attacks and strokes. Importantly, the intensity and duration of exercise are key determinants of these beneficial changes in lipid metabolism, with moderate exercise being particularly effective at producing these favorable outcomes (Thompson et al., 2001). Moderate exercise also has a significant anti-inflammatory effect, which is crucial in the prevention of CVD. ...
... Furthermore, moderate exercise improves autonomic function, which is essential for maintaining cardiovascular stability. The autonomic nervous system regulates heart rate, blood pressure, and vascular resistance, and regular physical activity helps to enhance parasympathetic activity while reducing sympathetic overdrive (Thompson et al., 2001). This shift in autonomic balance leads to lower resting heart rates, improved heart rate variability, and better regulation of blood pressure, all of which are associated with reduced cardiovascular risk (Myers et al., 2002). ...
... Moderate exercise can be sustained for longer periods, making it more suitable for older adults or individuals who may not tolerate the demands of high-intensity exercise. Additionally, moderate-intensity activity poses a lower risk of injury and cardiovascular complications, such as arrhythmias or excessive blood pressure spikes, which can occur with high-intensity workouts (Paffenbarger et al., 1994, Thompson et al., 2001. The cardiovascular benefits of both moderate and high-intensity exercise are undeniable, but moderate exercise has the advantage of being more sustainable for long-term adherence. ...
This comprehensive review examines the cardiovascular benefits of moderate exercise, exploring the molecular and physiological mechanisms through which it reduces cardiovascular disease (CVD) risk. The study aimed to identify the specific ways in which moderate exercise improves cardiovascular health, focusing on key factors such as endothelial function, lipid metabolism, inflammation, and glucose homeostasis. A thorough review of existing literature was conducted to elucidate the mechanisms and impact of moderate exercise compared to other intensities. The findings highlight that moderate exercise optimizes cardiovascular health by enhancing nitric oxide production, reducing oxidative stress, and improving autonomic function, while also lowering blood pressure and cholesterol levels. Additionally, moderate exercise was shown to have anti-inflammatory effects, crucial for mitigating chronic conditions like atherosclerosis and diabetes-related cardiovascular complications. The review concludes that while high-intensity exercise offers rapid fitness improvements, moderate exercise is more accessible, safer, and sustainable for a broad population. Furthermore, it presents a promising non-pharmacological intervention for CVD prevention. Future research should explore individual variability in exercise responses, the role of skeletal muscle as a secretory organ, and the interaction between exercise and the gut microbiome. The study emphasizes the need for personalized exercise prescriptions and further investigation into the long-term benefits of exercise to optimize public health strategies. Keywords: Moderate Exercise, Cardiovascular Disease, Endothelial Function, Inflammation, Lipid Metabolism, Exercise Prescription.
... Cardiovascular diseases (CVDs) remain the leading cause of rising health costs 1 and mortality among the elderly. 1 2 Sedentary behaviour and physical inactivity are particularly emphasised as major modifiable cardiometabolic markers, 3 which are reflected by the increased prevalence of hypertension, diabetes and dyslipidaemia in older adults. 2 CVDs can be prevented by controlling key determinants of cardiometabolic markers, such as blood pressure (BP), blood glucose (BG) and lipids, through lifestyle modifications like exercise. 1 Acute aerobic exercise (AE) on lipid profile, BP and BG has been shown to reduce cardiometabolic markers and improve cardiovascular health. [4][5][6][7][8][9][10][11] However, most related studies have been restricted to younger individuals in clinical trials with an acute bout of exercise lasting 30-60 min at moderate to high intensity (VO2max 40%-75%) exercise. 4-7 11-14 Furthermore, it seems that the effects of acute exercise on ...
... 10 This might clarify the previously reported view that the acute effect of exercise on glucose metabolism appears to require exercise near 70% VO2max. 4 In our study, the intensity of golf was approximately 61%, while for Nordic walking and walking it was 76%-77% of the maximum HR. Golf affected BG more efficiently compared with walking due to a longer exercise duration, despite the lower intensity. ...
... 12 41 It seems that the acute effect of exercise on BP is a low threshold phenomenon observed after energy expenditures requiring only 40% maximal capacity. 4 In this study, sPB decreased immediately postexercise in every group. The reduction in sBP was quite similar in the Nordic walking and walking Open access groups; this was expected as these are more intense AEs than golf. ...
Objectives
The acute effects of aerobic exercise on cardiometabolic markers are well documented in younger healthy individuals, but the same effects in older adults have not been elucidated. As such, this study compares the acute effects of three different types of age-appropriate aerobic exercises on cardiometabolic markers.
Methods
Healthy older golfers (n=25, 16 male and 9 female, 68±4 years) were enrolled in a randomised cross-over experiment. We compared the effects of three different acute aerobic exercises (18-hole golf, 6 km Nordic walk, 6 km walk) on blood pressure, blood glucose and blood lipid profile in a real-life environment.
Results
In the between-group comparison, playing golf resulted in a difference in blood glucose (golf: 0.01±1.0 mmol/L, walk: 1.3±0.9 mmol/L, p<0.001) compared with walking and triglycerides (golf: 0.13±0.2 mmol/L, Nordic walk: 0.31±0.2 mmol/L, walk: 0.23±0.2 mmol, p=0.012) and high-density lipoprotein cholesterol (golf: 0.04±0.06 mmol/L, Nordic walk: −0.02±0.06 mmol/L, walk: −0.02±0.07 mmol/L, p=0.002) compared with Nordic walking and walking. In addition, all groups had significant decreases (p<0.001) in systolic blood pressure, and Nordic walking and walking also demonstrated a decrease in diastolic blood pressure (p<0.05).
Conclusion
Acute bouts of aerobic exercise improved cardiovascular profile in healthy older adults. Despite the lower exercise intensity of golf, the longer duration and higher energy expenditure appeared to have a more positive effect on lipid profile and glucose metabolism compared with Nordic walking and walking.
Trial registration number
ISRCTN10007294 .
... Therefore, exercise is recommended as essential lifestyle therapy for the primary prevention, treatment, and control of hypertension [1,3,5,6]. Aerobic exercise immediately reduces BP after a single isolated exercise session [7][8][9][10], termed postexercise hypotension (PEH). PEH persists for 24 h after the exercise bout and is correlated with the BP response to exercise training [11][12][13]. ...
... Shapiro-Wilk tests were used to determine whether data were normally distributed. ABP values were averaged over hourly intervals for the "awake" (hours 1-10), "sleep" (hours [11][12][13][14][15][16][17][18][19], and "19 h" (hours [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. The ABP changes in response to the GEST versus CONTROL were calculated as follows: [(GEST BP at each hourly interval-GEST BP baseline)-(CONTROL BP at each hourly interval-CONTROL BP baseline)] [15]. ...
... Hypertension is considered the most important global risk factor for CVD morbidity and mortality [26]. Hence, determining the predictors of PEH (i.e., the immediate, prolonged BP reductions that follow a bout of acute exercise) is of clinical importance among adults with hypertension [8][9][10][11]13,[27][28][29][30]. Consistent with our hypothesis and our previous work among firefighters with hypertension [15], we found that the magnitude of PEH was greatest among adults with hypertension and reduced parasympathetic predominance at rest independent of training status, which should be confirmed in future larger studies with different volumes and intensities of training. ...
Because data are scarce, we examined the relationship between postexercise hypotension (PEH) and heart rate variability (HRV) before and after aerobic exercise training among adults with hypertension. Participants completed a 12 w aerobic training program. Before and after training, they performed a peak graded exercise stress test (GEST) and nonexercise control (CONTROL) and were left attached to an ambulatory BP monitor. Prior to CONTROL, HRV was measured supine for 5 min using a 12-lead electrocardiogram (ECG). The participants (n = 18) were middle-aged (52.1 ± 11.7 y) and 50% men with hypertension (131.7 ± 9.8/85.9 ± 8.5 mmHg) and obesity (30.0 ± 3.7 kg·m⁻²). Before training, ambulatory systolic BP (ASBP) and diastolic ABP (ADBP) decreased by 3.2 ± 2.1 mmHg and 2.5 ± 1.5 mmHg, respectively, from baseline after the GEST versus CONTROL (p < 0.05). After training, ASBP tended to decrease by 3.5 ± 2.2 mmHg (p = 0.055) and ADBP decreased by 1.7 ± 2.5 mmHg (p = 0.001) from baseline after the GEST versus CONTROL. Before training, HRV high frequency (HFms²) (β = −0.441), age (β = 0.568), and resting SBP (β = 0.504) accounted for 66.8% of the ASBP response (p = 0.001), whereas the low frequency (LF)/HF ratio (β = 0.516) and resting DBP (β = 0.277) accounted for 35.7% of the ADBP response (p = 0.037). After training, the standard deviation of NN intervals (SDNN) (β = −0.556), age (β = 0.506), and resting SBP (β = 0.259) accounted for 60.7% of the ASBP response (p = 0.004), whereas SDNN (β = −0.236) and resting DBP (β = 0.785) accounted for 58.5% of the ADBP response (p = 0.001). Our preliminary findings show that adults with hypertension and parasympathetic suppression (i.e., lower SDNN and HFms² and higher LF/HF) may elicit PEH to the greatest degree independent of training status versus adults with parasympathetic predominance, suggesting that resting HRV may be an important determinant of PEH.
... To check for differences between groups regarding the acute (exercise-induced) and chronic (training-induced) changes in lipid and lipoprotein blood serum concentrations, univariate analyses of covariance (ANCOVA) with baseline values entered as a covariate (baseline-adjusted) were performed. Furthermore, regarding the analysis of acute exerciseinduced changes, the average work performed during the aerobic cycling session was entered as a second covariate because studies indicated that the magnitude of acute exercise-induced effects on lipid and lipoprotein concentrations appears to increase with energy expenditure (Thompson et al., 2001). Differences between groups are presented as mean differences together with the 95% confidence intervals to provide information about the magnitude and direction of an effect. ...
... Furthermore, some studies have shown an increase in blood HDL-C (Pay et al., 1992;Fittipaldi et al., 2020) concentrations after prolonged (i.e., 2 h walking) or exhaustive (i.e., maximal exercise test) acute aerobic exercise, while others have reported unchanged concentrations (Hughes et al., 1991;Imamura et al., 2000;Antunes et al., 2020) after low to high intensity continuous aerobic exercise. Considering these conflicting results, it was assumed that the acute effects of exercise (e.g., aerobic exercise) on blood lipid and lipoprotein concentrations are influenced by different factors (Thompson et al., 2001). The key factors include the subjects' physical fitness level and pre-exercise lipid level as well as the intensity, duration, and mode of exercise (Hicks et al., 1987;Ferguson et al., 1998;Antunes et al., 2020). ...
... The key factors include the subjects' physical fitness level and pre-exercise lipid level as well as the intensity, duration, and mode of exercise (Hicks et al., 1987;Ferguson et al., 1998;Antunes et al., 2020). Although the exact mechanisms remain elusive, it has been suggested that the changes in lipid and lipoprotein concentrations induced by acute aerobic exercise are largely related to increased lipoprotein lipase activity and to a high rate of lipolysis (Pronk, 1993;Thompson et al., 2001). Interestingly, it was shown that lipid oxidation rate (measured via indirect calorimetry) was increased 5 min after acute prolonged hypoxic exposure (180 min passive exposure, S p O 2~8 0%) in sedentary overweight/obese males (Workman and Basset, 2012). ...
Background: Intermittent hypoxic-hyperoxic exposure (IHHE) and aerobic training have been proposed as non-pharmacological interventions to reduce age-related risk factors. However, no study has yet examined the effects of IHHE before aerobic exercise on cardiovascular risk factors in the elderly. Therefore, the aim of this study was to investigate the acute and chronic effects of IHHE prior to aerobic cycling exercise on blood lipid and lipoprotein concentrations as well as blood pressure in geriatric patients.
Methods: In a randomized, controlled, and single-blinded trial, thirty geriatric patients (72–94 years) were assigned to two groups: intervention (IG; n = 16) and sham control group (CG; n = 14). Both groups completed 6 weeks of aerobic cycling training, 3 times a week for 20 min per day. The IG and CG were additionally exposed to IHHE or sham IHHE (i.e., normoxia) for 30 min prior to aerobic cycling. Blood samples were taken on three occasions: immediately before the first, ∼10 min after the first, and immediately before the last session. Blood samples were analyzed for total (tCh), high-density (HDL-C), and low-density lipoprotein cholesterol (LDL-C), and triglyceride (Tgl) serum concentration. Resting systolic (SBP) and diastolic blood pressure (DBP) was assessed within 1 week before, during (i.e., at week two and four), and after the interventions.
Results: The baseline-adjusted ANCOVA revealed a higher LDL-C concentration in the IG compared to the CG after the first intervention session (ηp ² = 0.12). For tCh, HDL-C, Tgl, and tCh/HDL-C ratio there were no differences in acute changes between the IG and the CG (ηp ² ≤ 0.01). With regard to the chronic effects on lipids and lipoproteins, data analysis indicated no differences between groups (ηp ² ≤ 0.03). The repeated measures ANOVA revealed an interaction effect for SBP (ηp ² = 0.06) but not for DBP (ηp ² ≤ 0.01). Within-group post-hoc analysis for the IG indicated a reduction in SBP at post-test (d = 0.05).
Conclusion: Applying IHHE prior to aerobic cycling seems to be effective to reduce SBP in geriatric patients after 6 weeks of training. The present study suggests that IHHE prior to aerobic cycling can influence the acute exercise-related responses in LDL-C concentration but did not induce chronic changes in basal lipid or lipoprotein concentrations.
... It could possibly be related to subsequent improvements in body fat distribution, atherogenic lipoprotein profiles, and BP, as well as beneficial effects on muscular capillary density and ANS balance [27]. Moreover, it is also proven in some of the findings that an acute bout of exercise elicits a number of transient physiological responses, whereas accumulated bouts of acute exercise will lead to more permanent chronic adaptations [28]. ...
... SBP indicates the force of contraction of the heart, whereas DBP is an indication of peripheral resistance [7]. There is ample evidence proving that moderateintensity aerobic exercise decreases BP and prevents hypertension [28]. It may be due to the fact that exercise induces the activation of sympathetic cholinergic nerves supplying skeletal blood vessels and a surplus of released metabolites and increased body temperature will apparently cause the vasodilatation of these vessels. ...
Background & Objectives: Obesity is a known risk factor for metabolic disorders such as high blood pressure, body fat abnormality, and glucose intolerance. In addition, obesity has been associated with dysregulation of autonomic function in humans, which may influence the morbidity and mortality of cardiovascular (CV) diseases. Being physically active has been proven to be a protective measure against CV diseases. Thus, this study aimed to determine the effect of moderate-intensity aerobic exercise on CV modulation among obese females in the mid-western region of Nepal. Materials and Methods: We screened 28 healthy subjects to study the correlation between exercise and CV reactivity (Autonomic Nervous System (ANS) modulated) in obese subjects. Anthropometric and autonomic function parameters were measured before and after the intervention of four months of aerobic exercise and analysed. Results: The result showed a strong correlation of exercise with Resting Heart Rate (RHR) (p= 0.02), baseline systolic blood pressure (SBP) (p= 0.01), and diastolic blood pressure (DBP) (p =0.03 ). It also showed a significant correlation between exercise and CV reactivity change in SBP (p = 0.01) during the cold pressor test (CPT). However, some variables like change in DBP during CPT did not have a significant correlation (p= 0.94 ) with exercise. Conclusion: As obesity-related morbidity and mortality are burgeoning in our society, it is imperative to focus on exercise training to prevent and reverse CV neuropathy. Relevant aerobic exercise intervention can serve as an excellent countermeasure for the prevention of CV disease (CVD) by CV autonomic modulation.
... In the present study, we also observed significant decreases in total cholesterol and apo B following the exercise week despite minimal reductions in body weight, an uncommon finding in the current literature (46,48). Changes in plasma volume could contribute to the acute reduction in plasma lipids and lipoproteins in the 48 h following exercise (49). However, adjustment for total body water in our models comparing values before and after the exercise week did not change the results (data not shown). ...
... Regarding glycemia and blood pressure, the positive effects of acute and chronic endurance have been extensively documented (49,52). To our knowledge, changes in HbA1c following 1 wk of extreme exercise have never been documented. ...
This cardiometabolic imaging study was designed to document the adaptation of middle-aged recreational cyclists to a large exercise prescription not aiming at weight loss. Eleven middle-aged recreational male cyclists traveled 1,144 km over seven consecutive days. A comprehensive cardiometabolic profile including visceral and ectopic adiposity assessed by magnetic resonance imaging was obtained at baseline and following the exercise week. Cardiorespiratory fitness (CRF) was measured using maximal cardiopulmonary exercise testing. During the week, heart rate was monitored to calculate individual energy expenditure. Baseline characteristics of cyclists were compared to 86 healthy males with the same age range. Cyclists presented higher baseline CRF (+9.2 mL/kg/min, p<0.0001) and lower subcutaneous (−56.2 mL, p<0.05) and liver fat (−3.3%, p<0.05) compared to the reference group. Despite the large energy expenditure during the cycling week, the increase in energy intake limited decreases in body weight (−0.8±0.9 kg, p<0.05) and body mass index (−0.3±0.3 kg/m ² , p<0.05). Loss of fat mass (−1.5±1.0 kg, p<0.001) and a trend toward an increased lean mass (+0.8±1.2 kg, p<0.07) were observed. Visceral adiposity (−14.1±14.2 mL, p<0.01) and waist circumference (−3.2±1.7 cm, p<0.0001) decreased while subcutaneous (−2.7±5.1 mL, NS), liver (−0.5±0.9%, NS) and cardiac fat (−0.3±2.3 mL, NS) remained unchanged. This cardiometabolic imaging study documents middle-aged recreational cyclists' subcutaneous and visceral adiposity as well as cardiac and liver fat responses to a large volume of endurance exercise despite an increase in energy intake aimed at limiting weight loss.
... Therefore, different results may be reported for people who perform extensive physical activity during work and locomotion. Fourth, measurements of acute physiological and metabolic changes that persist after physical activity remain unclear [39][40][41][42]. Particularly, HDL-cholesterol can improve from 24 h to 72 h, and improvement in insulin sensitivity can last several days [39][40][41][42]. ...
... Fourth, measurements of acute physiological and metabolic changes that persist after physical activity remain unclear [39][40][41][42]. Particularly, HDL-cholesterol can improve from 24 h to 72 h, and improvement in insulin sensitivity can last several days [39][40][41][42]. Therefore, future studies should consider the timing of cardiac metabolism and physical activity measurements and be asked not to exercise for 1 day before collecting individual blood samples. ...
These days, it is not common for people to have time to do physical activities regularly because of their own work. So, they perform physical activities all at once, which is often called the “weekend warrior”. Therefore, this study aimed to examine the association of the “weekend warrior” and other physical activity patterns with metabolic syndrome. Data from the Korea National Health and Nutrition Examination Survey were used, and 27,788 participants were included. The participants were divided into inactive, weekend warriors, and regularly active based on physical activity patterns. The risk of metabolic syndrome in each group was analyzed using multiple logistic regression. The inactive and weekend warrior groups showed a higher likelihood of developing metabolic syndrome than the regularly active groups (weekend warrior: odds ratio (OR) 1.29, confidence interval (CI) 1.02–1.65; inactive: OR 1.38, CI 1.25–1.53). According to the physical activity patterns, the weekend warrior group showed a dose-response relationship compared to the regularly active group (only moderate: OR 1.85, CI 1.25–2.72; only vigorous: OR 1.41, CI 0.93–2.14; both: OR 0.84, CI 0.56–1.27). This study found increasing the amount of physical activity and performing vigorous-intensity physical activity helped manage metabolic syndrome in the weekend warrior group.
... PA seems to contribute to lower values of the prevalence of hypertension through its acute effects, with particular relevance in the population identified with prehypertension, which considered a critical population [65]. Some investigations have studied the acute response on BP reduction [66,67] because they considered it relevant to the chronic effects [66]. ...
... PA seems to contribute to lower values of the prevalence of hypertension through its acute effects, with particular relevance in the population identified with prehypertension, which considered a critical population [65]. Some investigations have studied the acute response on BP reduction [66,67] because they considered it relevant to the chronic effects [66]. ...
Introduction:
Reducing the prevalence of hypertension is a major priority of the World Health Organization (WHO). Its high prevalence and associated risks generate high economic and social costs. Physical activity (PA) is associated with a decrease in hypertension and in the use of antihypertensive drugs.
Objective:
To explore the association between PA levels (PAL), prevalence of hypertension and the use of antihypertensive drugs in Spanish population. To calculate risks of hypertension and use of antihypertensive in the inactive versus physically active population.
Method:
This cross-sectional study used data from 17717 individuals, sampled in the 2017 National Health Survey. Interaction by sex, age groups, body mass index (BMI), hypertension prevalence, antihypertensive drugs use and PAL, using a pairwise z-test, and dependence relationships between variables, were studied using a chi square test. Odds ratios of hypertension and antihypertensive drug use were calculated among the inactive and the physically active populations.
Results:
The findings showed a significant inverse association between prevalence of hypertension, antihypertensive use, and PAL in both sexes and different age and BMI groups, with lower prevalence of hypertension and antihypertensive use when PAL were higher. The risks of hypertension and antihypertensive use seems to be reduced when related to higher PAL compared to inactive people.
Conclusions:
High PAL is associated with lower prevalence of hypertension and lower antihypertensive use. Thus, being physically active or very active may reduce the risks of suffering from hypertension and the need to use antihypertensives compared to inactive people or walkers.
... It is advantageous to conduct acute exercise studies first to inform the development of high-quality randomized controlled trials (RCTs) to investigate long-term effects of chronic exercise. It is common to conceptualize effects of chronic exercise as the accumulation of acute effects of exercise [15]. For example, evidence supports slight and transient decreases in resting blood pressure in the hours following an acute bout of aerobic exercise and stable, long-term blood pressure decreases at rest following an exercise training program [16,17]. ...
... For example, exercise training and cognitive rehabilitation programs have been conducted in sequence [70][71][72], but none have been combined as in this study, which may explain equivocal results reported when compared to individual modalities [73]. The proposed study will be the first such study to evaluate an acute exercise paradigm in persons with TBI [74], which is one approach for systematically developing an optimal aerobic exercise interventions [15,21,75]. ...
Persons with Traumatic Brain Injury (TBI) commonly present with long-term cognitive deficits in executive function, processing speed, attention, and learning and memory. While specific cognitive rehabilitation techniques have shown significant success for deficits in individual domains, aerobic exercise training represents a promising approach for an efficient and general treatment modality that might improve many cognitive domains concurrently. Existing studies in TBI report equivocal results, however, and are hampered by methodological concerns, including small sample sizes, uncontrolled single-group designs, and the use of suboptimal exercise modalities for eliciting cognitive improvements in this population. One particularly promising modality involves the application of environmental enrichment via virtual reality (VR) during aerobic exercise in persons with TBI, but this has yet to be investigated. One approach for systematically developing an optimal aerobic exercise intervention for persons with TBI involves the examination of single bouts of aerobic exercise (i.e., acute aerobic exercise) on cognition. Acute exercise research is a necessary first step for informing the development of high-quality exercise training interventions that are more likely to induce meaningful beneficial effects. To date, such an acute exercise paradigm has yet to be conducted in persons with TBI. To that end, we propose an acute exercise study that will investigate the acute effects of aerobic exercise with incremental degrees of environmental enrichment (VR) relative to a control comparison condition on executive function (divided attention and working memory) and processing speed in 24 people with TBI.
... 21 All of these are strongly supported by a study in 2001, which states heart rate and blood pressure will be reduced as blood flow improves by increasing physical activity level. 22 Our study shows that physical inactivity does put one at a higher risk of hypertension development. We could not establish a significant association between physical activity and hypertension in simple logistic regression analysis. ...
... This study received ethical approval (JKEtika 1/21 (22)) from Universiti Malaysia Sabah Medical Research Ethics Committee. ...
Background: Hypertension is one of the leading health concerns that can be intervened, especially in rural areas. Thus, this study determined the prevalence and risk factors associated with hypertension among rural dwellers in Kudat's village, Malaysia. Methods: This study used a cross-sectional design carried out from 5 th October 2019 until 17th October 2019. Universal sampling was used for sample size calculation. There are 111 respondents who are above 18 years old involved in this research. Association between hypertension and risk factors outcomes were analyzed by using logistic regression. The relationship between continuous variables was analyzed using correlation analysis. Results: The prevalence of hypertension among Kudat's villagers was 30% (n=33). There is a significant association between age and BMI with Hypertension. Also, there is a significant correlation between age, BMI, physical activity, with blood pressure. While other risk factors, including sociodemographic and lifestyles, do not significantly correlate with hypertension. Conclusion: Hypertension is highly prevalent in the village and is significantly associated with BMI and age group. Physical activity also correlates with blood pressure. Hence, an effective intervention that includes lifestyle and dietary behavior changes, health promotion, and health screening should be implemented to tackle this problem.
... These benefits encompass a reduction in cardiovascular risk, as indicated by a decrease in LDL fraction, an increase in HDL fraction, a reduction in blood pressure, and a decrease in insulin resistance through an increase in tissue demand for glucose. Other notable benefits include weight reduction, improved wellbeing, immune system function, and hormone management [1,2]. Type 2 diabetes is a growing problem particularly in developed countries becoming a 'pandemic' of the 21st century. ...
In recent decades, diabetes has become a prominent health concern in the developed world, with numerous researchers suggesting that it should be designated as the pandemic of the 21st century. Both type 1 and type 2 diabetes are on the rise, yet the latter poses a particularly significant threat. It is important to note that in a substantial number of cases, the underlying risk factors for type 2 diabetes are amenable to modification, highlighting the potential for preventative strategies. A major contributing factor is low physical activity, which significantly impedes disease control once it has developed.HIIT has been identified as a potentially effective and time-saving physical activity alternative for people with and at risk of diabetes. A comprehensive analysis of 12 papers from the 513 papers in the PubMed database was conducted, highlighting the substantial benefits of HIIT, including the immediate reduction in glucose levels post-training and the enhancement of the daily glycaemic profile due to increased insulin sensitivity of tissues. Similar observations were made regarding the reduction in systolic blood pressure and pro-inflammatory cytokines.
... A recent meta-analysis demonstrated that long-term IMT intervention decreased systolic blood pressure and diastolic blood pressure in healthy individuals and hypertensive patients and was in part mediated by an alteration in cardiac autonomic activity (6) . In addition, it is suggested that the chronic lowering of resting blood pressure following exercise training may be due to a repeated post-exercise hypotension (PEH) response (7,8) . Focus on acute exercise responses, a single bout of IMT exercise with a load of 30% of maximum inspiratory pressure (MIP) for 15 min, induced post-exercise hypotension together with improved heart rate variability (HRV) in young smokers (9) . ...
Acute responses following a single bout of exercise have been shown to predict blood pressure regulation and cardiovascular adaptations. Inspiratory muscle exercise (IMT) has been utilised in pulmonary rehabilitation programmes for COPD patients, but little is known about the immediate effects of IMT exercise on post-exercise blood pressure and cardiac responses. The current study aimed to investigate acute post-exercise blood pressure, cardiac autonomic, and myocardial oxygen demand responses to a single session of IMT among COPD individuals. Ten male COPD patients, with an average age of 65.44 ± 4.38 years, volunteered for the study. Subjects underwent the IMT protocol at 60% maximal inspiratory pressure as an inspiratory load (6 breaths/set, 1-minute rest between sets, 5 sets), while the control group subjects performed breathing without inspiratory load. Blood pressure and heart rate variability were measured before and immediately, 5, 15 and 30 min after the exercise. Systolic blood pressure in the IMT group was significantly higher than in the control group immediately after exercise. Sympathetic cardiac autonomic modulation and sympathovagal balance also showed similar responses to systolic blood pressure. The rate pressure product index of myocardial oxygen demand and heart rate significantly increased from baseline compared to immediate post-IMT exercise. However, all variables returned to the baseline values within 15 min following exercise, and no adverse effects were reported after the IMT programme. Our data suggest that single bouts of IMT sessions neither elicit post-exercise hypotension nor a high cardiac autonomic response in patients with COPD. Thus, moderate-intensity IMT exercise with a short duration appears to be safe for this population.
... The results showed that the program had a positive effect on the women's blood lipid levels (triglycerides, cholesterol, HDL and LDL). These findings demonstrate that there are clear, positive changes in lipid profile from aerobic exercise and match those of other research (Thompson et al., 2002;Kelley et al., 2005). Huang et al. (2022) stated that it would be possible to use a 10-week HIIT spinning bike exercise program as a complementary treatment to alleviate chronic diseases, suggesting it be employed to improve the health of women within the framework of an educational health plan (Biçer and Kaldırımcı, 2010) applied aerobic and aerobic + weight exercises for one hour, three days a week for three months to 30 sedentary women whose average age was 41.8 years. ...
This study investigated how a six-week training program involving aerobic exercise affected the lipid profile of women who were sedentary. Using the pre-test post-test model, 36 sedentary female volunteers aged 18-29 years participated in the study. After the participants had fasted overnight, healthcare professionals took blood samples from them both before and after the training program in a clinical setting. Measurements were taken of triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol. The data obtained was subjected to a paired-samples test using the SPSS 22.0 statistical program to compare the values before and after training. Effect sizes (Cohen's d) were used to clarify the levels of comparison. Statistically significant differences were seen in blood lipid levels (triglycerides, HDL, LDL, and total cholesterol) between pre- and post-training assessments (p < 0.05). This study found that a six-week aerobic exercise program significantly increased HDL cholesterol levels by 15.8% (from 46.66 mg/dL to 54.05 mg/dL, p = 0.000) and decreased LDL cholesterol levels by 15.7% (from 96.72 mg/dL to 81.52 mg/dL, p = 0.000) in sedentary women. The study adds to the growing body of evidence suggesting that aerobic exercise programs, such as spinning, can significantly improve lipid profiles in sedentary women, potentially reducing their risk of cardiovascular disease. Future research should incorporate control groups to strengthen these findings.
... It is generally accepted that total cholesterol and low-density lipoproteins, which are risk factors for ischaemic heart diseases, are less likely to be affected by exercise training. However, highdensity lipoprotein cholesterol (HDL-C) and triglyceride are more responsive to rehabilitation programmes [32,33]. ...
Objective: Few data are available on the effect of resistance exercise training combined with endurance training (circuit training) on new molecular biomarkers which are considered as early independent risk factors for atherosclerosis progression. The purpose of the present study was to evaluate the effect of a cardiac rehabilitation programme (CRP), on homocysteine (Hcy), apolipoprotein A1, peak VO 2 and muscle strength in patients with stable angina pectoris. Method: A total of 40 male patients with stable angina pectoris class I and class II according to the NYHA classification were recruited. Their ages ranged between 40 and 50 years. Patients were randomly divided into two groups: Group (A), the training group who received CRP for three months and Group (B), the control group. Results: At the end of the programme, the study group (A) showed a significant reduction in homo-cysteine along with a significant increase in ApoA1, peak VO 2 and muscle strength, while the control group showed a non-significant increase in homocysteine, peak VO 2 and muscle strength along with a non-significant decrease in ApoA1. There was a negative strong correlation between Hcy and apolipoprotein A1 (r ¼ À0.76, p ¼ .0001), between Hcy and peak VO2 (r ¼ À0.81, p ¼ .0001) and strong positive correlation between peak VO2 and ApoA1 in the study group. Conclusion: It could be concluded that CRP reduced serum Hcy levels with an increase in apolipopro-tein A1, peak VO 2 and muscle strength in patients with angina pectoris. ARTICLE HISTORY
... Previous studies related to accumulated exercise mostly focused on the effect of different interval times of accumulated exercise. It has been summarized that, at least as to cardiovascular risk factors, only when the residual effect from the previous exercise bout exists, the acute exercise effect may accrue in the next exercise bout (Thompson et al., 2001). Accumulated exercise with a shorter, as opposed to a longer, rest interval between exercise bouts elicited more pronounced neuroendocrine (Ronsen et al., 2002) and augmented metabolic stress (Ronsen et al., 2004). ...
Purpose: This research aims to study and compare the effects of moderate-intensity continuous exercise and accumulated exercise with different number of bouts on common carotid arterial stiffness and hemodynamic variables.
Methods: Thirty healthy male adults were recruited to complete four trials in a randomized crossover design: no-exercise (CON); continuous exercise (CE, 30-min cycling); accumulated exercise including two or three bouts with 10-min rest intervals (AE15, 2 × 15-min cycling; AE10, 3 × 10-min cycling). The intensity in all the exercise trials was set at 45%–55% heart rate reserve. Blood pressure, right common carotid artery center-line velocity, and arterial inner diameter waveforms were measured at baseline and immediately after exercise (0 min), 10 min, and 20 min.
Results: 1) The arterial stiffness index and pressure–strain elastic modulus of the CE and AE15 groups increased significantly at 0 min, arterial diameters decreased in AE15 and AE10, and all indicators recovered at 10 min. 2) The mean blood flow rate and carotid artery center-line velocity increased in all trials at 0 min, and only the mean blood flow rate of AE10 did not recover at 10 min. 3) At 0 min, the blood pressure in all trials was found to be increased, and the wall shear stress and oscillatory shear index of AE10 were different from those in CE and AE15. At 20 min, the blood pressure of AE10 significantly decreased, and the dynamic resistance, pulsatility index, and peripheral resistance of CE partially recovered.
Conclusion: There is no significant difference in the acute effects of continuous exercise and accumulated exercise on the arterial stiffness and diameter of the carotid artery. Compared with continuous exercise, accumulated exercise with an increased number of bouts is more effective in increasing cerebral blood supply and blood pressure regulation, and its oscillatory shear index recovers faster. However, the improvement of blood flow resistance in continuous exercise was better than that in accumulated exercise.
... Thus, it is important to prevent over-physiological increases in circulating FABP4 concentration for various diseases prevention. Chronic and acute aerobic exercise has beneficial effects on metabolic disorders via change in blood parameters [12,13]. Blood parameters such as inflammatory cytokines may exhibit differential responsiveness to acute and chronic exercise. ...
Background
Fatty acid-binding protein 4 (FABP4) has been associated with cardiovascular disease and diabetes. Acute aerobic exercise increases circulating FABP4 concentrations, but the underlying mechanisms remain unclear. The purpose of this study was to investigate the effects of inhibition of lipolysis by carbohydrate ingestion on circulating FABP4 concentrations during and after acute aerobic exercise in healthy men.
Methods
Men aged between 20 and 40, with no exercise habits and no metabolic diseases, were recruited. In a randomized crossover design, the participants underwent a carbohydrate-ingestion exercise (CE) and a fasted exercise (FE) trial. The CE trial consisted of 40-min acute aerobic exercise with ingestion of carbohydrates and 60-min bed rest. The FE trial followed the same protocol as the CE trial but without carbohydrate ingestion. Venous blood samples were collected to measure hormones (adrenaline, noradrenaline, and insulin) metabolites (glycerol, free fatty acids, and glucose), and FABP4 concentrations. Ventilation and gas exchange were also collected to measure substrate oxidation.
Results
Thirteen healthy men participated in and completed both the CE and FE trials. The insulin concentration was more than 4 times higher in the CE trial than in the FE trial (p < 0.004, effect size [ES] > 2.00). Free fatty acid concentrations were more than 4 times lower in the CE trial than in the FE trial (p < 0.02, ES > 2.04). However, there was no significant difference in the changes in circulating FABP4 concentrations between the CE and FE trials (p = 0.108), which did not change during aerobic exercise and significantly increased post-aerobic exercise in both trials (p < 0.002, ES > 1.212). Changes in FABP4 concentrations following aerobic exercise were not significantly correlated with changes in glycerol or free fatty acid concentrations during aerobic exercise.
Conclusions
The results suggest that suppression of lipolysis and elevation of insulin are not strongly involved in increases in FABP4 secretion following acute aerobic exercise.
... can persist for up to 22 h in hypertensive individuals (Pescatello, Franklin et al., 2004), it has been suggested that the lowering of resting blood pressure following regular endurance training may be related to repeated instances of post-exercise hypotension (Thompson et al., 2001). Moreover, post-exercise hypotension has been suggested to be an important stimulus necessary for eliciting certain adaptations to chronic exercise training, such as plasma volume expansion (Halliwill, 2001;Halliwill et al., 2014). ...
The effect of different exercise intensities on the magnitude of post‐exercise hypotension has not been rigorously clarified with respect to the metabolic thresholds that partition discrete exercise intensity domains (i.e., critical power and the gas exchange threshold (GET)). We hypothesized that the magnitude of post‐exercise hypotension would be greater following isocaloric exercise performed above versus below critical power. Twelve non‐hypertensive men completed a ramp incremental exercise test to determine maximal oxygen uptake and the GET, followed by five exhaustive constant load trials to determine critical power and W′ (work available above critical power). Subsequently, criterion trials were performed at four discrete intensities matched for total work performed (i.e., isocaloric) to determine the impact of exercise intensity on post‐exercise hypotension: 10% above critical power (10% > CP), 10% below critical power (10% < CP), 10% above GET (10% > GET) and 10% below GET (10% < GET). The post‐exercise decrease (i.e., the minimum post‐exercise values) in mean arterial (10% > CP: −12.7 ± 8.3 vs. 10% < CP: v3.5 ± 2.9 mmHg), diastolic (10% > CP: −9.6 ± 9.8 vs. 10% < CP: −1.4 ± 5.0 mmHg) and systolic (10% > CP: −23.8 ± 7.0 vs. 10% < CP: −9.9 ± 4.3 mmHg) blood pressures were greater following exercise performed 10% > CP compared to all other trials (all P < 0.01). No effects of exercise intensity on the magnitude of post‐exercise hypotension were observed during exercise performed below critical power (all P > 0.05). Critical power represents a threshold above which the magnitude of post‐exercise hypotension is greatly augmented.
... 30,31 The fall in BP seen after the exercise may be caused by a reduced signal transduction from sympathetic nerve activation into vasoconstriction and local vasodilator mechanisms. 32 Hypertension is frequently characterized by pathologic left ventricular remodeling with concentric hypertrophy. 28 In hypertensive patients, physical activity has been associated with paradoxical regression or prevention of left ventricular hypertrophy, suggesting a mechanism by which exercise can benefit hypertensive patients. ...
Hypertension is a great public health problem worldwide and is associated with increased cardiovascular, cerebrovascular and renal complications. The development of nonpharmacological therapies is a cost-effective strategy that helps in the prevention of comorbidities. Beneficial effects of structured exercise have been demonstrated for the primary prevention and treatment
of hypertension. This paper aims to review the components of exercise prescription and the approaches to developing appropriate exercise prescription for patients with hypertension.
... Physical activity and exercise offer a wide range of health benefits. Physical activity was reported for all ages to minimize cardiovascular risks, improve immune function, energy balance, psychological status, and improve overall health for all ages [1,2]. Type 2 diabetes mellitus is considered one of the most serious chronic diseases that often follows obesity. ...
Background and Objectives: Physical exercise is an important therapeutic modality for treating and managing diabetes. High-intensity interval training (HIIT) is considered one of the best non-drug strategies for preventing and treating type 2 diabetes mellitus (T2DM) by improving mitochondrial biogenesis and function. This study aimed to determine the effects of 12 weeks of HIIT training on the expression of tumor suppressor protein-p53, mitochondrial cytochrome c oxidase (COX), and oxidative stress in patients with T2DM. Methods: A total of thirty male sedentary patients aged (45–60 years) were diagnosed with established T2DM for more than five years. Twenty healthy volunteers, age- and sex-matched, were included in this study. Both patients and control subjects participated in the HIIT program for 12 weeks. Glycemic control variables including p53 (U/mL), COX (ng/mL), total antioxidant capacity (TAC, nmole/µL), 8-hydroxy-2′-deoxyguanosine (8-OHdG, ng/mL), as well as genomic and mitochondrial DNA content were measured in both the serum and muscle tissues of control and patient groups following exercise training. Results: There were significant improvements in fasting glucose levels. HbA1c (%), HOMA-IR (mUmmol/L²), fasting insulin (µU/mL), and C-peptide (ng/mL) were reported in T2DM and healthy controls. A significant decrease was also observed in p53 protein levels. COX, 8-OhdG, and an increase in the level of TAC were reported in T2DM following 12 weeks of HIIT exercise. Before and after exercise, p53; COX, mt-DNA content, TAC, and 8-OhdG showed an association with diabetic control parameters such as fasting glucose (FG), glycated hemoglobin (HbA1C, %), C-peptide, fasting insulin (FI), and homeostatic model assessment for insulin resistance (HOMA-IR) in patients with T2DM. These findings support the positive impact of HIIT exercise in improving regulation of mitochondrial biogenesis and subsequent control of diabetes through anti-apoptotic and anti-oxidative pathways. Conclusions: A 12-week HIIT program significantly improves diabetes by reducing insulin resistance; regulating mitochondrial biogenesis; and decreasing oxidative stress capacity among patients and healthy controls. Also; p53 protein expression; COX; 8-OhdG; and TAC and mt-DNA content were shown to be associated with T2DM before and after exercise training.
... The present study investigated the acute and chronic effects of ST on plasma levels of adipokines in healthy young men. Thompson et al. assumed that isolated exercise sessions elicit acute effects when transient cardiovascular and metabolic responses occur; however, frequent repetition of these isolated sessions produces more permanent adaptations, referred to as the exercise training response or chronic response [28]. The main findings of this study were as follows: (1) Fatouros et al. [29] detected a significant increase in the plasma adiponectin levels immediately after a high intense ST protocol (80-85 % 1RM) in sedentary elderly men when compared to baseline. ...
Adipose tissue is specialized cells that produce and release adipokines. Exercise may modulate adipokine production in adipocytes. The aim of this longitudinal study was to evaluate the acute and chronic effects of strength training (ST) on plasma levels of adiponectin, leptin, and resistin. Twelve untrained young male participants (23.42±2.67 years) were selected. The training protocol consisted of 3 exercises, with 3 sets of 65% of 1RM (one-repetition maximum) with pause of 90 s between sets with duration of 5 s/repetition (2 s conc/3 s ecc), 3 times a week for 10 weeks. Blood was collected at four time points: before and after the first ST session and before and after the last ST session. The comparisons between adipokine levels before and after the same training session showed acute changes, while the comparisons between levels before or after the first session versus before or after the last session revealed chronic alterations. ST increased adiponectin levels after the first exercise session in comparison to levels before this session [50 952 (46 568–51 894) pg/mL vs. 52 981 (49 901–54 467) pg/mL, p=0.019]. Similar differences were observed for resistin levels, which were higher after the last session compared to before [4 214.4 (±829) pg/mL vs. pre-S30 2 251.3 (±462.2) pg/mL, p=0.0008] and in the comparison between after the last and after the first ST sessions [4 214.4 (±829.0) pg/mL vs. 1 563.7 (±284.8) pg/mL, p=0.004]. Leptin levels acutely changed in the last training session. ST produced acute and chronic changes in plasma adipokines.
... Low cardiorespiratory fitness is a well-known risk factor for chronic diseases like heart disease, T2DM and obesity, and is a key predictor of death among diabetics [12][13][14]. Physical activity and exercise, on the other hand, provide a wide range of health benefits, including improved cardiorespiratory fitness, energy balance, psychological well-being, immune function, strength, and flexibility, making it the most important means of improving overall health and well-being for people of all ages [15,16]. ...
... This response may last up to 22 h after exercise and, due to the decrease in systemic vascular resistance, usually drops the arterial blood pressure by 5-7 mmHg. The reduction in blood pressure after exercise can be sustained for up to 1-2 weeks, after three or more separate bouts of exercise (6). Over time, these changes chronically translate into eccentric left ventricular hypertrophy with a preserved cardiac function (7). ...
Physical exercise is found to have positive health and well being of a person since time immemorial. Regular exercise has proved to normalize the elevated blood pressure of mild to moderate intensity by many studies. The blood pressure response to such exercise may also be used to screen normotensive persons for the risk of developing elevated blood pressure. For mild hypertension aerobic exercise and life style changes such as weight loss, dietary changes such as salt restriction and cessation of smoking are probably better choices. In moderate to severe essential hypertension, exercise should be combined with life style changes and medication. The aim of this review study is to delineate the effect of exercise in the control of elevated blood pressure. Methods used were analysis of the published article collected from the internet and other sources. The specific aims were to emphasis the importance of exercise as therapeutic intervention for the control of hypertension. doi: 10.3329/uhj.v5i1.3440 University Heart Journal Vol. 5, No. 1, January 2009 36-39
... Details about specific blood sample analyses can be found in Study V. Briefly, after an overnight fast (≥10 hours) participants arrived at the Hospital, where approximately 50 mL was drawn from the antecubital vein for analyses of traditional and 'novel' biomarkers of CVD risk. Strong evidence suggests that the effects on some risk factors (including blood biomarkers) attributed to exercise training may at least partially reflect the result of the latest exercise bout (231). For participants in UBROW, blood sampling was therefore performed between 36 and 60 hours after the last exercise session at both 6W and 12W to minimize any acute effects from the last exercise session on blood biomarkers. ...
People using a wheelchair are less physically active than able-bodied because they
face tremendous physical, psychological, and socio-environmental barriers for
physical activity. Accordingly, wheelchair users, including those with a spinal cord
injury (SCI), are at an increased risk of cardiometabolic diseases. Previous exercise
studies performed in wheelchair users with SCI have reported limited effects of
exercise training on traditional risk factor for cardiometabolic diseases, including lipid
profile, glycemic control, and blood pressure. Recently, exercise guidelines for adults
with SCI was updated, however few studies have examined the efficacy of these
guidelines on traditional cardiometabolic risk factors, as well as measures of vascular
function and structure.
Study I, a cross-sectional study, identified physical activity barriers among 181
Danish manual wheelchair users. The most prevalent and severe reported barriers
were related to an inaccessible community-built environment, shoulder pain, fatigue,
and a lack of accessible exercise equipment. Study II investigated associations
between wheelchair user sociodemographic characteristics and physical activity
barrier perception and found that wheelchair users with body mass index ≥30 kg/m2;
who did not complete high school; or were unemployed rated barriers higher than their
non-obese, higher educated and employed counterparts. Study III described the
protocol for a randomized controlled trial consisting of an exercise intervention
designed to mitigate some of the identified barriers from Study I, specifically the ‘lack
of accessible exercise equipment’ and ‘shoulder pain’ barriers. Study IV examined
the feasibility, acceptability, and preliminary efficacy of the exercise modality
proposed in Study III, ergometer rowing adapted to wheelchair users. This study
provided evidence suggesting that upper-body rowing exercise is a feasible and
effective exercise modality that provides an available exercise option in community
fitness centers and can be performed without exacerbating shoulder pain. Study V, a
randomized controlled trial, demonstrated that 12-weeks of upper-body rowing
exercise complying with current exercise guidelines for adults with SCI improves
cardiorespiratory fitness and increases resting brachial artery diameter (determined by
high-resolution ultrasound), with limited effects on traditional cardiometabolic risk
factors.
The results of this dissertation highlight the need of reducing physical activity barriers
among wheelchair users, and/or develop solutions that mitigate the impact of such
barriers on physical activity behavior. Work from this dissertation also suggests that
ergometer rowing exercise adapted to wheelchair users may provide a useful and
pragmatic tool for performing aerobic exercise without exacerbating shoulder pain.
Finally, the results indicate that complying with the current exercise guidelines for
adults with SCI elicit improvements in cardiorespiratory fitness and structural
vascular adaptations.
... Therefore, we hypothesized that arm arterial stiffness would be reduced following both steady state eccentric and concentric arm cycling, but that central arterial stiffness would remain unchanged. Determining if upper-body eccentric exercise minimizes arterial stiffness is clinically relevant because repeated bouts of acute exercise training could have cumulative benefits over time (39). ...
Upper-body resistance exercise effectively increases muscular strength, but may concomitantly increase arterial stiffness. Eccentric exercise can lead to muscle soreness and arterial stiffness in untrained participants. However, it is unclear if upper-body eccentric exercise could reduce arterial stiffness in a single session for participants that have undergone progressive training. Our purpose was to compare acute responses to upper-body eccentric (novel, ECCarm) and concentric (traditional, CONarm) steady state arm cycling. We hypothesized that arm arterial stiffness would be reduced after both ECCarm and CONarm. Twenty-two young healthy individuals performed either ECCarm (n = 11) or CONarm (n = 11) at ~70% of peak heart rate for 20 min after a training period. Heart rate, central pulse wave velocity (cPWV), and peripheral pulse wave velocity (pPWV; i.e., arm arterial stiffness) were assessed before, 10 min, and 30 min after exercise. Heart rate was not elevated at 10 min post ECCarm, but was elevated at 10- and 30-min post CONarm (p < 0.01). After exercise, pPWV was decreased at 10 min post for both ECCarm (7.1 ± 0.3 vs. 6.5 ± 0.2 m/s) and CONarm (7.0 ± 0.2 vs. 6.5 ± 0.2 m/s; p < 0.05), while both groups returned to baseline values 30 min post. cPWV did not change in either group. Our results indicate that acute ECCarm provides a high-force, low energy cost form of resistance exercise that acutely reduces arm arterial stiffness. The reduction in pPWV and rapid heart rate recovery suggests that ECCarm is a safe form of exercise for overall and cardiovascular health.
... Resistance exercise training induces not only muscle adaptations such as increases in muscle strength and mass, but also positive effects on insulin sensitivity and blood lipid profile (Tsekouras et al., 2009;Bacchi et al., 2012). Generally, chronic adaptations to an exercise training can be predicted by acute responses to a bout of exercise (Thompson et al., 2001). However, changes in insulin sensitivity and blood lipid profile markers after an acute resistance exercise are not necessarily reflective of those after resistance exercise training. ...
An acute bout of eccentric exercise affects insulin sensitivity and lipid profile, but how the magnitude of muscle damage affects them is not clear. We compared changes in blood insulin sensitivity and lipid markers after the first (EC1) and second (EC2) eccentric exercise bouts. Fifteen sedentary young men performed arm, leg and trunk muscle eccentric exercises, and repeated them 2 weeks later. Fasting blood samples were taken before, 2 h and 1–5 days after each exercise bout to analyze plasma creatine kinase (CK) activity, serum glucose (GLU), insulin, homeostasis model assessment (HOMA), triacylglycerols (TG), total (TC) and low- (LDLC) and high-density lipoprotein cholesterol (HDLC) concentrations as well as TC/HDLC ratio. Changes in these measures were compared between bouts and relationships to peak plasma CK activity were analyzed. Plasma CK activity increased (p < 0.05) after EC1 (peak: 101,668 ± 58,955 IU/L) but not after EC2. The magnitude of changes in GLU (peak after EC1: 26 ± 10% vs. EC2: 7 ± 6%), insulin (46 ± 27% vs. 15 ± 8%), HOMA (86 ± 48% vs. 24 ± 15%), TC (−20 ± 5% vs. −6 ± 4%), TG (−32 ± 11% vs. −6 ± 3%), LDHC (−47 ± 15% vs. −12 ± 9%), HDLC (35 ± 26% vs. 7 ± 4%), and TC/HDLC ratio (−139 ± 13% vs. −11 ± 7%) were significantly greater after EC1 than EC2. Peak plasma CK activity was significantly (p < 0.05) correlated with the peak changes in blood insulin sensitivity and lipid markers for the combined data of EC1 and EC2. These results suggest that the greater the magnitude of muscle damage, the greater the magnitude of changes in the insulin sensitivity to a negative direction and lipid markers to a positive direction.
... Paradoxically, this slower recovery of cardiovagal modulation might promote a super-compensation response before full recovery [20,21]. Thus, acute aerobic exercise presents a challenge to the cardiac autonomic system that can predict the effects of chronic exercise, as in the case of blood pressure reduction [22], and provide mechanistic insights on the individual fitness responses to exercise [23]. In fact, cardiorespiratory fitness level (CRF) has been suggested to be a modulator of the cardiovagal modulation response following aerobic exercise, as individuals with high CRF have a reduced suppression and a faster cardiovagal modulation reactivation [21]. ...
We compared response patterns of cardiovagal modulation through indices of heart-rate variability (HRV) and baroreflex sensitivity (BRS) at 10 and 60 min following an acute bout of high-intensity interval exercise (HIIE) and moderate-intensity continuous exercise (MICE) in active young and older adults. Twelve young (aged 20-40 years) and older (aged 57-76 years) healthy and active male adults performed an isocaloric acute bout of HIIE, MICE, or a non-exercise condition in a randomized order. HRV and BRS indices were analysed offline with R-R intervals obtained from a supine position. HIIE decreased natural logarithm (Ln) standard deviation of NN intervals (d= -0.53; 95% CI: -0.77 to -0.30 ms, p<0.001), Ln-root mean square of successive differences (d= -0.85; 95% CI: -1.09 to -0.61 ms, p<0.001), Ln-high-frequency power (d= -1.60; 95% CI: -2.11 to -1.10 ms2; p<0.001), and BRS (d= -6.28; 95% CI: -8.91 to -3.64 ms/mmHg, p <0.001) following exercise in young and older adults, whereas MICE did not. Indices returned to baseline following 60 min. We found no evidence of age-associated response patterns in HRV or BRS to a single bout of HIIE or MICE in active participants. HIIE reduced cardiovagal modulation in active young and older adults, returning to baseline values 60 min into recovery.
... Blood pressure reduction caused by aerobic exercise is caused by changes in arterial compliance. Furthermore, changes in vasodilation vasa vasorum in the aorta are influenced by nitric oxide and temperature (27). Endothelial cells that are intact and functional can release vasodilator compounds and vasoconstrictors to control blood flow and vascular tone during rest and exercise (28). ...
Background:
The goal of this study is to see how elderly gymnastics affect blood pressure, plasma glucose levels, and total cholesterol levels in women over the age of 65.
Objective:
The purpose of this study is to look into the effects of gymnastics on changes in blood pressure, blood sugar levels, and total cholesterol levels in the elderly..
Methods:
Thirty-four female elderly women were divided into two groups: those who received gymnastics and those who did not. For three weeks, regular gymnastics exercises were performed on a weekly basis. Blood pressure, plasma glucose levels, and total cholesterol levels were measured using standard techniques and methods.
Results:
When compared to controls, regular gymnastics exercise can significantly lower blood pressure (p < 0.05). This decrease is also observed in total cholesterol levels (p < 0.05).
Conclusions:
Elderly gymnastics was found to lower blood pressure and total cholesterol levels in the elderly. As a result, elderly gymnastics could be a viable option for preventing cardiovascular disease and metabolic syndrome.
... Additionally, Chodzko-Zajko [7] studied the benefits of being physically active in healthy aging, while he also proved that physical inactivity could lead to the development of numerous chronic diseases and conditions. Overall, physical activity has been recommended as a therapeutic intervention for the management and treatment of many chronic conditions and diseases, such as depression and anxiety disorders [8], dementia [9], type 2 diabetes [10], obesity [11], osteoporosis [12,13], hypertension [14,15], and coronary heart disease [16,17]. ...
Physical activity recognition through wearables has enabled the development of novel applications in healthcare. Most of the existing studies focus on predicting activities using wearable sensors, either in a controlled or uncontrolled environment. However, there is not a clear distinction between these two environments. Hence, this thesis aimed to answer the research question “How accurately can we classify physical activity based on wearable accelerometers placed on the wrist and chest in a controlled and in a free-living environment?".
For the data collection phase, two experiments were conducted in the working environment of imec. 40 participants were recruited and were asked to participate in the Controlled and Free-Living Study. The subjects wore two imec wearables, a wrist-worn and chest-worn accelerometer sensor and performed everyday activities. These activities include sitting, dynamic sitting, lying with face up and face down, lying to the left and right, standing, dynamic standing, walking upstairs, walking downstairs, walking, running, and cycling. The Controlled Study showed that most of these activities could be detected accurately using accelerometer data from both sensors with a 91.83% F1-score. Similarly, the combination of these two sensors achieved the best performance for the Free-Living Study with 86.98% F1-score. Finally, this work proved that between the two environments a correlation could be possible only for the activity cycling. Consequently, this research concludes that activity recognition should be explicitly investigated in free-living environments, focusing on real-time activity detection.
... The superior effects of intermittent exercise might depend on the residual effect of the prior short exercise bout 19 , and we found that when the interval duration was elongated, the superior effects of intermittent exercise on arterial stiffness might disappear 11 . This inspired us to hypothesize that shortening the interval between bouts might enhance the effects of two 10-min bouts. ...
To compare the acute effects of low-volume intermittent and higher-volume continuous exercise on arterial stiffness, 20 healthy men (22.4 ± 0.4 years) were randomized to non-exercise control (CON), high-volume Continuous Exercise (CE), lower-volume Intermittent exercise of Long bouts with Long interval (ILL), of Long bouts with Short interval (ILS), and of Short bouts with Short interval trial (ISS). Exercise intensity was 35% heart rate reserve. Arterial stiffness in Cardio-ankle vascular index (CAVI) was measured at baseline (BL), immediately (0 min) and 40 min after exercise. CAVI changes from BL in the same trial (⊿CAVI) were used for analysis. There was no significant ⊿CAVI change in CON. ⊿CAVI decreased significantly at 0 min in all exercise trials, and reverted to baseline at 40 min only in CE and ILL. At 40 min, ⊿CAVI in ILS and ISS remained significantly lower than that of CON and CE. When ILS and ISS were compared with CON at 40 min, only ⊿CAVI in ISS remained significantly lower than that of CON. Despite low volume, the effect of intermittent exercise on arterial stiffness could be either equal or superior to that of higher-volume continuous exercise.
... In healthy individuals, a bout of prolonged aerobic exercise (involving high rates of oxygen delivery and consumption) lowers fasting blood TG levels and raises high-density lipoprotein-c concentrations. 71 The TG-lowering effect of exercise appears to be more powerful after ingestion of a fatty meal (high atherogenic risk) than after an overnight fast (Fig. 3). A bout of exercise reduces PPTG levels not only in healthy individuals but also in individuals with dyslipidemia, 52 MetS, 20 and other CVD risk factors. ...
Background
Individuals at risk of suffering cardiovascular disease (CVD) present larger increases in blood triglyceride (TG) concentration after a high-fat meal than healthy individuals. This postprandial hypertriglyceridemia (PPTG) is an independent risk factor for CVD. Prescription of statins and a bout of prolonged exercise are both effective in lowering PPTG. We aimed to evaluate the comparative effectiveness of statins versus a bout of aerobic exercise in reducing fasting and postprandial blood TG in individuals at high risk of developing CVD.
Methods
Thirty-seven studies from a systematic literature search of the PubMed, EMBASE, and Cochrane databases were included in this review. The selected studies conducted trials involving statin therapy (n = 20) or a bout of aerobic exercise (n = 19) and measured their impact on PPTG as an outcome. Two studies analyzed both treatments and were included in duplicate. The meta-analysis was constructed using a random-effects model to calculate the mean difference (MD). Student's t test was used to compare the data sets for statins vs. exercise.
Results
Overall, statin and exercise interventions showed a similar reduction in PPTG levels, with an MD of –0.65 mmol/L for statins (95% Confident Interval (95%CI): –0.54 to –0.77; p < 0.001) and -0.46 mmol/L for exercise (95%CI: –0.21 to –0.71; p < 0.01). However, statins lowered fasting TG more than exercise (MD = –1.54 mmol/L, 95%CI: –2.25 to –0.83; p = 0.009).
Conclusion
Although aerobic exercise is effective in lowering blood TG, statins seem to be more efficient, especially in the fasted state. A combination of exercise and statins might reveal a valuable approach to the treatment and prevention of CVD. More studies are required to determine the underlying mechanisms and the possible additive effects of these interventions.
[Purpose] This research focused on examining how an 8-weeks intervention of high-intensity (HIAE) and moderate-intensity aerobic exercise (MIAE) influenced body composition, β-amyloid (Aβ) levels, metabolic markers (glucose, insulin, and HOMA-IR), and blood lipid profiles (total cholesterol [TC], triglycerides [TG], low-density lipoprotein-cholesterol [LDL-C], and high-density lipoprotein-cholesterol [HDL-C]) in obese middle-aged women.[Methods] Thirty obese middle-aged women (body mass index [BMI] ≥ 25 kg/m2, body fat ≥ 30%) were randomly divided into three groups: HIAE, MIAE, or control groups (n = 10 per group). The exercise groups performed aerobic exercise three times per week for 8 weeks at an intensity of 80–85% (HIAE) and 60–65% (MIAE) of VO2max. Body composition, Aβ levels, metabolic markers, and blood lipid profiles were measured before and after the intervention. A two-way repeated-measures analysis of variance (ANOVA) was applied to analyze the data and determine interaction effects.[Results] Both the HIAE and MIAE groups showed notable reductions in body weight, body fat percentage, BMI, Aβ, glucose, insulin, HOMA-IR, and all blood lipid variables over time compared to the control group ( p < 0.001). Significant time-by-group interaction effects were observed for each variable, with HIAE resulting in greater reductions in TC, TG, and LDL-C, and greater increases in HDL-C. Post hoc analyses showed a substantial rise in HDL-C levels for the HIAE group compared to the control group ( p = 0.000), with a trend toward greater increases than in MIAE ( p = 0.058).[Conclusion] HIAE and MIAE interventions effectively improved metabolic and cognitive health markers in middle-aged women with obesity. These findings emphasize the dose-response effects of exercise intensity, with HIAE offering greater benefits for lipid control and Aβ reduction.
Randomized controlled trials (RCTs) are the gold standard of research design and therefore provide the bedrock of evidence for claims regarding the health benefits of exercise training across the human lifespan. Nevertheless, there is substantial heterogeneity between RCTs regarding the outcomes of exercise training, as RCTs sometimes provide null or negative results regarding changes in outcomes, and positive results might even suffer from a lack of reproducibility by other scientists. This paper reviews the National Institutes of Health (NIH) Stage Model of Intervention Development and then identifies aligning research approaches and design considerations for informing and conducting RCTs of exercise training and its health benefits. The primary goal is the provision of a thoughtful and deliberate approach for designing RCTs that yield strong and reproducible research results regarding the health benefits of exercise training. This is necessary for strengthening the science behind the implementation and dissemination of evidence-based exercise training programs.
Background: Endurance, defined as the ability to sustain exercise, involves multiple organs and physiological processes. Aim : This study aimed to evaluate of INDUS1710, a composition of 4-hydroxyisoleucine, trigonelline, and select glycosides-based standardised fenugreek seed extracts, during treadmill running exercise (EXE) for endurance enhancement in laboratory rats. Methods: Male Wistar rats were randomly divided into six groups of 12 rats each and orally administered vehicle (distilled water, VC), INDUS1710 (20, 30, or 60 mg/kg), L-arginine (308 mg/kg), or vehicle for 28 days. All groups, except VC, underwent EXE without incline at a speed of 14 m/min for 6 days, followed by a speed of 20 m/min on the 7th day for 28 days until exhaustion. The physiological, functional, and metabolic parameters; relative organ weights; glycogen content of gastrocnemius muscle; and histological parameters of the heart were recorded. Results: Subacute supplementation with EXE of INDUS1710 resulted in a dose-dependent increase in time to exhaustion and prevented EXE-induced changes in organ function (heart, lungs, kidney, and liver), metabolic processes (carbohydrates, proteins, and lipids), and skeletal muscle glycogen content without causing pathological changes in skeletal or cardiac muscles. Conclusion: INDUS1710 supplementation with EXE showed comprehensive endurance enhancement efficacy and safety in laboratory rats.
This project aims to study the relationship between cardiovascular risk profile (sum of cardiovascular risk factors), using the SCORE´s system, with Physical Activity (amount, intensity and frequency of PA), collected through the international physical activity questionnaire (I-PAQ), on a population group of 50 individuals aged 40-64 years in the province of Malaga.
Obesity has a complex multifactorial etiology and is characterized by excessive accumulation of adipose tissue. Visceral adipose tissue has deleterious effects on health because it secretes large amounts of inflammatory cytokines. Nutritional calorie restriction associated with strength training may be useful in managing chronic systemic inflammation. This study aimed to evaluate the acute effect of a single strength-training session on plasma adipokine levels in sedentary, overweight, and obese young men. This study included twelve men (Age: [34.95 ± 9.77] years; Height: [174.16 ± 3.66] centimeter [cm]; Weight: [97.83 ± 12.87] kilogram (kg); body mass index [BMI]: [32.30 ± 4.51] kg/m²), who performed a single strength training session. The strength training protocol consisted of 4 sets of 12 repetitions in the following six exercises, 45° leg press, bench press, leg extension, machine row, leg curl, and shoulder press. Blood samples were collected before, immediately after, and 1-h subsequent after strength training. The plasma levels of resistin and leptin were measured. A significant decrease in resistin levels were found 1 h after the strength training session if compared to levels before the training session (pre-[before] [2 390 ± 1 199] picograms per milliliter [pg/mL] vs post-1 h [1-h subsequent] [1 523 ± 798],6 pg/mL, p = 0.002 8). The plasma leptin levels did not differ at any time point. In conclusion, a very well controlled single session of strength training significantly decreased the plasma levels of resistin without altering the concentration of leptin in overweight and obese individuals. This effect, at least in part, supports the benefits of exercise by reducing the low grade inflammation and insulin resistance in obesity.
Mood disturbance is a common, long‐term, negative consequence of traumatic brain injury (TBI) that is insufficiently addressed by most traditional treatment modalities. A large body of evidence supports the efficacy of exercise training (ET) to broadly improve mood, as measured most often by the Profile of Mood States (POMS). However, this behavioral approach is not used nearly enough in the TBI population, and when it is, mood is rarely measured. This scoping review will evaluate the use of POMS as a mood measure in TBI research and to establish a rationale for using ET as a behavioral approach to broadly improve mood in persons with TBI.
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Metabolic syndrome includes a set of metabolic disorders such as obesity, high blood pressure, hypertriglyceridemia, lipid disorders, and glucose intolerance. In this cross-sectional (descriptive-analytical) study, 2,426 people were selected from the 60 years old and above population of Bushehr for a second-phase investigation of the relationship between neck circumference (NC) and cardiometabolic risk factors in the elderly people. The data (mean and standard deviation) were analyzed using STATA MP Version 15 software. The results of the study showed that the average age of all elderly participants in the study was 69.34 ± 6.39 years. The mean and standard deviation of the NC index in men, women, and all participants were 39.31 ± 2.89, 34.86 ± 2.84, and 37.00 ± 3.62, respectively. The mean and standard deviation of most laboratory indicators (triglyceride [TG], total cholesterol [TC], low-density lipoprotein [LDL], high-density lipoprotein [HDL]) were significantly higher in women, and there was no significant difference in fasting blood glucose (FBG) between men and women. NC index in the total population was significantly associated with all risk factors of metabolic syndrome (body mass index, systolic blood pressure, diastolic blood pressure) and laboratory indicators (FBG, TG, TC, LDLC, and HDL). The present study shows that the NC index can be a good predictor for the diagnosis of metabolic syndrome and visceral adipose tissue in the elderly.
This study aimed to investigate the association between changes in FABP4 concentration and hormones and metabolites levels during and after acute low- and moderate-intensity aerobic exercise in healthy men. Eleven healthy men (24.4 ± 1.4 years) were administered three trials in random order: 1) low-intensity aerobic exercise trial (LE trial; acute exercise at 40% peak oxygen uptake [Vo2peak] + bed rest), 2) moderate-intensity aerobic exercise trial (ME trial: acute exercise at 60%Vo2peak + bed rest), and 3) bed rest (Con trial). Expired gas and venous blood samples were collected at baseline, and immediately, 30 and 60 min after exercise, and substrate oxidation and hormone, metabolite, and FABP4 concentrations were measured. FABP4 concentration did not increase during aerobic exercise in LE and ME trials (p > 0.05) However, FABP4 concentration significantly increased after the acute aerobic exercise in both the LE and ME trials (p ≤ 0.003). Increased FABP4 concentration after acute exercise was not correlated with adrenaline, noradrenaline, other hormone, and metabolite concentration changes. These findings suggest that FABP4 concentration increases after acute aerobic exercise independently of exercise intensity. Furthermore, increased FABP4 concentration after acute aerobic exercise may not be involved in the magnitude of adrenaline, noradrenaline, and lipolytic response.
The worldwide population of Adult Congenital Heart Disease (ACHD) patients are expanding and becoming older. Many congenital heart disease (CHD) patients have multiple surgeries causing surgical scars or residual anatomical and haemodynamic lesions which can overlap with acquired heart disease and comorbidities. Therefore, the traditional cardiovascular risk factors are ever more relevant, and regular physical activity is more important than ever in optimising long-term outcomes for these patients. It is important to promote healthy lifestyle choices in terms of physical activity and exercise, diet, smoking and substance abuse. ACHD Clinical Nurse Specialists (CNS), as part of a wider multidisciplinary team play an integral role in patient education, and support and counsel ACHD patients to set measurable and realistic physical activity goals.The aim of this chapter is to discuss the benefit of physical activity and exercise including the physical, social and psychological effects. The role of the ACHD CNS working in collaboration with the patient will be discussed. The role of the CNS in gathering the baseline information to discuss with the wider team including the cardiologist, physiotherapist, psychologist and/or nutritionist will be highlighted in order to devise an individualised plan for the ACHD patient thereby promoting regular physical activity.KeywordsAdult congenital heart diseasePhysical activity and exerciseNursing assessmentClinical nurse specialistTeamworkSupporting patientsIndividualised careCounsellingPatient empowermentPatient education
The purpose of this study was to examine whether dog walking is beneficial for dog owners’ health by providing sufficient physical activity for health benefits and improving their psychological health immediately after dog walking. The sample was comprised of 61 dog walkers who wore an accelerometer for one week on all of their dog walks and completed seven visual analogue scales assessing their psychological health before and after each of their dog walks. Slightly more than half of the time spent dog walking was at the moderate- to vigorous-intensity level recommended for health benefits. Furthermore, through dog walking alone, approximately two in five dog walkers met Canada’s 150-minute physical activity guideline for health benefits. Analyses comparing dog walkers’ psychological health before and after their dog walks revealed an improvement on six out of seven psychological health measures. Dog walkers felt less stressed after walking their dog and experienced an increase in their energy, self-esteem, social life satisfaction and overall life satisfaction as well as a more positive mood. Taken together, these findings provide objective evidence that dog walking is a viable means of attaining the physical activity needed for health benefits and highlight the need to further explore the short-term health benefits of dog walking.
Abstract
—— Background: Access to green space has been shown to be effective in reducing stress and improving mental wellbeing. This led to the proposal of horticulture being used to improve physical and mental health alike.
—— Objective: This paper reviews the evidence around whether horticulture improves mental wellbeing and helps manage poor mental health in middle aged and older adults, whether healthy or with pre-existing mental health problems.
—— Methodology: A literature search using the keywords such as [Horticulture AND Mental
health] into the following databases: PUBMED, Medline, Web of science, PsycINFO. Inclusion criteria such as participants with mental health problems, studies that analysed cortisol samples and a publication date between 2005 and 2020 provided the most up-to-date and relevant research.
—— Results: The first half of the paper shows a reduction in salivary cortisol levels after
horticulture therapy with both healthy participants and also those with mental health conditions such as depression and Alzheimer’s disease. The reduction in cortisol is associated with a reduction in stress and therefore anxiety and depression symptoms. The second half of the paper uses mental health Inventory tests such as the DASS-21, BDI, STAISS, PSS and PANNS to assess participants’ mental health state before and after horticulture. Overall the results show a decrease in levels of anxiety, depression, schizophrenia and stress.
—— Conclusions: Horticulture is effective in lowering symptoms of mental illness and improving mental wellbeing. Horticulture can be prescribed by doctors and therapists as a cost effective and relatively low risk alternative to pharmacological interventions. Some studies were limited as they had a small number of participants. Future research should look at the
use of horticulture on a larger scale, longer timeline and with a more diverse look at
different horticulture activities and their effects on mental health.
Introduction
The benefits of physical activity for glycaemic control in type 2 diabetes (T2D) are well-known. However, whether established glycaemic and cardiovascular benefits can be maximised by exercising at a certain time of day is unknown. Given postprandial glucose peaks contribute to worsening glycated haemoglobin (HbA1c) and cardiovascular risk factors, and that exercise immediately lowers blood glucose, prescribing exercise at a specific time of day to attenuate peak hyperglycaemia may improve glycaemic control and reduce the burden of cardiovascular disease in people with T2D.
Methods and analysis
A single-centre randomised controlled trial will be conducted by the University of Wollongong, Australia. Individuals with T2D (n=70, aged 40–75 years, body mass index (BMI): 27–40 kg/m ² ) will be recruited and randomly allocated (1:1), stratified for sex and insulin, to one of three groups: (1) exercise at time of peak hyperglycaemia (ExPeak, personalised), (2) exercise not at time of peak hyperglycaemia (NonPeak) or (3) waitlist control (WLC, standard care). The trial will be 5 months, comprising an 8-week intervention and 3-month follow-up. Primary outcome is the change in HbA1c preintervention to postintervention. Secondary outcomes include vascular function (endothelial function and arterial stiffness), metabolic control (blood lipids and inflammation) and body composition (anthropometrics and dual-energy X-ray absorptiometry (DEXA)). Tertiary outcomes will examine adherence.
Ethics and dissemination
The joint UOW and ISLHD Ethics Committee approved protocol (2019/ETH09856) prospectively registered at the Australian New Zealand Clinical Trials Registry. Written informed consent will be obtained from all eligible individuals prior to commencement of the trial. Study results will be published as peer-reviewed articles, presented at national/international conferences and media reports.
Trial registration number
ACTRN12619001049167.
Background and aims
Sauna bathing and aerobic exercise have each been shown to affect cardiovascular function. However, direct comparisons between standalone sauna bathing and a combination of exercise and sauna on vascular indices remain limited. Therefore, we conducted a cross‐over study using matched durations to explore the hemodynamic changes of sauna exposure when compared to a combination of aerobic exercise and sauna exposure.
Methods
Participants (N = 72) with at least one cardiovascular risk factor underwent, on two separate occasions: (a) a 30‐minute sauna at 75°C (SAUNA) and (b) the combination of a 15‐minute cycling exercise at 75% maximum heart rate followed by 15‐minute sauna exposure (EX+SAUNA). Relative changes to arterial stiffness (PWV), augmentation index (Alx), brachial systolic and diastolic blood pressure (SBP and DBP), central SBP (cSBP), mean arterial pressure (MAP), and heart rate (HR) were compared PRE‐POST and pre‐ to 30‐minutes post‐intervention (PRE‐POST30).
Results
Baseline SBP and DBP were 143 (SD 18) mmHg and 86 (SD 10) mmHg, respectively. From PRE‐POST, SAUNA had lower DBP (mean difference [95% CI] 2.5 [1.0, 4.1], P = .002) and MAP (2.5 [0.6, 4.3], P = .01). However, EX+SAUNA had lower SBP (−2.7 [−4.8, −0.5], P = .02), DBP (−1.8 [−3.3, −0.4], P = .01), and MAP (−2.0 [−3.5, −0.5], P = .009) PRE‐POST30. There were no statistically significant differences between SAUNA and EX+SAUNA for other measured parameters.
Conclusion
This study demonstrated that when matched for duration, EX+SAUNA and SAUNA elicit comparable acute hemodynamic alterations in middle‐aged participants with cardiovascular risk factors. The sauna is a suitable option for acute blood pressure reductions in those who are unable to perform aerobic exercise, and may be a viable lifestyle treatment option to improve blood pressure control.
Physical activity and its sustained and purposeful performance - exercise - promote a broad and diverse set of metabolic and cardiovascular health benefits. Regular exercise is the most effective way to improve cardiorespiratory fitness, a measure of one's global cardiovascular, pulmonary and metabolic health and one of the strongest predictors of future health risk. Here, we describe how exercise affects individual organ systems related to cardiometabolic health, including the promotion of insulin and glucose homeostasis through improved efficiency in skeletal muscle glucose utilization and enhanced insulin sensitivity; beneficial changes in body composition and adiposity; and improved cardiac mechanics and vascular health. We subsequently identify knowledge gaps that remain in exercise science, including heterogeneity in exercise responsiveness. While the application of molecular profiling technologies in exercise science has begun to illuminate the biochemical pathways that govern exercise-induced health promotion, much of this work has focused on individual organ systems and applied single platforms. New insights into exercise-induced secreted small molecules and proteins that impart their effects in distant organs ("exerkines") highlight the need for an integrated approach towards the study of exercise and its global effects; efforts that are ongoing.
To quantify the duration of postexercise hypotension at different exercise intensities, we studied six unmedicated, mildly hypertensive men matched with six normotensive controls.
Each subject wore a 24-hour ambulatory blood pressure monitor at the same time of day for 13 consecutive hours on 3 different days. On each of the 3 days, subjects either cycled for 30 minutes at 40% or 70% maximum VO2 or performed activities of daily living. There was no intensity effect on the postexercise reduction in blood pressure, so blood pressure data were combined for the different exercise intensities. Postexercise diastolic blood pressure and mean arterial pressure were lower by 8 +/- 1 (p less than 0.001) and 7 +/- 1 mm Hg (p less than 0.05), respectively, than the preexercise values for 12.7 hours in the hypertensive group. These variables were not different before and after exercise in the normotensive group. Systolic blood pressure was reduced by 5 +/- 1 mm Hg (p less than 0.05) for 8.7 hours after exercise in the hypertensive group. In contrast, systolic blood pressure was 5 +/- 1 mm Hg (p less than 0.001) higher for 12.7 hours after exercise in the normotensive group. When the blood pressure response on the exercise days was compared with that on the nonexercise day, systolic blood pressure (135 +/- 1 versus 145 +/- 1 mm Hg) and mean arterial pressure (100 +/- 1 versus 106 +/- 1 mm Hg) were lower (p less than 0.05) on the exercise days in the hypertensive but not in the normotensive group. We found a postexercise reduction in mean arterial pressure for 12.7 hours independent of the exercise intensity in the hypertensive group. Furthermore, mean arterial pressure was lower on exercise than on nonexercise days in the hypertensive but not in the normotensive group.
These findings indicate that dynamic exercise may be an important adjunct in the treatment of mild hypertension.
We investigated the effects of 1 wk of intense exercise on glucose tolerance in 10 men with abnormal glucose tolerance [7 had mild non-insulin-dependent diabetes mellitus (NIDDM), and 3 had impaired glucose tolerance]. The 7 days of exercise did not result in significant changes in body weight or maximal oxygen uptake. Plasma glucose concentration at 120 min averaged 227 +/- 23 mg/dl in an oral glucose tolerance test (OGTT) before and 170 +/- 18 mg/dl after the 7 days of exercise (P less than .001). There was a 36% reduction in the area under the glucose tolerance curve. Plasma insulin concentration at 120 min of the OGTT averaged 172 +/- 27 microU/ml before and 106 +/- 13 microU/ml after 7 days of exercise (P less than .001); the area under the insulin curve was decreased by 32%. In contrast to the response to 7 days of exercise, one bout of exercise did not result in an improvement in glucose tolerance. These results provide evidence that regularly performed, vigorous exercise can be effective in decreasing insulin resistance and improving glucose tolerance within 7 days in some patients with mild NIDDM.
Regional fat distribution is an important determinant of insulin resistance in obesity. In the current study, the relationship between skeletal muscle insulin sensitivity, mid-thigh muscle composition, and the metabolic profile of muscle was investigated. Muscle composition was assessed by computed tomography of the mid-thigh, and by activities of marker enzymes of aerobic-oxidative and glycolytic pathways and muscle fiber typing using biopsies of the vastus lateralis muscle. Muscle with reduced Hounsfield attenuation on computed tomography scans was increased in proportion to obesity, and was strongly related to insulin resistance, reduced muscle oxidative capacity, and increased anaerobic and glycolytic capacities by muscle. These findings suggest that as part of its expression of insulin resistance, skeletal muscle of obese individuals is also poorly equipped for substrate oxidation and manifests increased storage of fat.
The purpose of this study was to determine if 14 wk of exercise training would increase insulin-sensitive glucose transporter protein (GLUT-4) concentration in skeletal muscle of previously sedentary middle-aged men (47.2 +/- 1.3 yr; n = 13). Muscle samples (lateral gastrocnemius) and insulin action [insulin sensitivity index (ISI), minimal model] were obtained in the sedentary condition and 48 h after the final training bout. GLUT-4 protein concentration increased (P < 0.001, 2,629 +/- 331 to 4,140 +/- 391 absorbance units/100 micrograms protein) with exercise training by 1.8-fold. ISI increased by twofold (P < 0.05, 2.1 +/- 0.5 to 3.4 +/- 0.7 SI x 10(5) min/pM) with training. The percentage of GLUT-4 rich type IIa muscle fibers increased by approximately 10% (P < 0.01), which may have contributed to the elevation in transporter protein. GLUT-4 concentration and citrate synthase activity (1.7-fold, P < 0.001) also increased by similar increments. These findings indicate that GLUT-4 protein concentration is elevated in middle-aged individuals with exercise training.
To test the effect of diet on the short-term lipid response to exercise, fourteen moderately trained (VO2max: 50.2 ± 6.7 ml/kg/min), healthy men (mean age: 28 ± 4 years) were alternately fed a high fat (60±6.7% fat) and a high carbohydrate (63 ± 3.2% carbohydrate) isoenergetic diet for 2 weeks in a randomized crossover design. During the last 4 days of the treatments, fasting total cholesterol, triglyceride. HDL-cholesterol, and HDL3-cholesterol were measured the day before, and again immediately, 24 hr. and 48 hr after exercise (4190 kJ, 70% VO2max). LDL-cholesterol and HDL2-cholesterol were calculated. Lipid concentrations were adjusted for plasma volume changes after exercise. A 2 (diet) × 4 (time) ANOVA with repeated measures revealed no significant interaction between the diet and exercise treatments. Furthermore, diet alone did not influence lipid concentrations in these trained men. Exercise resulted in an increase in HDL-C (10.7%) and HDL3-C (8.5%) concentrations and a concomitant fall in triglyce...
Endurance exercise training reduces systolic and diastolic blood pressures in approximately 75% of people who have essential hypertension; these reductions are approximately 10 mmHg for both systolic and diastolic blood pressures. Exercise training at intensities of 40–70% VO2max appears to lower systolic blood pressure somewhat more and diastolic blood pressure to the same degree as higher-intensity training. Additional benefits of endurance exercise training on other risk factors for coronary heart disease make such training an efficacious intervention for people who have mild-to-moderate elevations in blood pressure.
We studied ten male distance runners before and after a marathon to determine the effects of prolonged exercise on serum lipoprotein values and the capacity to clear plasma triglycerides. Serum lipid and lipoprotein concentrations, intravenous fat clearance, and postheparin plasma lipolytic activities were measured 24 hours before and 18 hours after the race. The clearance rate of exogenous fat increased 76% ±64% postheparin lipoprotein lipase activity increased 46% ±35% and fasting triglyceride levels decreased 26% ±13% after the race. High-density lipoprotein (HDL) cholesterol level increased 10%±8% primarily due to a 19%± 17% increase in the HDL 2 subfraction. Changes in the clearance rate of exogenous fat were directly related to changes in HDL cholesterol level and the HDL2 subfraction. Thus, the rise in HDL cholesterol concentrations after prolonged exercise may be a consequence of enhanced fat clearance.
(JAMA 1986;256:2552-2555)
The effect of different intensities of aerobic exercise on blood pressure remains uncertain. The goal of this trial was to compare the effect of two different levels of aerobic physical training on 24-hour ambulatory blood pressure. In this double-blind parallel-group trial, 28 sedentary hypertensive patients (mean diastolic blood pressure of 90 to 104 mmHg) were randomly assigned to 10 weeks of physical training at 20% (Group I) or 60% (Group II) of their maximal workload on a cycle ergometer (mean load of 32 and 85 watts, respectively). Maximal oxygen consumption was estimated by the time spent on a mechanical braked Monark bicycle (Monark, Sáo Paulo, Brazil). Indexes of physical fitness were determined by cycle ergometer tests before and after the experimental period. The principal outcome variable was mean 24-hour ambulatory blood pressure. Mean 24 hour systolic blood pressure fell from 137.2 ± 14.9 to 135.2 ± 12.7 mmHg in Group I and from 144.4 ± 13.3 to 138.6 ± 12.9 in Group II (mean between group difference of –2.1 mmHg, P = 0.479, adjusted for baseline blood pressure). Mean diastolic blood pressure fell from 9.21 ± 10.0 to 89.3 ± 7.7 mmHg in Group I and from 93.3 ± 5.8 to 90.6 ± 6.8 mmHg in Group II (mean adjusted difference of –0.06, P = 0.765). Nighttime blood pressure did not change in either group. Across all participants, a reduction in systolic blood pressure was significantly associated with improved physical fitness as manifest by increased physical work capacity at heart rate of 130 bpm (PWC130), increased systolic blood pressure at PWC130, and decreased maximum heart rate measured during the cycle ergometer test We conclude that aerobic training programs at 20% and 60% of the maximum work capacity have similar effects on ambulatory blood pressure.
HE EFFECT of six months of physical conditioning upon a number of physiologic variables has been investigated in a group of previously sedentary middle-aged men.’ This study was performed to help lay the groundwork for a possible large-scale, long term investigation of whether or not regular exercise protects against the development of coronary heart disease. A major aim of the present study was to try to
Objective.
—To assess the effects of physical exercise training on blood pressure in patients with mild hypertension.
Design.
—Randomized controlled trial.
Setting.
—Hospital-based cardiac rehabilitation program.
Patients.
—Ninety-nine men and women with untreated mild hypertension (systolic blood pressure, 140 to 180 mm Hg; diastolic blood pressure, 90 to 105 mm Hg) were included in the volunteer sample.
Interventions.
—Subjects were randomly assigned to a 4-month program of aerobic exercise training, strength and flexibility training, or to a waiting list control group.
Main Outcome Measures.
—The main outcome measures were systolic and diastolic blood pressures measured four times with a random zero sphygmomanometer on 3 separate days in a clinic setting.
Results.
—After 4 months of exercise training, subjects in the aerobic exercise group did not exhibit greater reductions in blood pressure than subjects in the control group. We expected a differential decline of 5 mm Hg between the aerobic exercise and waiting list control groups and found a difference of -1.0±16 mm Hg and -1.2±10 mm Hg at α=.05 for systolic and diastolic blood pressure, respectively.
Conclusions.
—Moderate aerobic exercise alone should not be considered a replacement for pharmacologic therapy in nonobese patients with mild hypertension.(JAMA. 1991;266:2098-2104)
Experimental and theoretical progress is handicapped by a disregard of the Law of Initial Value which states that "there is a specific inverse relation between the intensity and direction of a response to a stimulus, on one hand, and the pre-experimental level of a function tested on the other." A brief survey is presented of the large but scattered neurological and psychiatric literature, and indications are given of the practical and theoretical possible applications of this law. 90 references. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
To assess the role of different factors on the long-term antihypertensive effect of regular exercise we examined the time course of changes in haemodynamics, oxygen consumption and plasma noradrenaline in 10 normal healthy subjects. For 12 weeks, subjects performed alternating months of training and detraining in a random order. Training involved 40min of bicycle exercise three times per week at 60-70% of maximum work. Steady-state changes at the end of 1 month's exercise were: (1) falls in resting blood pressure when supine and erect by 8/5 and 10/6 mmHg, respectively (P < 0.01); (2) a reduction in the total peripheral resistance index of 14%; (3) an increase in maximum oxygen consumption of 14% (P < 0.005); and (4) a fall in plasma noradrenaline of 21% (P < 0.05). A significant fall in blood pressure occurred at the third training bout (P < 0.005), at the beginning of the second week, and no further reduction occurred beyond the fourth bout of exercise. The reduction in plasma noradrenaline concentration was confined to the second half of the month in which exercise took place and lagged behind the blood pressure changes. There were significant differences between the rates of the initial fall of blood pressure and noradrenaline, and the times taken for the maximum changes to occur (P < 0.05). During detraining, blood pressure remained low for 1-2 weeks after cessation of exercise, as did plasma noradrenaline. Both then rose gradually towards the initial sedentary levels. We conclude that non-autonomic factors related to the fall in total peripheral resistance are likely to be important in the initial lowering of blood pressure, while autonomic factors contribute to the maintenance of lower blood pressure later in training and for some time during the detraining period.
(C) Lippincott-Raven Publishers.
The concentration of triglycerides, cholesterol and phospholipids in plasma and in ultracentrifugally separated plasma lipoproteins was studied in normal persons during participation in 1962 and 1963 in a yearly skiracing. The skiing time was around 8–9 hours. In the group studied in 1962 as well as in the 1963 group there was a significant fall in the concentration of triglycerides and phospholipids in plasma. When the 1962 group was studied during ordinary activities with identical caloric intake and at identical times as during the skiing no significant changes were found in the plasma lipids. The most pronounced decreases of the plasma lipids was in the triglyceride fraction and this decrease was directly and highly significantly correlated to the fasting triglyceride concentration. About three quarters of the decrease in triglyceride concentration was due to a decrease in the amount of triglycerides in the very low density lipoproteins. The triglyceride concentration in the low and the high density lipoprotein classes also decreased. The decrease of triglycerides was directly correlated to the fasting level in each lipoprotein class. No significant changes were observed in the cholesterol content of any of the lipoproteins. The phospholipid concentration, however, decreased in all three lipoprotein classes. The most pronounced decrease of phospholipids was found in the high density lipoproteins. Mechanism(s) for these changes in the concentration of the plasma lipids and lipoproteins during prolonged, heavy exercise were discussed.
The short-term effects of prolonged intense exercise on plasma lipid transport parameters including cholesterol, triglycerides (TGs), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and its subfractions HDL2 cholesterol and HDL3 cholesterol, on apolipoproteins (apos) A-I, A-II, and B, and on mass and activity of cholesteryl ester transfer protein (CETP) were studied in eight male endurance-trained athletes over the first week after a bicycle marathon. CETP mass concentration in plasma was quantified by a newly developed immunoradiometric assay (IRMA). Plasma concentrations of cholesterol, TGs, LDL cholesterol, apo B, CETP, and cholesteryl ester transfer activity (CETA) were significantly reduced in the recovery period compared with pre-exercise values (cholesterol by 20%, P < .05; TGs by 63%, P < .05; LDL cholesterol by 32%, P < .05; apo B by 18%, P < .05; CETP mass by 29%, P < .05; and CETA by 14%, P < .05). HDL cholesterol and HDL2 cholesterol, in contrast, were significantly increased in the post-exercise period (HDL cholesterol by 12%, P < .05, and HDL2 cholesterol by 96%, P < .05), whereas HDL3 cholesterol showed a tendency to decrease in the late recovery period (by 8%, NS). Although changes in cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, apo B, and CETP mass and activity were already evident in the early recovery period, HDL2 cholesterol showed a delayed response, reaching its maximum 72 hours after initiation of exercise. In addition, significant increases in plasma levels of apo A-I and A-II were found 8 days after the marathon (by 5%, P < .05, and by 12%, P < .05, respectively). Our data suggest that even in highly trained athletes, universally favorable lipoprotein changes of unexpected quantity result from a single episode of heavy exertion. The sustained and pronounced increase of HDL2 cholesterol may be explained at least in part by the decrease in CETP after short-term exercise.
Stimulated by increasing evidence of an inverse relationship between plasma high-density lipoprotein cholesterol level and frequency of coronary heart disease, we determined concentrations of fasting plasma cholesterol, triglyceride, and lipoproteins in 41 very active men (running greater than 15 miles/wk for the previous year) 35-59 years of age (mean age, 47) and in a comparison group of men of similar age, randomly selected from three northern California communities. The runners had significantly (p less than 0.05) decreased mean plasma triglyceride (70 versus 146 mg/100 ml), total plasma cholesterol (200 versus 210 mg/100 ml), and low-density lipoprotein (LDL) cholesterol (125 versus 139 mg/100 ml) concentrations, and a higher mean level of high-density lipoprotein (HDL) cholesterol (64 versus 43 mg/100 ml) than the comparison group (n equals 147 for HDL and LDL; n equals 743 for total cholesterol and triglycerides). These very active men exhibited a plasma lipoprotein profile resembling that of younger women rather tan of sedentary, middle-aged men. This characteristic, and apparently advantageous, pattern could be only partially accounted for by differences in adiposity between runners and control subjects.
The purpose of this study was to determine the effects of exercise intensity on lipid and lipoprotein metabolism. Concentrations of triglyceride, cholesterol, high-density lipoprotein cholesterol (HDL-C) and its subfractions (HDL2-C and HDL3-C), low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, and apolipoproteins A-I, A-II, and B were measured. Ten well-trained runners completed treadmill exercise on two different occasions: a high-intensity session at 75% maximal oxygen consumption lasting 60 min and a low-intensity session at 50% maximal oxygen consumption lasting 90 min. Energy expenditure for each session was equal. Fasted blood samples were obtained 24 h before, immediately before, immediately after, and 1, 24, 48, and 72 h after each exercise session. No significant differences were found for the blood variables across time or between treatments. However, HDL-C and HDL2-C were slightly elevated on the days after each treatment. These results suggest that acute exercise sessions lasting less than 90 min, regardless of intensity, do not elicit plasma lipid, lipoprotein, and apolipoprotein changes in men who are habitually physically active and have high initial concentrations of HDL-C.
Blood pressure falls after a single session of exercise. The duration for which this fall in blood pressure persists is not known. Sustained hypotension after a single session of exercise may have important implications in the treatment of patients with mild hypertension. We studied 24 subjects (12 normotensive subjects and 12 patients with mild or borderline hypertension). Blood pressure was measured in the laboratory for 30 minutes before and for an hour after graded bicycle exercise to maximal voluntary capacity. Subjects then left the hospital and measured their blood pressures at home (three measurements every 2 hours) following a strict measurement protocol for the rest of the day (usually between 8 and 12 hours). These home blood pressure measurements were compared with home blood pressure measurements recorded at the same times on a nonexercise control day. At 30 minutes after the graded maximal exercise test, the hypertensive patients experienced a fall in blood pressure from 142 +/- 3.5/93 +/- 6.5 mm Hg (mean +/- SEM) to 124 +/- 4.5/79 +/- 2.8 mm Hg (p less than 0.01). For the normotensive subjects, blood pressure after exercise fell from 117 +/- 3.1/70 +/- 2.1 mm Hg to 109 +/- 3.1/62 +/- 2.8 mm Hg (p less than 0.01). Despite these striking blood pressure reductions for the second half hour after exercise, blood pressure measurements recorded at home were not significantly different on the exercise and control days in either group. We conclude that although a single bout of exercise lowers blood pressure for a short (1-hour) period, this hypotension is not sustained.
--To assess the effects of physical exercise training on blood pressure in patients with mild hypertension.
--Randomized controlled trial.
--Hospital-based cardiac rehabilitation program.
--Ninety-nine men and women with untreated mild hypertension (systolic blood pressure, 140 to 180 mm Hg; diastolic blood pressure, 90 to 105 mm Hg) were included in the volunteer sample.
--Subjects were randomly assigned to a 4-month program of aerobic exercise training, strength and flexibility training, or to a waiting list control group.
--The main outcome measures were systolic and diastolic blood pressures measured four times with a random zero sphygmomanometer on 3 separate days in a clinic setting.
--After 4 months of exercise training, subjects in the aerobic exercise group did not exhibit greater reductions in blood pressure than subjects in the control group. We expected a differential decline of 5 mm Hg between the aerobic exercise and waiting list control groups and found a difference of -1.0 +/- 16 mm Hg and -1.2 +/- 10 mm Hg at alpha = .05 for systolic and diastolic blood pressure, respectively.
--Moderate aerobic exercise alone should not be considered a replacement for pharmacologic therapy in nonobese patients with mild hypertension.
Most studies of exercise and blood pressure have used a standard exercise programme with a single level of physical activity. To determine the nature of the dose-response relationship however it is necessary to examine several levels of activity, preferably in the same subjects. We have recently performed several randomised crossover studies comparing different levels of regular exercise. The intensity and duration of exercise bouts were constant throughout the studies, but their frequency was varied. Standard bouts consisted of 30 min of bicycling at 60%-70% of maximum work capacity. The exercise was performed either three-weekly or 7-weekly in randomised order and each level was maintained for one month. In sedentary normal subjects three bouts of exercise/week for a total of 90 min lowered blood pressure by 10/7 mmHg. With seven bouts, i.e. a total of 210 min exercise/week, blood pressure was only slightly lower than 3-week exercise and was 12/7 mmHg below sedentary values. Responses to measures of physical fitness including maximum oxygen consumption and work capacity were linearly related to the amount of exercise performed each week. Similar results were obtained in hypertensives. Another randomised study was performed amongst expeditioners to Antarctica where environmental conditions determined that they were sedentary in winter and active in summer. The addition of either 3-week or 7-week exercise in winter significantly lowered blood pressure. In summer when the background level of activity was higher, blood pressure with no added exercise was similar to exercising levels in winter. There was no further fall in blood pressure with either 3-week or 7-week additional exercise.(ABSTRACT TRUNCATED AT 250 WORDS)
The experimental goals were to determine if regular low-intensity aerobic exercise reduces 24-hour arterial blood pressure in middle-aged and older (aged 50 years or older) humans with mild diastolic (90-105 mm Hg) essential hypertension and, if so, whether this is accurately reflected by changes in casual recordings made at rest. Fourteen subjects walked 3-4 days/wk for 6 months, with 10 exercising an additional 6 months; 12 other subjects served as nonexercising controls. In the exercising subjects, maximal oxygen consumption increased 7-14% (p less than 0.05) with little or no change in body weight or fat. Conventional casual readings of systolic, mean, and diastolic arterial pressure at rest were lower (5-10 mm Hg, p less than 0.05) in all body positions after 6 months of exercise and changed little thereafter. Casual recordings made during additional circulatory measurements showed 6-month decreases of only half this magnitude and were specific to a particular blood pressure phase and body position; however, all changes were significant after 12 months of exercise. The reductions in arterial pressure at rest were associated with decreases in heart rate (p less than 0.05) and cardiac output (p less than 0.05). Ambulatory-determined 24-hour arterial pressure was unchanged after 6 months of exercise, but mean levels were slightly lower (4 mm Hg, p less than 0.05) after 12 months due to reductions in daytime (7 mm Hg, p less than 0.05) and nighttime (4 mm Hg, NS) systolic pressure; diastolic pressure was unchanged throughout the year of training. In the controls, conventionally recorded casual blood pressure levels were lower after 6 months (p less than 0.05), but no other changes were observed in any other variable over the 12 months of study. We conclude 1) regular low-intensity aerobic exercise at best produces only small reductions in 24-hour levels of arterial pressure in middle-aged and older humans with mild (diastolic) essential hypertension and 2) training-associated changes in casually determined blood pressure at rest are dependent on the measurement conditions and, most importantly, do not necessarily reflect the magnitude or even the direction of changes in arterial pressure throughout an entire day.
To document the possible influence of a single episode of maximal aerobic stress on the serum lecithin:cholesterol acyltransferase (LCAT) activity in subjects with differing histories of training, two groups of healthy male adults [controls (C), n = 18, 28.6 years, SD 5.2, 50.1 ml.kg-1.min-1 maximal O2 uptake (VO2max), SD 5.3; endurance trained athletes (T), n = 18, 31.4 years, SD 8.8, 65.0 ml.kg-1.min-1 VO2max, SD 2.8] were examined in a maximal aerobic stress test. In addition to the routine assessment of lipid status, LCAT activity was measured immediately before and after exercise. At rest nearly identical LCAT activity values were found in both groups: C 64.4 nmol.ml-1.h-1, SD 16.7 vs T 65.0 nmol.ml-1.h-1, SD 20.9. The post-exercise LCAT values induced by the maximal stress test increased significantly to (C) 95.7 nmol.ml-1.h-1, SD 23.5, +48.6%, P less than 0.001; (T) 83.5 nmol.ml-1.h-1, SD 24.3, +29.1%, P less than 0.01. Neither the pre nor the postexercise individual LCAT activity values showed any significant correlation to the corresponding data on physical performance.
Endurance athletes have higher high density lipoprotein (HDL) concentrations than sedentary controls. To examine the mechanism for this effect, we compared HDL apoprotein metabolism in 10 endurance athletes aged 34 +/- 6 years (mean +/- SD) and 10 sedentary men aged 36 +/- 8 years.
Subjects were maintained on controlled diets for 4 weeks, and metabolic studies using autologously labeled 125I HDL were performed during the final 2 weeks. Lipids and lipoproteins were measured daily during these 2 weeks, and the average of 14 values was used in the analysis. HDL cholesterol (58 +/- 14 versus 41 +/- 10 mg/dl), HDL2 cholesterol (26 +/- 10 versus 12 +/- 8 mg/dl), and apolipoprotein A-I (apo A-I) (144 +/- 18 versus 115 +/- 22 mg/dl) were higher in the athletes, whereas triglyceride concentrations (60 +/- 18 versus 110 +/- 48 mg/dl) were lower (p less than 0.01 for all). Postheparin lipoprotein lipase activity was not different, but hepatic triglyceride lipase activity was 27% lower (p less than 0.06) in the athletes. The athletes' mean clearance rate of triglycerides after an infusion of Travamulsion (1 ml/kg) was nearly twofold that of the inactive men (5.8 +/- 1.5 versus 3.2 +/- 0.9%/min, p less than 0.001). There was no differences in HDL apoprotein synthetic rates, whereas the catabolic rates of both apo A-I (0.15 +/- 0.02 versus 0.22 +/- 0.05 pools per day, p less than 0.01) and apolipoprotein A-II (apo A-II) (0.15 +/- 0.02 versus 0.20 +/- 0.04 pools per day, p less than 0.05) were reduced in the trained men. Apo A-I and apo A-II half-lives correlated with HDL cholesterol in each group (r greater than 0.76, p less than 0.05 for all) but not consistently with lipase activities or fat clearance rates. This relation between apoprotein catabolism and HDL cholesterol was strongest at HDL cholesterol concentrations of less than 60 mg/dl.
We conclude that higher HDL levels in active men are associated with increased HDL protein survival. The mechanisms mediating this effect require better definition, and other factors appear to contribute to HDL cholesterol and protein concentrations among individual subjects.
The purpose of this investigation was to examine the immediate and delayed effects of prolonged strenuous exercise on plasma lipid and lipoprotein concentrations in female runners. Venous blood samples were collected from 12 female runners 24 h before, 10 min after, and 1, 3, and 5 d after running a 42 km marathon. Whole blood was analyzed for hematocrit and hemoglobin to determine plasma volume shifts. Plasma aliquots were assayed for total cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglyceride concentrations, while low-density lipoprotein cholesterol (LDL-C) was estimated. Total cholesterol concentrations were significantly reduced 1 d following the exercise and were still lower 3 and 5 d post-marathon. LDL-C was lower immediately and 1 d after the marathon. HDL-C concentrations, corrected for changes in plasma volume, were elevated 24 h post-exercise. The ratio of HDL/total cholesterol was increased 24 h post-exercise. Triglyceride concentrations were elevated immediately following the marathon but returned to baseline levels by 24 h post-exercise. These results demonstrate that prolonged strenuous exercise in women produces changes in blood lipid profiles that can last for several days.
The purpose of this study was to determine the effect of exercise intensity on lipoprotein responses. Eleven normolipidemic male volunteers (X +/- SD = 23.1 +/- 2.4) participated in the study. The subjects were assessed for VO2max and ventilatory threshold (VT), matched for VO2max and then randomly assigned to one of two groups: Group A, which exercised for 12 minutes at an intensity 15% below VT (n = 5), and Group B, which exercised for 12 minutes at an intensity 15% above VT (n = 6). The lipoprotein measures HDL-C, LDL-C, total cholesterol (TC), and triglycerides (TG) were assessed from blood samples taken pre-exercise and immediately post-exercise as well as one, 24, and 48 hours post-exercise. A 2 X 5 split plot ANCOVA (controlling for pre-exercise values), revealed no significant differences between groups for HDL-C, TC or LDL-C. However, when means were collapsed across groups, TC levels measured immediately post-exercise were significantly higher than those taken 24 and 48 hours post-exercise (168.0, 159.1, and 159.9 mg.dl-1, respectively; p less than 0.05). A significant interaction was found for the TG measurements. For Group A, TG levels were elevated immediately post-exercise, but decreased significantly at the 1 and 24 hours post-exercise sampling, before returning to baseline levels at the 48 hour post-exercise measurement (93.2 +/- 3.1, 69.5 +/- 4.2, 66.8 +/- 6.7 and 99.5 +/- 2.1 mg.dl-1, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
Twenty-one male and female adults 43 +/- 4 yr of age completed in 8-wk control period, 16 wk of conditioning, and 12 wk of deconditioning to determine whether exercise alters blood pressure. Subjects were classified as borderline/mild hypertensive (H, diastolic pressure greater than or equal to 85 and less than 104 mm Hg, N = 8) or normotensive (N, diastolic pressure less than 85 mm Hg, N = 13) based on average blood pressure during the control period. Conditioning increased (P less than 0.05) VO2max to a similar extent in both groups (average, 14%) and decreased (P less than 0.05) resting heart rate (H, 78 +/- 5 to 65 +/- 3; N, 75 +/- 3 to 71 +/- 3 beats.min-1). The double product over 24 h of ambulatory monitoring of blood pressure and heart rate decreased (P less than 0.05) in both groups. After deconditioning, VO2max returned to values not different (P greater than 0.05) from those of the control period. Ambulatory 24-h double product and heart rate increased (P less than 0.05). In spite of this strong evidence of a conditioning effect, neither group showed changes (P greater than 0.05) in average 24-h ambulatory or casual blood pressure. The average ambulatory blood pressure for 8-h segments of the day (8 a.m.-4 p.m., 4 p.m.-12 a.m., and 12 a.m.-8 a.m.) was also not altered. Cardiac output and total peripheral resistance at rest did not change (P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
The effect of 4 months of physical training on resting, exercise and 24-hour blood pressure (BP) was studied using a randomized crossover design in 26 healthy, sedentary men, with an average age of 39 +/- 10 (standard deviation) years. Peak oxygen uptake increased by 14% (p less than 0.001) and the physical working capacity at a heart rate of 130 beats/min by 25% (p less than 0.001). The heart rate was reduced by 7 beats/min at night (p less than 0.01) and by 6 beats/min during the day (p less than 0.001). Training-induced changes of BP varied according to measuring conditions. A decrease in BP at rest while sitting in the morning in the laboratory was significant for diastolic (-5 mm Hg, p less than 0.01) but not for systolic BP. During exercise, systolic BP was significantly lower after training, when measured at the same submaximal workloads. However, when workload was expressed as a percentage of peak oxygen uptake, systolic BP was not different before and after training. When measured during 24 hours, the training-induced change in BP was not significant at night either for systolic or diastolic BP. During the day the decrease in diastolic BP was significant (-5 mm Hg, p less than 0.001), but the change in systolic BP was not.
In normal subjects during moderate exercise there is a strong negative correlation between plasma glucose and hepatic glucose output (HGO) suggesting a negative feedback regulation of HGO by plasma glucose. Little information is available about HGO responses to exercise in non-insulin-dependent diabetes mellitus (NIDDM). To determine whether the same feedback relationship is operative, we have compared the glucose turnover responses to moderate exercise (50% Vo2max for 60 minutes) of nonobese non-insulin-dependent diabetic subjects (NIDDM, n = 7) with a group of age-matched controls (n = 5). Glucose turnover responses to exercise in NIDDM were heterogeneous. Plasma glucose showed sustained falls, no change, or sustained rises in different individuals. Similarly, HGO responses ranged from undetectable to responses comparable to those of normal subjects. The mean integrated HGO response in NIDDM was significantly reduced compared with controls (11 +/- 6 [SEM] v 33 +/- 7 mmol/h/70 kg, P less than .05); mean glucose utilization response was also reduced but not significantly different from controls (NIDDM 18 +/- 5 v control 35 +/- 6). In NIDDM there was no significant feedback-control relationship between plasma glucose and HGO (r = -0.20, P = NS) in contrast to controls (r = -0.87, P less than .01). We conclude that feedback control of HGO by plasma glucose during moderate exercise is impaired in NIDDM. This impairment may be due to defective nonpancreatic glucoregulatory mechanisms.
We studied the effects of exercise on the levels of plasma glucose and glucoregulatory hormones before and after 6 weeks of thrice-weekly physical training in 20 sedentary type II (non-insulin-dependent) diabetic patients and 11 control subjects matched for previous physical activity. Parameters were measured at rest, after 30 minutes of bicycle exercise at 70% to 75% of maximal oxygen uptake, and after 30 minutes of recovery. In the untrained state exercise resulted in a decrease in plasma glucose levels in diabetics but not in controls (-12 +/- 5 v + 4 +/- 2 mg/dL, P less than .01) and the expected drop in plasma insulin level was absent in diabetics. These differences in glucose and insulin response persisted after physical training. There was a tendency for patients with diabetes to have a smaller R-R interval variation during deep breathing, an abnormal resting heart rate response to physical training, and a lesser increment in plasma epinephrine levels following exercise, findings consistent with autonomic dysfunction. Physical training resulted in a blunting of the exercise-induced increment of plasma epinephrine, growth hormone, and lactate levels in control subjects, but not in diabetics. Our data demonstrate a hypoglycemic effect of exercise in mildly hyperglycemic nonobese type II diabetics. Possible causative factors include: hyperglycemia per se, a lack of physiologic suppression of plasma insulin, and abnormalities of autonomic or hypothalamic regulatory function.
We compared the clearance rate (K2) of plasma triglycerides (TG) following the intravenous (IV) infusion of a fat emulsion in 13 male endurance athletes (age 33 +/- 5.6 years, mean +/- SD) and 12 sedentary men (33 +/- 5.6 years). The athletes had lower fasting triglycerides (TG) (75 +/- 30.4 mg/dL v 125 +/- 52.5 mg/dL) and higher high-density lipoprotein (HDL) cholesterol concentrations (64 +/- 16.2 mg/dL v 42 +/- 9.4 mg/dL) than the sedentary subjects (P less than .01 for all). The higher HDL concentrations were due to increases in both the HDL2 and HDL3 subfractions. K2 in the athletes was 92% higher than that in the sedentary men (4.8 +/- 2.3%/min v 2.5 +/- 0.7%/min, P less than .01), but there was no difference in postheparin lipoprotein lipase activity (LPLA) between the groups (P greater than .05). K2 was positively correlated with LPLA (r = .51) and inversely related to fasting TG concentrations (r = -.73, P less than .01 for both). Furthermore, K2 was directly related to HDL (r = .75), HDL2 (r = .72), and HDL3 (r = .60) cholesterol concentrations (P less than .01 for all). These data suggest that the low TG levels in endurance athletes result at least in part from increased TG removal and that the elevated HDL concentrations of endurance athletes are related to enhanced fat clearance.
Obesity and physical inactivity are associated with both elevated cardiovascular risk and blood pressure (BP), but the interrelation of exercise, weight loss and BP is poorly understood. This study examines the independent effects of exercise and weight loss on both standard clinic and automated, ambulatory BP in 115 overweight, sedentary, normotensive men (aged 30 to 59 years) who were randomly assigned to control status or to lose weight over 1 year by moderate caloric restriction (dieting) or by increased caloric expenditure (exercise). Median daytime and evening BP were determined from measurements made every 20 minutes while the subjects were awake. After 1 year, the control group gained (mean +/- standard deviation) 0.5 +/- 3.8 kg while the diet group lost 6.9 +/- 4.4 kg and the exercise group lost 4.6 +/- 3.5 kg. Clinic BP decreased similarly in all 3 groups, but daytime and evening ambulatory BP decreased in both intervention groups and increased in the control group. Relative to the 1-year change in control subjects, net change in daytime ambulatory BP averaged -2 to -3 mm Hg in both dieters and exercisers, while net change in evening ambulatory BP averaged -3 to -4 mm Hg. These changes were all statistically significant (p less than 0.05) when compared with control subjects except for daytime systolic BP in both intervention groups and evening diastolic BP in dieters. Weight loss achieved through caloric restriction or expenditure may cause important decreases in BP in normotensive men; exercise appears to confer no unique benefit. If confirmed, these results have important public health implications for the prevention of cardiovascular disease.
We studied ten male distance runners before and after a marathon to determine the effects of prolonged exercise on serum lipoprotein values and the capacity to clear plasma triglycerides. Serum lipid and lipoprotein concentrations, intravenous fat clearance, and postheparin plasma lipolytic activities were measured 24 hours before and 18 hours after the race. The clearance rate of exogenous fat increased 76% +/- 64%, postheparin lipoprotein lipase activity increased 46% +/- 35%, and fasting triglyceride levels decreased 26% +/- 13% after the race. High-density lipoprotein (HDL) cholesterol level increased 10% +/- 8%, primarily due to a 19% +/- 17% increase in the HDL2 subfraction. Changes in the clearance rate of exogenous fat were directly related to changes in HDL cholesterol level and the HDL2 subfraction. Thus, the rise in HDL cholesterol concentrations after prolonged exercise may be a consequence of enhanced fat clearance.
We studied the effects of a single exercise session on lipid and lipoprotein concentrations and on postheparin plasma lipoprotein lipase (LPLA) and hepatic triglyceride hydrolase activities (HTGLA) in 11 trained (T) and ten untrained (UT) men. Subjects exercised on a bicycle ergometer at 80% of their maximal heart rate for one (UT) or two hours (T). Blood samples were drawn 24 hours before and at ten minutes and 24, 48, and 72 hours after exercise. Values were analyzed before and after adjustment for estimated changes in plasma volume (PV). High density lipoprotein cholesterol (HDL-C) increased 2 +/- 4 mg/dL in T (P less than 0.05) and 1 +/- 2 mg/dL in UT subjects beginning 48 hours after exercise. This increase was magnified by adjusting for the 5% to 8% postexercise expansion of PV. The increase in HDL in the T subjects was produced by increases in the HDL2-C subfraction (+3 +/- 4 mg/dL, P less than 0.05) whereas HDL3 increased in the UT men (+2 +/- 3 mg/dL, P less than 0.05). LPLA did not change in either subject group when estimated PV changes were ignored but increased 11% (P less than 0.05) at 24 hours after exercise when PV was considered. HTGLA was 11% below baseline in the UT men 24 to 72 hours after exercise (P less than 0.05) but showed no change in either subject group after adjustment for PV. These results demonstrate that exercise acutely increases HDL levels by raising the HDL2 subfraction in T and the HDL3 subfraction in UT men.(ABSTRACT TRUNCATED AT 250 WORDS)
The effects of prior high-intensity cycle exercise (85% VO2 max) to muscular exhaustion on basal and insulinstimulated glucose metabolism were studied in obese, insulin-resistant, and normal subjects. Six obese (30.4% fat) and six lean (14.5% fat) adult males underwent two separate, two-level hyperinsulinemic-euglycemic clamp studies (100-min infusions at 40 and 400 mU/m2/min), with and without exercise 12 h earlier. Carbohydrate oxidation was estimated by indirect calorimetry using a ventilated hood system, and endogenous glucose production by D-(3-3H)-glucose infusion. Glycogen content and glycogen synthase activity (GS %l) were measured in vastus lateralis muscle biopsies before and at the end of each insulin clamp procedure.
After exercise, the obese and lean subjects had comparably low muscle glycogen concentrations (0.10 versus 0.08 mg/g protein, respectively), and equal activation of muscle GS activity (54.4 versus 45.3 GS %l, respectively). In the obese subjects, insulin-stimulated glucose disposal was increased significantly, but not totally corrected to normal. In both groups there was a comparable increase in nonoxidative glucose disposal (NOGD), whereas glucose oxidation was decreased and lipid oxidation was increased. Thus, the major effect of prior exercise was to increase insulin-stimulated glucose disposal in the obese subjects and to alter the pathways of glucose metabolism to favor NOGD and decrease glucose oxidation.
No correlation was found between the exercise-induced increase in GS %l and NOGD, except in the normal subjects during maximal insulin stimulation. Thus, glycogen synthase activity does not appear to be ratelimiting fpr NOGD at physiologic insulin concentrations. Our findings suggest that a single bout of glycogendepleting exercise can increase glucose disposal for at least 12–14 h in obese subjects with insulin resistance.
The delayed lipoprotein changes after a 3-hour running test were examined in 14 moderately trained young male subjects. Fasting blood samples were obtained one day before, immediately before, and one, two, and four days after the race. Nonfasting samples were collected immediately after, one, and three hours after exercise. Three hours after the race, the ratio of unesterified cholesterol to cholesteryl esters was significantly increased, and one and two days after the race it was significantly decreased compared to the preexercise value. The HDL2/HDL3 ratio, measured by density-gradient ultracentrifugation was one and three hours after the running significantly elevated. However, no redistribution of the HDL2/HDL3 cholesterol ratio determined by a precipitation method with polyanions was found at this time. One day postexercise HDL cholesterol rose significantly above the preexercise value, and this was associated with an elevation of the HDL3 subfraction. On the following day a significant increase of HDL2 cholesterol and the HDL2/HDL3 cholesterol ratio was found. The apolipoproteins A-I, A-II, and B, measured by radial immunodiffusion, did not change during the first hours and the first two days after the race. On the second postexercise day the Lp(a) lipoprotein rose significantly above the preexercise value. Compared with the preexercise level the LCAT activity was significantly elevated three hours after the race and significantly decreased two days later. The present study suggests that during the first few days after prolonged exercise a number of plasma lipoprotein changes take place that are similar to those observed after a period of physical training.
Serum lipids, lipoproteins, apolipoproteins, physical characteristics, and 10-day dietary records of 20 male distance runners (aged 20-42 years) were compared with those of 14 sedentary controls (aged 23-34 years). Runners had significantly greater levels (mean +/- SD) of high density lipoproteins (HDL) whether estimated as HDL-cholesterol (66 +/- 12 vs 46 +/- 10 mg/dl) or as the major HDL apolipoproteins, apoA-I (170 +/- 36 vs 124 +/- 27 mg/dl) or apoA-II (39 +/- 5 vs 34 +/- 4 mg/dl). Runners were leaner with considerably less body fat (8.3 +/- 1.7 vs 16.2 +/- 3.9%) than the sedentary men despite consuming 20% more calories. Moreover, the additional calories consumed were largely carbohydrate. This comparison illustrates that high absolute quantities of dietary carbohydrate do not depress HDL levels in lean individuals engaged in exercise training. Furthermore, the results suggest that dietary factors may be as important as exercise itself in producing the lipoprotein pattern characteristic of endurance athletes.
The interaction of exercise and diet in determining the lipid profiles of endurance athletes is poorly defined. Since active men consume more calories than sedentary individuals, we examined the effects of caloric restriction alone or in combination with exercise cessation on the serum lipid levels of men running 16 km daily. For seven days before each study, subjects consumed diets composed of 15% protein, 32% fat, and 53% carbohydrate. During ten-day experimental periods, one group (n = 10) continued running and consumed the same diet containing 3670 kcal/day, while two other groups consumed an identical diet containing 20% fewer calories and either continued (n = 16) or stopped (n = 15) exercise training. High-density lipoprotein cholesterol (HDL-C) concentrations decreased 1% to 5% in all groups during the seven-day preliminary diet. Additional reductions in total HDL-C concentrations were similar in the control and exercise cessation groups, but HDL2-C level decreased 15% during exercise cessation. During caloric restriction and continued running, in contrast, HDL-C concentration increased 8% and the HDL2-C subfraction increased 23%. There was little change in levels of apolipoprotein A-I concentrations during any of the protocols, demonstrating that changes in HDL-C are not necessarily attended by changes in the major HDL apoprotein. Low-density lipoprotein cholesterol (LDL-C) level decreased 10% to 15% in all groups during the preliminary period. Only small additional reductions occurred in men who continued running. Exercise cessation, however, was associated with a 10% increase in LDL-C level after only two days of inactivity.(ABSTRACT TRUNCATED AT 250 WORDS)
We investigated the acute effects of prolonged exercise on lipoprotein metabolism. Serum lipid and lipoprotein concentrations and plasma postheparin lipolytic activity were measured in ten well-trained men (ages 21 to 39) the day before and after a 42 km foot race. LDL cholesterol decreased by 10% (113 +/- 31 to 103 +/- 32 mg/dL, P less than 0.01) and total HDL-cholesterol levels increased by 9% (65 +/- 18 to 71 +/- 19 mg/dL, P less than 0.01) the day after the race. No changes in the concentration of apolipoprotein A-I or A-II occurred. Triglyceride levels decreased by 39% (95 +/- 38 to 58 +/- 23 mg/dL, P less than 0.001). Two days after the race, total HDL cholesterol (74 +/- 21 mg/dL, P less than 0.05) and the HDL2 subfraction (37 +/- 19 mg/dL, P less than 0.05) remained significantly elevated compared to pre-race values. Most dramatically, the level of lipoprotein lipase activity measured in postheparin plasma nearly doubled after the race, demonstrating that vigorous exercise acutely increases this enzyme activity. The increase in lipoprotein lipase activity probably mediated the fall in serum triglycerides after exercise and may also account for the increase in HDL cholesterol.
The metabolic response to exercise in obese postabsorptive noninsulin-dependent diabetics was compared to that of obese nondiabetics. Exercise consisted of 45 min on a cycle ergometer at 60% maximum oxygen consumption. Six diabetic subjects were studied during oral hypoglycemic therapy and four on diet alone. The sulfonylurea therapy had no effect on the response. Glycemia was elevated at rest in both diabetic subgroups (192 +/- 24 mg/dl for diet alone, 226 +/- 36 mg/dl for sulfonylurea treatment) and a similar fall (35 and 37 mg/dl, respectively) occurred with exercise. In control subjects, glycemia was 86 +/- 4 mg/dl and did not change with exercise. In the diabetics at rest, glucose production was elevated (220 +/- 25 mg/min), whereas the metabolic clearance of glucose was suppressed. During exercise the increase in glucose utilization was similar to that in controls, but glucose production failed to increase significantly, thus accounting for the decline in plasma glucose. At rest, plasma immunoreactive insulin (IRI) was elevated to 0.90 ng/ml in the controls and decreased to 0.65 ng/ml with exercise. In the diabetics IRI was similarly elevated (0.89 ng/ml) but failed to decrease normally with exercise. Lactate, pyruvate, alanine, and free fatty acids increased similarly in diabetics and controls, whereas the increase in 3-hydroxybutyrate during recovery was less in diabetics. The sustained insulinemia, the basal overproduction of glucose, and hyperglycemia itself may all contribute to the observed differences in glucose flux during exercise in noninsulin-dependent diabetics.
Acute reductions in triglycerides and low density lipoprotein (LDL) cholesterol concentrations have been demonstrated in endurance athletes after prolonged exercise. To determine if similar changes occur in untrained subjects and to determine the duration of exercise necessary for such changes, we measured serum lipids and lipoproteins in 10 sedentary men after 1 hour of exercise at their anaerobic threshold. Findings in sedentary men were compared with those of 9 competitive cyclists after 1 and 2 hr of exercise. LDL cholesterol increased in the cyclists immediately after 1 and 2 hours of exercise. Total cholesterol and high density lipoprotein (HDL) cholesterol also increased in the cyclists immediately after the 2 hr session. These increases were transient and not significant when corrected for changes in plasma volume. Serum triglycerides were unchanged for 4 hr after exercise. By 24 hr, however, triglycerides had decreased in both the trained (17%) and untrained men (22%) after the 1 hr session and in the trained men (33% p less than 0.01) after the 2 hr session. These results demonstrate a delayed decrease in triglyceride concentration that is related to the duration of exercise and probably has no distinct threshold. The lower level of triglycerides in endurance athletes and in sedentary subjects after exercise training is due at least in part to an acute exercise effect.
The acute effects of a single prolonged exercise session on the serum concentrations of cholesterol, triglycerides (TG), glycerol, high density lipoprotein (HDL) cholesterol, and the major HDL protein, apolipoprotein A-I(apoA-I), were examined in 12 trained male runners participating in a 42-km footrace. Serum TG levels were unchanged up to 4 h after the race, but at 18, 42, and 66 hr mean reductions of 65%, 39%, and 32% were observed. Free glycerol concentrations were increased fivefold immediately after the race, but did not differ from prerace levels by 4 hr. Total cholesterol concentration did not change immediately after exercise, but unexpected significant reductions of 6%-10% were found at 4-66 hr. Only small and transient increases in HDL cholesterol and apoA-I levels were noted after exercise. These results suggest that prolonged exercise acutely lowers TG and total cholesterol, but has little effect on HDL mass.
The purpose of this study was to characterize the short-term changes in blood lipid and apolipoprotein concentrations in healthy hypercholesterolemic men after high-intensity [80% maximal O2 uptake (VO2max); n = 20] or moderate-intensity (50% VO2max; n = 19) cycle ergometer exercise balanced for caloric expenditure (350 kcal). The men's age, height, weight, %fat, and VO2max were 46 +/- 2 yr, 173 +/- 7 cm, 82.7 +/- 2.2 kg, 28 +/- 1%, and 31.1 +/- 1.0 ml O2.kg-1.min-1, respectively. Blood samples were drawn before exercise, immediately after exercise, then 24 and 48 h later, and concentrations of all variables were adjusted for changes in plasma volume. Significant changes (P < 0.0016) were as follows: total and low-density lipoprotein cholesterol fell by 4% immediately after exercise and then rose by 5-8% by 48 h. Triglycerides were 18 and 15% lower at 24 and 48 h, respectively. HDL-cholesterol, high-density lipoprotein3-cholesterol, and apolipoprotein B rose 8-9% by 24 h and remained elevated. High-density lipoprotein2-cholesterol rose by 27% by 48 h after exercise, but this change was not significant. Apolipoprotein A-I did not change with exercise. The response patterns were not affected by exercise intensity. These data show that a single session of exercise performed by untrained hypercholesterolemic men alters blood lipid and apolipoprotein concentrations. Furthermore, the postexercise response patterns are not influenced by exercise intensity, as long as caloric expenditure is held constant.
To characterize splanchnic and muscle metabolism during exercise in non-insulin-dependent diabetes mellitus (NIDDM), eight male nonobese patients and seven healthy control subjects (CON) were studied during 40 min of bicycle exercise at 60% of maximal oxygen uptake. Biopsies were obtained from the quadriceps femoris muscle at rest and immediately after exercise. Arterial glucose concentration in NIDDM had declined by 10% (P < 0.01) at the end of exercise, whereas in CON it had risen by 21% (P < 0.05). Leg glucose uptake rose from 0.19 +/- 0.06 mmol/min at rest to 2.25 +/- 0.61 mmol/min at the end of exercise in NIDDM and from 0.13 +/- 0.05 to 1.17 +/- 0.34 mmol/min in CON. Splanchnic glucose output increased from 0.52 +/- 0.06 to 2.37 +/- 0.26 mmol/min in NIDDM and from 0.79 +/- 0.12 to 2.44 +/- 0.38 mmol/min in CON. Leg lactate output during exercise was twofold higher in NIDDM. Muscle contents of lactate and glycogen were similar in both groups at rest, whereas after exercise lactate tended to be higher (19.5 +/- 1.7 vs. 12.7 +/- 5.9 mmol/kg dry wt) and glycogen lower (154 +/- 35 vs. 251 +/- 41 mmol glucosyl units/kg dry wt) in NIDDM. Whole body respiratory exchange ratio during exercise was higher in NIDDM (0.84 +/- 0.02 vs. 0.78 +/- 0.02, P < 0.05). Exercise-induced changes in other muscle metabolites were similar in NIDDM and CON. These data indicate that the decline in blood glucose during exercise in nonobese NIDDM is due to enhanced peripheral glucose utilization rather than to an attenuated increase in splanchnic glucose output.
To determine the effects of prior exercise and naloxone on haemodynamics, muscle sympathetic nerve activity, pituitary hormones and ambulatory blood pressure.
We studied 14 mild hypertensive and 14 normotensive subjects on two days. After baseline measurements, subjects were randomly allocated to vehicle or naloxone (0.4 mg/kg) 30 min before 45 min treadmill exercise.
In both groups blood pressure, stroke volume, and calf and total peripheral resistances were lower 1 h after exercise, whereas sympathetic activity was unchanged. In normotensive subjects naloxone abolished this calf vasodilation without altering muscle sympathetic nerve activity, and attenuated these haemodynamic aftereffects of exercise, implying a peripheral opioidergic mechanism. Naloxone had no haemodynamic effect in hypertensive subjects. In normotensives there was an inverse relationship between changes in blood pressure and sympathetic activity after vehicle and exercise. This was transformed by naloxone into a positive relationship (r = 0.69, P < 0.02) similar to that observed in hypertensives after vehicle and exercise. Naloxone did not alter the latter positive relationship. Naloxone altered exercise-induced changes in prolactin and luteinizing hormone, but only in normotensive males. In both groups ambulatory blood pressures and heart rates over 2 h after subjects left the laboratory were higher than the values recorded at baseline or 1 h after exercise, and were unaffected by naloxone.
The depressor effect of exercise is due to peripheral vasodilation, occurs in the absence of sympathetic withdrawal and is short-lived. Endogenous opioids, activated by running, participate in the haemodynamic, sympathoneural and pituitary hormone aftereffects of exercise in normotensive subjects, whereas in hypertensives these aftereffects of exercise are achieved through non-opioidergic mechanisms. These observations are consistent with the concept that activation of endogenous opioid systems by exercise is impaired in mild hypertension.
The Guidelines for Exercise Training initially developed by the American College of Sports Medicine in 1978 and updated in 1990 have served as the foundation for most recommendations regarding physical activity program design for the general public. These guidelines have proven to be very useful by providing a specific regimen for enhancing aerobic capacity and body composition. As data supporting a causal link between increased activity or fitness and health status have evolved, questions have been raised about potential limitations of these guidelines for promoting physical activity to increase the health status of sedentary adults. The major issues have involved the necessity to achieve the values for each of the program parameters, especially the intensity, duration, and frequency of exercise, in order to improve health status. To address these issues, a paradigm shift from exercise training to promote physical fitness to physical activity to promote health has been introduced. This new paradigm is based on the results from numerous studies indicating that a generally active life style is associated with better health and performance and greater longevity and a certain set of assumptions, yet to be fully tested. The following article provides some background leading to the development of the ACSM guidelines and presents some of those issues we understand and some we do not regarding the characteristics of daily physical activity or exercise training that are likely to improve the physical health status of sedentary persons.
A possible hypotensive action of regular endurance exercise in normotensive sedentary subjects still remains a matter of debate. This is partly caused by the fact that the anticipated fall in resting blood pressure is rather small and fluctuations in blood pressure during the day can be large. The benefits of ambulatory blood pressure monitoring (ABP) originate to a great deal from the fact that the repeatability on different occasions of the ambulatory blood pressure average is improved by the greater number of readings. In this context we evaluated the effect of moderate exercise training in 19 sedentary male subjects, aged 22 to 44 years, with normal or slightly elevated blood pressure. They entered a randomized cross-over study. Measurements were performed before the study, after 6 weeks of sedentary life style (S) and after 6 weeks of training (T) on a cycle ergometer 3 times a week for 45 min at 75% VO2max. ABP was measured with a Spacelabs 90207 monitor and cardiac output at rest with echo-Doppler. Training increased VO2max from 3.13 +/- 0.09 to 3.40 +/- 0.08 l/min (p < 0.01). Resting heart rate decreased from 60 +/- 2 to 57 +/- 2 bpm (p < 0.05). Resting blood pressure was unchanged after training. Resting stroke volume increased from 82 +/- 3 to 89 +/- 3 ml (p < 0.02). Systemic vascular resistance index was significantly decreased due to conditioning (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Recent investigations have demonstrated that there is a sustained reduction in arterial blood pressure after a single bout of exercise, ie, postexercise hypotension (PEH). The purpose of this discussion is to integrate the available information on this topic and to review studies using sustained stimulation of somatic afferents in experimental rats as a model to study the role of somatic afferents in PEH. PEH occurs in response to several types of large-muscle dynamic exercise (ie, walking, running, leg cycling, and swimming) at submaximal intensities greater than 40% of peak aerobic capacity and exercise durations generally between 20 and 60 minutes. PEH is observed in both normotensive and hypertensive humans and in spontaneously hypertensive rats but is generally greater in magnitude in hypertensive subjects. The maximal exercise-induced reductions in systolic and diastolic arterial blood pressures have been on average 18 to 20 and 7 to 9 mm Hg, respectively, in hypertensive humans and 8 to 10 and 3 to 5 mm Hg, respectively, in normotensive humans. PEH has been reported to persist for 2 to 4 hours under laboratory conditions. Whether PEH is sustained for a prolonged period of time under free-living conditions remains controversial, although the results of one study indicate that PEH can persist for up to 13 hours. Possible mechanisms involved in mediating postexercise and poststimulation reductions in arterial blood pressure include decreased stroke volume and cardiac output; reductions in limb vascular resistance, total peripheral resistance, and muscle sympathetic nerve discharge; group III somatic afferent activation; altered baroreceptor reflex circulatory control; reduced vascular responsiveness to alpha-adrenergic receptor-mediated stimulation; and activation of endogenous opioid and serotonergic systems. It appears that the magnitude of PEH in hypertensive subjects is clinically significant; however, more investigation is required to determine if the duration is sufficient under real-life conditions to contribute to the reduction in blood pressure observed with chronic exercise conditioning.
It is generally accepted that physical training decreases blood pressure in hypertensive subjects, but the importance of training intensity has not been established. This study compared the effects of endurance training at different intensities on ambulatory blood pressure and on blood pressure load (percentage of readings above 140/90 and 120/80 mm Hg during the waking and sleeping periods, respectively).
Previously sedentary subjects with mild to moderate hypertension were evaluated in a crossover fashion according to a Latin square after a sedentary control period and after training at low and at moderate intensity corresponding to 50% and 70% of maximal oxygen uptake, respectively. Each period lasted 10 weeks. After training at moderate intensity, a higher maximal oxygen uptake was found compared with sedentary values but not after training at low intensity. Both training intensities exerted a similar antihypertensive effect of about 5 mm Hg for systolic and diastolic 24-hour blood pressures. However, training at low intensity reduced blood pressure exclusively during the walking hours, whereas training at a moderate intensity reduced blood pressure only during the evening and sleeping hours. Waking blood pressure load decreased from 66% to 49% after training at low intensity, whereas sleeping blood pressure load decreased from 61% to 34% after training at moderate intensity (both P < .05).
Low- and moderate-intensity training produce similar 24-hour blood pressure reductions, but each training intensity may interfere with different pathogenic effects associated with different blood pressure profiles.
To assess the relationship of insulin levels and glucose tolerance to blood pressure in hypertension.
An open, prospective trial of exercise training with ambulatory blood pressure monitoring and intravenous glucose tolerance testing before and after a 14-week training programme.
Twenty sedentary, untreated, non-obese, normoglycaemic individuals of both sexes with uncomplicated essential hypertension, of whom 16 completed the study.
Fourteen weeks of supervised, low-intensity, group exercise of three 1-h sessions per week.
Ambulatory and clinic blood pressure, and glucose and insulin responses to an intravenous glucose tolerance test.
Maximal work capacity on a bicycle ergometer increased by 20% (P < 0.001); 24-h ambulatory blood pressure was 143 +/- 12/87 +/- 5 mmHg before and 142 +/- 13/87 +/- 7 mmHg after training. Clinic blood pressure decreased from 166 +/- 14/103 +/- 5 mmHg to 157 +/- 12/99 +/- 6 mmHg (P < 0.03). Two-way analysis of variance indicated significant decreases in both glucose (P < 0.04) and insulin (P < 0.03), fasting and throughout the intravenous glucose tolerance test.
Although mild exercise reduced clinic blood pressure significantly, it did not affect ambulatory blood pressure despite a marked reduction in glucose and insulin levels. This finding argues against a determinant role of insulin in the 24-h maintenance of blood pressure in hypertensive patients under the conditions of the study.