Hypotensive effects of exercise training: are postmenopausal women with hypertension non-responders or responders?

We tested the hypothesis that increasing the exercise dose or changing the exercise mode would augment hypotensive effects when traditional aerobic exercise training failed to produce it in postmenopausal women. Sixty-five postmenopausal women with essential hypertension were randomly allocated into the continuous aerobic training (CAT) and non-exercising control (CON) groups. CAT group cycled at moderate intensity 3 times a week for 12 weeks. Individuals who failed to decrease systolic blood pressure (BP) were classified as non-responders (n = 34) and performed an additional 12 weeks of exercise training with either increasing the exercise dose or changing the exercise mode. The 3 follow-up groups were continuous aerobic training 3 times a week, continuous aerobic training 4 times a week, and high-intensity interval training. After the first 12 weeks of exercise training, systolic BP decreased by 1.5 mmHg (NS) with a wide range of inter-individual responses (-23 to 23 mmHg). Sixty-seven percent of women who were initially classified as non-responders participated in the second training period. Sixty percent of women who participated in continuous exercise training 3 or 4 times a week at greater exercise intensities reduced systolic BP. All (100%) of the women who performed high-intensity interval training experienced significant reductions in systolic BP. Traditional aerobic exercise was not sufficient to decrease BP significantly in the majority of postmenopausal women. However, those women who were not sensitive to recommended exercise may reduce BP if they were exposed to continuous aerobic exercise at higher intensities and/or volumes or a different mode of exercise.

Moderate-Intensity Combined Training Induces Lipidomic Changes in Individuals with Obesity and Type 2 Diabetes.

CONTEXT: Alterations in the lipid metabolism are linked to metabolic disorders such as insulin resistance (IR), obesity and type 2 diabetes (T2D). Regular exercise, particularly combined training (CT), is a well-known non-pharmacological treatment that combines aerobic (AT) and resistance (RT) training benefits. However, it is unclear whether moderate-intensity exercise without dietary intervention induces changes in lipid metabolism to promote a 'healthy lipidome'. OBJECTIVE: The study aimed to investigate the effect of 16 weeks of CT on plasma and white adipose tissue in both sexes, middle-aged subjects with normal weight, obesity and T2D using an ultra-high performance liquid chromatography-mass spectrometry (UHPLC-MS) untargeted lipidomics approach. METHODS: Body composition, maximum oxygen consumption (VO2 max), strength, and biochemical markers were evaluated before and after the control/training period and correlated with lipid changes. CT consisted of 8 to 10 RT exercises, followed by 35 min of AT (45 -70% VO2 max), 3 times a week for 16 weeks. RESULTS: The CT significantly reduced the levels of saturated and monounsaturated fatty acid side-chains (SFA/MUFA) in sphingolipids, glycerolipids (GL) and glycerophospholipids (GP) as well as reducing fat mass, circumferences and IR. Increased levels of polyunsaturated fatty acids in GPs, and GLs were also observed, along with increased fat-free mass, VO2 max, and strength (all p < 0.05) after training. CONCLUSION: Our study stated that 16 weeks of moderate-intensity CT remodelled the lipid metabolism in OB, and T2D individuals, even without dietary intervention, establishing a link between exercise-modulated lipid markers and mechanisms that reduce IR and obesity-related comorbidities.

Rho-Kinase Is Differentially Expressed in the Adipose Tissue of Rodent and Human in Response to Aging, Sex, and Acute Exercise.

White adipose tissue (WAT) controls energy storage, expenditure, and endocrine function. Rho-kinase (ROCK) is related to impaired thermogenesis, downregulation of preadipocyte differentiation, and adipokine production. Furthermore, WAT ROCK responds to metabolic stress from high-fat diets or diabetes. However, ROCK distribution in adipose depots and its response to aging and sex remain unclear. Thus, we aim to investigate ROCK function in adipose tissue of rodent and human in response to aging and sex. We observed specific differences in the ROCK1/2 distribution in inguinal WAT (ingWAT), perigonadal WAT (pgWAT), and brown adipose tissue of male and female rodents. However, ROCK2 expression was lower in female ingWAT compared with males, a fact that was not observed in the other depots. In the pgWAT and ingWAT of male and female rodents, ROCK activity increased during development. Moreover, middle-aged female rodents and humans showed downregulation in ROCK activity after acute physical exercise. Interestingly, ROCK levels were associated with several inflammatory markers both in rats and humans WAT (Nfkb1, Tnf, Il1b, Il6, and Mcp1). Induction of cell senescence by etoposide elevates ROCK activity in human preadipocytes; however, silencing ROCK1/2 demonstrates improvement in the inflammatory and cell senescence state. Using public databases, several pathways were strongly associated with ROCK modulation in WAT. In summary, WAT ROCK increases with development in association with inflammatory markers. Further, ROCK activity was attenuated by acute physical exercise, implicating it as a possible therapeutic target for metabolism improvement mediated by adipose tissue inflammatory state changes.

Effects of Different Exercise Types on Chrna7 and Chrfam7a Expression in Healthy Normal Weight and Overweight Type 2 Diabetic Adults.

Purpose: Considering that the CHRNA7 and CHRFAM7A genes can be modulated by acute or chronic inflammation, and exercise modulates inflammatory responses, the question that arises is whether physical exercise could exert any effect on the expression of these genes. Thus, the aim of this work is to identify the effects of different types of exercises on the expression of the CHRNA7, CHRFAM7A and tumor necrosis factor-α (TNF-α) in leukocytes of healthy normal weight (HNW), and overweight with type 2 diabetes (OT2D) individuals. Methods: 15 OT2D and 13 HNW participants (men and women, from 40 to 60 years old) performed in a randomized crossover design three exercise sessions: aerobic exercise (AE), resistance exercise (RE) and combined exercise (CE). Blood samples were collected at rest and post-60-min of the exercise sessions. The leukocytes were the analysis of the CHRNA7, CHRFAM7A and (TNF-α) gene expression. Results: At baseline, OT2D had higher CHRFAM7A and TNF-α expression compared to HNW. No statistical differences were observed between groups for CHRNA7; however, the HNW group presented almost twice as many subjects with the expression of this gene (24% vs. 49%). Post exercise, the CHRFAM7A increased in AE, RE and CE for HNW, and in AE and CE for OT2D. There was no significant difference for TNF-α and CHRNA7 expression between any type of exercise and group. Conclusions: Our study shows that OT2D individuals presented higher baseline expression of TNF-α and CHRFAM7A, besides evidence of decreased CHRNA7A expression in leukocytes when compared with HNW. On the other hand, acutely physical exercise induces increased CHRFAM7A expression, especially when the aerobic component is present.

Exercise effect on symptom severity, morbidity and mortality in viral infections: a systematic review and meta-analysis.

There is a knowledge gap regarding the consequences of exercise during acute infections in humans and contradictory findings in animal studies, compromising public health advice on the potential benefits of physical activity for immunity. Here, we carried out a meta-analysis of studies of the effects of moderate exercise (ME) and exercise until fatigue (EF) on symptom severity, morbidity and mortality during viral infection in animal models. The systematic review on PubMed, Scopus, Embase, Web of Science, Cochrane and EBSCOhost (CINAHL and SPORT Discus) identified 8 controlled studies, with 15 subgroups within them. The studies exposed the animals (mice [7 studies] and monkeys [1 study]) to exercise immediately before or after viral inoculation (HSV-1, H1N1 influenza and B.K. virus) with follow-up for 21 days. ME significantly reduced morbidity (OR 0.43 [0.19; 0.98], P = 0.04) with no change for symptom severity (SMD -3.37 [-9.01; 2.28], P = 0.24) or mortality (OR 0.48 [0.08;3.03], P = 0.43). In contrast, EF gave a trend towards increased symptom severity (SMD 0.96 [-0.06; 1.98], P = 0.07) and mortality (OR 1.47 [0.96;2.28], P =0.08) with no change in morbidity (OR 1.22 [0.60;2.5], P = 0.58). We conclude that in animals moderate exercise during infection is advantageous, whilst exercise until fatigue should be avoided. Further research is required to determine if moderate exercise may also be beneficial in humans during infection.

Pre-competitive overload period impairs parasympathetic modulation in athletes: A systematic review and meta-analysis.

OBJECTIVE: The aim was to meta-analyze the effect of different type of overloads on parasympathetic modulation to the heart, assessed by root-mean-square difference of successive normal RR intervals (RMSSD) of athletes. METHODS: The analysis of the 14 studies selected (20 subgroups within studies), compared RMSSD of the same athletes before and after an overload period. RESULTS: RMSSD of athletes were lower at pre-competition compared to baseline (SMD = -0.50 [-0.83; -0.18], p = 0.002), while volume, volume plus intensity and post-competition overloads showed similar RMSSD than their respective normal load periods. CONCLUSION: The lower RMSSD during pre-competition overload, characterize an loss of homeostasis, and could be explained by the presence of pre-competition anxiety, stress, and higher psychological challenges in addition to the same physical stress present in the other types of overloads (i.e.: higher volume or training intensity).

Combined training increases thermogenic fat activity in patients with overweight and type 2 diabetes.

BACKGROUND: Exercise is an important strategy in the management of diabetes. Experimental studies have shown that exercise acts, at least in part, by inducing the production of myokines that improve metabolic control and activate brown/beige adipose tissue depots. Combined training (CT) is recommended by the major diabetes guidelines due to its metabolic and cardiovascular benefits, however, its impact on brown/beige adipose tissue activities has never been tested in humans with overweight and type 2 diabetes (T2D). Here, we evaluated the effects of 16-week combined training (CT) program on brown adipose tissue activity; browning and autophagy markers, and serum pro-thermogenic/inflammatory inducers in patients with overweight and T2D. METHODS: Thirty-four patients with overweight and T2D were assigned to either a control group (CG) or a combined training group (CTG) in a randomized and controlled study. Functional/fitness parameters, anthropometry/body composition parameters, blood hormone/biochemical parameters, thermogenic/autophagic gene expression in subcutaneous adipose tissue were evaluated before and at the end of the intervention. In addition, cold-induced 18-Fluoroxyglucose Positron Emission Computed Tomography (18F-FDG PET/CT) was performed in the training group before and after the end of the intervention. RESULTS: CT increased cervical/supraclavicular brown adipose tissue (BAT) thermogenic activity (p = 0.03) as well as in perirenal adipose tissue (p = 0.02). In addition, CT increased the expression of genes related to thermogenic profile (TMEM26: + 95%, p = 0.04; and EPSTI1: + 26%, p = 0.03) and decreased autophagic genes (ULK1: -15%, p = 0.04; LC3: -5%, p = 0.02; and ATG4: -22%, p < 0.001) in subcutaneous adipose tissue. There were positive correlations between Δ% BAT activity with Δ% of post training energy expenditure cold exposure, HDL-c, IL4, adiponectin, irisin, meteorin-like, and TMEM26 and ZIC1 genes, besides negative correlations with LDL-c, total cholesterol and C-reactive protein. CONCLUSION: This is the first evidence of the beneficial actions of CT on adipose tissue thermogenic activity in humans, and it adds important support for the recommendation of CT as a strategy in the management of diabetes.

Inhibitory control after aerobic exercise with and without blood flow restriction in older adults / Controle inibitório após exercícios aeróbicos com e sem restrição do fluxo sanguíneo em idosos / Control inhibitorio después del ejercicio aeróbico con y sin restricción del flujo sanguíneo en adultos mayores

Introduction: Regular aerobic exercise (AE) can reduce the cognitive losses typically experienced with aging can be blunted by regular aerobic exercise (AE). AE also induces acute improvement of cognitive function among older adults; and AE practice with blood flow restriction (BFR) addss other benefits to elderly health, such as improvements in aerobic fitness, and increase in muscle mass and strength, however, it is not clear which EA protocol is more efficient to cognitive function. Objectives: Thus, the aimof this study was to compare AE protocols with and without BFR on the inhibitory control of the elderly. Methodology: Twenty-one elderly performed the Stroop test before and after three AE sessions in a repeated measure, cross-over design: AE with high load (70% VO2max), AE with low load (40% VO2max), and AE with blood flow restriction (AE-BFR) BFR (40% VO2max and 50% of BFR). Results and discussion: There was no significant effect from experimental sessions on cognitive function, assessed by inhibitory control in Stroop test. Perhaps, the load applied was not proper to stimulate cognitive function improvements, as seen the moderate loads have been more efficient to increase cerebral blood flow, among other physiological mechanisms encompassed. Final Considerations: Moreover, we observed very heterogeneous responses among individuals and sessions, suggesting that future research also considers biological individuality.

Introdução: As perdas cognitivas tipicamente experimentadas com o envelhecimento podem ser atenuadas por exercícios aeróbicos (EA) regulares. EA também induz melhora aguda da função cognitiva em idosos; e a prática de EA com restrição de fluxo sanguíneo (RFS) agrega outros benefícios à saúde do idoso, como melhorias na aptidão aeróbia e aumento da massa e força muscular. No entanto, não está claro qual protocolo de EA é mais eficaz para a funcao cognitiva. Objetivos: Assim, o objetivo deste estudo foi comparar diferentes protocolos de EA com e sem RFS no controle inibitório de idosos. Metodologia: Vinte e um idosos realizaram o teste de Stroop antes e após três sessões de EA em medida repetida, desenho cruzado: EA com alta carga (70% VO2máx), EA com baixa carga (40% VO2máx) e EA com RFS (40% VO2máx e 50% do RFS). Resultados e discussão: Não houve efeito significativo das sessões experimentais na função cognitiva avaliada pelo controle inibitório no Stroop Test. Talvez, as cargas aplicadas não tenham sido adequadas para estimular melhorias no controle inibitório, visto que as cargas moderadas têm sido mais eficientes para aumentar o fluxo sanguíneo cerebral, entre outros mecanismos fisiológicos Considerações Finais: Além disso, observamos respostas bastante heterogêneas entre indivíduos e sessões, sugerindo que pesquisas futuras considere também a individualidade biológica.

Introducción: El ejercicio aeróbico regular (EA) puede reducir la perdida cognitiva tipicamente experimentada durante el envejecimiento. EA puede tambien inducir mejora en la funcion cognitiva entre adultos mayores, ademas, la practica de resticcion de flujo sanguíneo (RFS) agrega otros beneficios para la salud en los ancianos, así como mejoras en la aptitud aeróbica, aumento de la masa muscular y la fuerza, sin embargo, no está claro qué protocolo de EA es más eficiente para la función cognitiva. Objetivos: El objetivo de este estudio fue comparar los protocolos de EA con y sin RFS en el control inhibitorio de los ancianos. Metodología: Veintiún ancianos realizaron la prueba de Stroop antes y después de tres sesiones de EA en medida repetida, diseño cruzado: EA con carga alta (70% VO2max), EA con carga baja (40% VO2max) y EA con restricción del flujo sanguíneo (EA-RFS) RFS (40% VO2max y 50% de RFS). Resultados y discusión: No hubo efecto significativo de las sesiones experimentales sobre la función cognitiva, evaluada por el control inhibitorio en la prueba de Stroop. Quizás, la carga aplicada no fue la adecuada para estimular mejoras en la función cognitiva, ya que las cargas moderadas han sido más eficientes para aumentar el flujo sanguíneo cerebral, entre otros mecanismos fisiológicos englobados. Consideraciones finales: Además, nosotros observamos respuestas muy heterogéneas entre individuos y sesiones, lo que sugiere que para futuras investigaciones también se debe considerar la variabilidad biológica.

HIIT vs. SIT: What Is the Better to Improve V˙O2max? A Systematic Review and Meta-Analysis.

Lack of time is seen as a barrier to maintaining a physically active lifestyle. In this sense, interval training has been suggested as a time-efficient strategy for improving health, mainly due to its potential to increase cardiorespiratory fitness. Currently, the most discussed interval training protocols in the literature are the high-intensity interval training (HIIT) and the sprint interval training (SIT). Objective: We investigated, through a systematic review and meta-analysis, which interval training protocol, HIIT or SIT, promotes greater gain in cardiorespiratory fitness (V˙O2max/peak). The studies were selected from the PubMed (MEDLINE), Scopus and Web of Science databases. From these searches, a screening was carried out, selecting studies that compared the effects of HIIT and SIT protocols on V˙O2max/peak. A total of 19 studies were included in the final analysis. Due to the homogeneity between studies (I2 = 0%), fixed-effects analyses were performed. There was no significant difference in the V˙O2max/peak gains between HIIT and SIT for the standardized mean difference (SMD = 0.150; 95% CI = -0.038 to 0.338; p = 0.119), including studies that presented both measurements in mL·kg-1·min-1 and l·min-1; and raw mean differences (RMD = 0.921 mL·kg-1·min-1; 95% CI = -0.185 to 2.028; p = 0.103) were calculated only with data presented in mL·kg-1·min-1. We conclude that the literature generates very consistent data to confirm that HIIT and SIT protocols promote similar gains in cardiorespiratory fitness. Thus, for this purpose, the choice of the protocol can be made for convenience.

Association Between Changes in Serum and Skeletal Muscle Metabolomics Profile With Maximum Power Output Gains in Response to Different Aerobic Training Programs: The Times Study.

Purpose: High heterogeneity of the response of cardiorespiratory fitness (CRF) to standardized exercise doses has been reported in different training programs, but the associated mechanisms are not widely known. This study investigated whether changes in the metabolic profile and pathways in blood serum and the skeletal muscle are associated with the inter-individual variability of CRF responses to 8-wk of continuous endurance training (ET) or high-intensity interval training (HIIT). Methods: Eighty men, young and sedentary, were randomized into three groups, of which 70 completed 8 wk of intervention (> 90% of sessions): ET, HIIT, or control. Blood and vastus lateralis muscle tissue samples, as well as the measurement of CRF [maximal power output (MPO)] were obtained before and after the intervention. Blood serum and skeletal muscle samples were analyzed by 600 MHz 1H-NMR spectroscopy (metabolomics). Associations between the pretraining to post-training changes in the metabolic profile and MPO gains were explored via three analytical approaches: (1) correlation between pretraining to post-training changes in metabolites' concentration levels and MPO gains; (2) significant differences between low and high MPO responders; and (3) metabolite contribution to significantly altered pathways related to MPO gains. After, metabolites within these three levels of evidence were analyzed by multiple stepwise linear regression. The significance level was set at 1%. Results: The metabolomics profile panel yielded 43 serum and 70 muscle metabolites. From the metabolites within the three levels of evidence (15 serum and 4 muscle metabolites for ET; 5 serum and 1 muscle metabolites for HIIT), the variance in MPO gains was explained: 77.4% by the intervention effects, 6.9, 2.3, 3.2, and 2.2% by changes in skeletal muscle pyruvate and valine, serum glutamine and creatine phosphate, respectively, in ET; and 80.9% by the intervention effects; 7.2, 2.2, and 1.2% by changes in skeletal muscle glycolate, serum creatine and creatine phosphate, respectively, in HIIT. The most changed and impacted pathways by these metabolites were: arginine and proline metabolism, glycine, serine and threonine metabolism, and glyoxylate and dicarboxylate metabolism for both ET and HIIT programs; and additional alanine, aspartate and glutamate metabolism, arginine biosynthesis, glycolysis/gluconeogenesis, and pyruvate metabolism for ET. Conclusion: These results suggest that regulating the metabolism of amino acids and carbohydrates may be a potential mechanism for understanding the inter-individual variability of CRF in responses to ET and HIIT programs.

The effects of exercise training on hypertensive older adults: an umbrella meta-analysis.

Exercise training has been shown to blunt many of the physiological declines and common diseases of the aging process. One such beneficial effect is the reduction of blood pressure (BP) in hypertensive older adults. However, there is no consensus about which benefits of aerobic (AT) or resistance training (RT) may be lost by the use of combined training (CT) or even what benefits could be acquired only by performing CT, considering the extensive health needs of older adults with hypertension. Thus, we performed an umbrella meta-analysis. The benefits conferred by CT are extensive and encompass cardiorespiratory fitness, muscular fitness, and blood lipid profile improvements. CT may be recommended to improve the extensive health needs of hypertensive older adults that go beyond blood pressure reduction.

Effects of induced local ischemia during a 4-km cycling time trial on neuromuscular fatigue development.

The present study analyzed the effects of local ischemia during endurance exercise on neuromuscular fatigue (NMF). Nine cyclists performed, in a counterbalanced order, two separate 4-km cycling time trials (TT) with (ISCH) or without (CONTR) induced local ischemia. NMF was characterized by using isometric maximal voluntary contractions (IMVC), whereas central [voluntary activation (VA)] and peripheral fatigue [peak torque of potentiated twitch (TwPt)] of knee extensors were evaluated using electrically evoked contractions performed before (PRE) and 1 min after (POST) the TT. Electromyographic activity (EMG), power output (PO), oxygen uptake (V̇o2), and rating of perceived exertion (RPE) were also recorded. The decrease in IMVC (-15 ± 9% vs. -10 ± 8%, P = 0.66), VA (-4 ± 3% vs. -3 ± 3%, P = 0.46), and TwPt (-16 ± 7% vs. -19 ± 14%, P = 0.67) was similar in ISCH and CONTR. Endurance performance was drastically reduced in ISCH condition (512 ± 29 s) compared with CONTR (386 ± 17 s) (P < 0.001), which was accompanied by lower EMG, PO, and V̇o2 responses (all P < 0.05). RPE was greater in ISCH compared with CONTR (P < 0.05), but the rate of change was similar throughout the TT (8.19 ± 2.59 vs. 7.81 ± 2.01 RPE.% of total time-1, P > 0.05). These results indicate that similar end-exercise NMF levels were accompanied by impaired endurance performance in ISCH compared with CONTR. These novel findings suggest that the local reduced oxygen availability affected the afferent feedback signals to the central nervous system, ultimately increasing perceived effort and reducing muscle activity and exercise intensity to avoid surpassing a sensory tolerance limit before the finish line.

Acute/Chronic Responses of Combined Training on Serum Pro-thermogenic/Anti-inflammatory Inducers and Its Relation With Fed and Fasting State in Overweight Type 2 Diabetic Individuals.

Concentrations of pro-thermogenic/anti-inflammatory inductors are influenced by fed/fasting, sedentary/trained states, and metabolic pattern. However, there is a lack of information on the interactions of these conditions, especially in humans. Thus, the present study aimed to evaluate the chronic and acute training responses as well as the fed/fasted states of serum pro-thermogenic/anti-inflammatory inducers in overweight type 2 diabetics individuals. Fifteen individuals with type 2 diabetes [body mass index (BMI): 29.61 ± 3.60 kg/m2; age: 50.67 ± 3.97 years] participated in the study. In the pre- and post-experimental periods, baseline clinical parameters analyses were performed. Pro-thermogenic/anti-inflammatory inductors were evaluated pre/post-baseline and before, shortly after, and after 30' and 60' in the first and last sessions of a 16-week combined training (CT) period. These inducers were also compared for fasting and feeding before and after the training period. CT has improved baseline physical fitness, metabolic pattern, and it has also increased interleukin (IL)33 and FNDC5/irisin. In the first training session, there was a decrease in IL4, IL13, and IL33, besides an increase in FNDC5/irisin, and natriuretic peptides. In the last training session, there was an increase in natriuretic peptides and bone morphogenic protein 4 (BMP4). Differences in responses between the first and last training sessions were observed at certain post-session times for IL4, IL33, and natriuretic peptides, always with higher concentrations occurring in the last session. In evaluating the area under the curve (AUC) of the first and last training session, FNDC5/irisin, natriuretics peptides, and meteorin-like showed increased areas in the last training session. The pre-training fed state showed an increase in IL4 and IL33, while in fasting there was an increase in meteorin-like, natriuretic peptides, and FNDC5/irisin. In the post-training, IL4, IL13, and IL33 were increased in the fed state, while meteorin-like, natriuretic peptides, and FNDC5/irisin remained increased in the fast. Adaptation to physical training and a better metabolic pattern favor an improvement in the acute secretory pattern in part of pro-thermogenic and anti-inflammatory substances analyzed. The fed and fasting states also interfere differently in these substances, where fasting interferes with the increase of myokines, while the fed state induces an increase in interleukins. Clinical Trial Registration: [http://www.ensaiosclinicos.gov.br/rg/RBR-62n5qn/], identifier [U1111-1202-1476].

Do baseline blood pressure and type of exercise influence level of reduction induced by training in hypertensive older adults? A meta-analysis of controlled trials.

BACKGROUND: Exercise recommendations for hypertensive individuals encourage the use of aerobic training (AT) for lowering blood pressure (BP). However, it is not clear whether equivalent BP-lowering effects are obtained with different exercise training types in older adults, among whom hypertension is more prevalent. DESIGN: We meta-analyzed previous literature testing different types of training [AT, resistance (RT) and combined (CT)] effects on casual systolic BP (SBP) and diastolic BP (DBP), taking into account age and baseline BP influences. METHODS: Randomized controlled trials (RCTs), published up to August 2019 (PubMed), assessing exercise training effects on BP in hypertensive older adults (aged ≥50 years) were included (11, 8 and 3 RCTs tested the effects of AT, RT and CT, respectively). RESULTS AND CONCLUSIONS: First, both AT and RT reduced SBP (-12.31 [-16.39; -8.24] and - 6.76 [-8.36; -5.17] mm Hg, respectively) and DBP (-4.31 [-5.96; -2.65] and - 3.53 [-4.22; -2.85] mm Hg, respectively) in older adults, while there was not enough evidence for the effects of CT on SBP, due to high variance among the small number of CT studies. Second, training-induced BP reductions were more prominent in patients <65 years compared to those >65 years. However, this difference was mostly driven by differences between AT and CT versus RT intervention on age subgroups. Third, baseline BP values, rather than type of exercise and age, were the main determinant of BP response to exercise (predicted 74% and 53% of SBP and DBP reduction, respectively), indicating this is a major confounding factor to be considered in studies evaluating the impact of exercise training on BP.

The effect of an airflow restriction mask (ARM) on metabolic, ventilatory, and electromyographic responses to continuous cycling exercise.

This study analyzed the physiological adjustments caused by the use of the Elevation training mask® (2.0), an airflow restriction mask (ARM) during continuous exercise. Eighteen physically active participants (12 men and 6 women) were randomized to two protocols: continuous exercise with mask (CE-ARM) and continuous exercise without mask (CE). Exercise consisted of cycling for 20 minutes at 60% of maximum power. Metabolic variables, lactate, and gas concentration were obtained from arterialized blood samples at pre and post exercise. Continuous expired gases and myoelectric activity of the quadriceps were performed at rest and during the test. We observed no reduction in oxygen saturation in CE-ARM, leading to lower pH, higher carbon dioxide, and greater hematocrit (all p <0.05). The expired gas analysis shows that the CE-ARM condition presented higher oxygen uptake and expired carbon dioxide concentrations (p <0.05). The CE-ARM condition also presented lower ventilatory volume, ventilatory frequency, and expired oxygen pressure (p <0.05). No changes in electromyography activity and lactate concentrations were identified. We conclude that using ARM does not induce hypoxia and represents an additional challenge for the control of acid-base balance, and we suggest the use of ARM as being suitable for respiratory muscle training.

Association of skeletal muscle and serum metabolites with maximum power output gains in response to continuous endurance or high-intensity interval training programs: The TIMES study - A randomized controlled trial.

BACKGROUND: Recent studies have begun to identify the molecular determinants of inter-individual variability of cardiorespiratory fitness (CRF) in response to exercise training programs. However, we still have an incomplete picture of the molecular mechanisms underlying trainability in response to exercise training. OBJECTIVE: We investigated baseline serum and skeletal muscle metabolomics profile and its associations with maximal power output (MPO) gains in response to 8-week of continuous endurance training (ET) and high-intensity interval training (HIIT) programs matched for total units of exercise performed (the TIMES study). METHODS: Eighty healthy sedentary young adult males were randomized to one of three groups and 70 were defined as completers (> 90% of sessions): ET (n = 30), HIIT (n = 30) and control (CO, n = 10). For the CO, participants were asked to not exercise for 8 weeks. Serum and skeletal muscle samples were analyzed by 1H-NMR spectroscopy. The targeted screens yielded 43 serum and 70 muscle reproducible metabolites (intraclass > 0.75; coefficient of variation < 25%). Associations of baseline metabolites with MPO trainability were explored within each training program via three analytical strategies: (1) correlations with gains in MPO; (2) differences between high and low responders to ET and HIIT; and (3) metabolites contributions to the most significant pathways related to gains in MPO. The significance level was set at P < 0.01 or false discovery rate of 0.1. RESULTS: The exercise programs generated similar gains in MPO (ET = 21.4 ± 8.0%; HIIT = 24.3 ± 8.5%). MPO associated baseline metabolites supported by all three levels of evidence were: serum glycerol, muscle alanine, proline, threonine, creatinine, AMP and pyruvate for ET, and serum lysine, phenylalanine, creatine, and muscle glycolate for HIIT. The most common pathways suggested by the metabolite profiles were aminoacyl-tRNA biosynthesis, and carbohydrate and amino acid metabolism. CONCLUSION: We suggest that MPO gains in both programs are potentially associated with metabolites indicative of baseline amino acid and translation processes with additional evidence for carbohydrate metabolism in ET.

Effect of resistance training on inflammatory markers of older adults: A meta-analysis.

INTRODUCTION: Low-grade inflammation is associated with several deleterious health outcomes and may aggravate sarcopenia and dynapenia during aging. A strategy to alleviate these conditions is resistance training (RT). Thus, the aim was to critically examine the effects of regular RT on inflammatory markers of older adults from previous studies. METHODS: The search was conducted on MEDLINE, July 2017. Only randomized controlled trials (RCTs) testing RT effects on C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and/or interleukin-6 (IL-6) of adults over 50 years-of-age were selected by two independent reviewers. RESULTS: The main meta-analyses showed RT reduced CRP in older adults (standard mean difference [SMD] = -0.61, 95%CI = -0.83; -0.31, p < 0.001), tended to reduce IL-6 (SMD = -0.19, 95%CI = -0.42; 0.02, p = 0.07) and did not change TNF-α. Further exploratory sub-group analyses showed a potential association of muscle mass for both CRP and TNF-α changes. Reductions in CRP and TNF-α only occurred in RCTs performing a higher number of exercises (>8), higher weekly frequency (3 times/week) and longer durations than 12 weeks. CONCLUSIONS: Anti-inflammatory effects of RT were significant only for CRP with a tendency for a decrease in IL-6 as well. The exploratory analyses suggested the reduction in inflammatory markers could be dependent on increases in muscle mass and higher volume of RT protocols. These potential mediators of RT anti-inflammatory effects should be addressed in future meta-analyses to clarify the effects of RT on inflammatory markers of older adults with very specific conditions and larger numbers of studies.

Low-load resistance exercise improves cognitive function in older adults / Exercício resistido com baixa carga melhora a função cognitiva em idosos / Ejercicio resistido com baja carga mejora la función cognitiva en adultos mayores

ABSTRACT Introduction: Resistance exercise (RE) training is widely recommended for increasing muscle strength and mass in older adults. RE is also a potential stimulus to improve cognitive functions (CF), but the best protocol for this purpose is unknown. Objective: To compare the effects of different RE protocols on CF in the same group of individuals. Methods: Twenty-four older adults were randomized (cross over) to control (CON) and lower limb RE protocols with high load (HL - 80% of 1RM), low load (LL - 30% of 1RM) and LL with blood flow restriction (LL-BFR - 30% of 1RM and 50% BFR). For CF assessment, participants underwent the Stroop test before and after each RE protocol. Results: Reduction in response time for Stroop neutral stimuli was greater after LL (effect size (ES) = -0.92) compared to CON (ES = -0.18) and HL (ES = -0.03), but was not different from LL-BFR (ES = -0.24). The reduced response time was associated with reduced parasympathetic modulation and increased cardiac output across protocols. Conclusion: LL was the most effective RE protocol to improve CF of older adults and a potential beneficial effect of LL-BFR on CF (non-significant) was identified. Therefore, LL resistance exercise appears to stimulate acute cognitive improvements in healthy older adults, probably through exercise-induced optimal autonomic modulation changes. Level of Evidence I; Therapeutic studies-Investigating the results of treatment.

RESUMO Introdução: O treinamento com exercício resistido (ER) é amplamente recomendado para aumento de força e massa muscular em idosos. O ER também é um possível estímulo para melhorar funções cognitivas (FC), mas o melhor protocolo para esse fim não é conhecido. Objetivo: Comparar os efeitos de diferentes protocolos de ER sobre a FC de um mesmo grupo de indivíduos. Métodos: Vinte e quarto idosos foram randomizados (cross-over) em grupo controle (CON) e grupos protocolos de ER para membros inferiores com carga alta (CA - 80% 1RM), carga baixa (CB - 30% 1RM) e carga baixa com restrição de fluxo sanguíneo (CB-RFS - 30% 1RM e 50% RFS). Para a avaliação de FC, os participantes realizaram o teste de Stroop antes e depois de cada protocolo de ER. Resultados: A redução do tempo de resposta para o estímulo neutro de Stroop foi maior após o CB (tamanho de efeito [TE] = -0,92) comparado ao CON (TE = -0,18) e CA (TE = -0,03), mas não foi diferente de CB-RFS (TE = -0,24). A redução do tempo de resposta foi associada à redução da modulação parassimpática e ao aumento de débito cardíaco em todos os protocolos. Conclusões: CB foi o protocolo de ER mais eficiente para aumentar a FC em idosos e identificou-se um efeito benéfico em potencial do CB-RFS sobre a FC (não significante). Desta forma, o exercício resistido de CB parece estimular a melhora aguda da função cognitiva em idosos saudáveis, provavelmente devido à alteração ideal da modulação autonômica induzida pelo exercício. Nível de Evidência I; Estudos Terapêuticos - Investigação dos resultados do tratamento.

RESUMEN Introducción: El entrenamiento con ejercicio resistido (ER) es ampliamente recomendado para aumento de fuerza y masa muscular en ancianos. El ER también es un posible estímulo para mejorar las funciones cognitivas (FC), pero el mejor protocolo para este fin no es conocido. Objetivo: Comparar los efectos de diferentes protocolos de ER sobre la FC de un mismo grupo de individuos. Métodos: Veinte y cuatro ancianos fueron aleatorizados (cross-over) en grupo control (CON) y grupos protocolos de ER para extremidades inferiores con carga alta (CA - 80% 1RM), carga baja (CB - 30% 1RM) y carga baja con restricción de flujo sanguíneo (CB-RFS - 30% 1RM y 50% RFS). Para la evaluación de FC, los participantes realizaron el test de Stroop antes y después de cada protocolo de ER. Resultados: La reducción del tiempo de respuesta para el estímulo neutro de Stroop fue mayor después del CB (tamaño de efecto [TE] = -0,92) comparado al CON (TE = -0,18) y CA (TE = -0,03), pero no fue diferente de CB-RFS (TE = -0,24). La reducción del tiempo de respuesta fue asociada a la reducción de la modulación parasimpática y al aumento del gasto cardiaco en todos los protocolos. Conclusiones: CB fue el protocolo de ER más eficiente para aumentar la FC en ancianos y se identificó un efecto beneficioso potencial del CB-RFS sobre la FC (no significativo). De esta forma, el ejercicio resistido de CB parece estimular la mejora aguda de la función cognitiva en ancianos sanos, probablemente debido a la alteración ideal de la modulación autonómica inducida por el ejercicio. Nivel de Evidencia I; Estudios Terapéuticos - Investigación de los resultados del tratamiento.

Concurrent Training with Blood Flow Restriction does not Decrease Inflammatory Markers.

The aging process is associated with several changes in the elderly such as the decrease in cardiorespiratory fitness, strength and muscle mass, in addition to chronic low-grade inflammation. Concurrent training with blood flow restriction can be an interesting alternative to improve functional capacity with low mechanical stress in the elderly. The purpose of this study was to compare the inflammatory effects in older individuals submitted to two different protocols of concurrent training. Twenty-two healthy older adults (63.7±3.8 years; 69.8±8.9 kg; 1.6±0.1 m) performed 12 weeks of concurrent training (CT) or concurrent training with blood flow restriction (CTBFR) and the effects on inflammatory markers were analyzed. We found inflammatory behavior for the CTBFR group with a significant difference in serum concentration of C-reactive protein between pre- and post-moment (0.96±0.37 to 1.71±1.45, p=0.049), with no difference between groups, and a time effect in interleukin-6 (pre=0.86±0.43; post=1.02±0.46, p=0.016). We conclude that the CTBFR showed a pro-inflammatory profile after the period of intervention whereas the CT showed the opposite.