Thermoregulation During Pregnancy: a Controlled Trial Investigating the Risk of Maternal Hyperthermia During Exercise in the Heat.

OBJECTIVES: Despite the well-established benefits of exercise, pregnant women are discouraged from physical activity in hot/humid conditions to avoid hyperthermia (core temperature (Tcore) ≥ 39.0 °C). Recent epidemiological evidence also demonstrates greater risk of negative birth outcomes following heat exposure during pregnancy, possibly due to thermoregulatory impairments. We aimed to determine (1) the risk of pregnant women exceeding a Tcore of 39.0 °C during moderate-intensity exercise in the heat; and (2) if any thermoregulatory impairments are evident in pregnant (P) versus non-pregnant (NP) women. METHODS: Thirty participants (15 pregnant in their second trimester or third trimester) completed two separate exercise-heat exposures in a climate chamber (32 °C, 45%RH). On separate occasions, each participant cycled on a semi-recumbent cycle ergometer for 45 min at a workload representative of a moderate-intensity (1) non-weight-bearing (NON-WB), or (2) weight-bearing (WB) activity. Thermoregulatory responses were monitored throughout. RESULTS: The highest rectal temperature observed in a pregnant individual was 37.93 °C. Mean end-exercise rectal temperature did not differ between groups (P:37.53 ± 0.22 °C, NP:37.52 ± 0.34 °C, P = 0.954) in the WB trial, but was lower in the P group (P:37.48 ± 0.25 °C, vs NP:37.73 ± 0.38 °C, P = 0.041) in the NON-WB trial. Whole-body sweat loss was unaltered by pregnancy during WB (P:266 ± 62 g, NP:264 ± 77 g; P = 0.953) and NON-WB P:265 ± 51 g, NP:300 ± 75 g; P = 0.145) exercise. Pregnant participants reported higher ratings of thermal sensation (felt hotter) than their non-pregnant counterparts in the WB trial (P = 0.002) but not in the NON-WB trial, (P = 0.079). CONCLUSION: Pregnant women can perform 45 min of moderate-intensity exercise at 32 °C, 45%RH with very low apparent risk of excessive maternal hyperthermia. No thermoregulatory impairments with pregnancy were observed.

Role of Neuronal Guidance Cues in the Pathophysiology of Obesity: A Peripheral and Central Overview.

Obesity is associated with an exacerbated synthesis and secretion of several molecules, which culminates in chronic low-grade inflammation and insulin resistance. Such conditions affect molecular and physiological responses of several organs and, if not resolved, predispose the obese patients to other diseases such as Type 2 diabetes, atherosclerosis, cancer, neural injuries, and cognitive impairments. A microenvironment with an excess of pro-inflammatory cytokines released by different cells, including immune and adipose cells lead to metabolic and non-metabolic diseases during obesity. In this context, the role of neuronal guidance cues named netrin, semaphorin and ephrin is novel. Specifically, the available literature indicates that besides their classic role as molecules that guide the axon to its target site, the neuronal guidance cues exhibit immunomodulatory functions from adipose tissue to the neural environment. In the current narrative review, we discuss the participation of the neuronal guidance cues on the physiology and pathophysiology of obesity. We also discuss the feedback loop of obesity on the netrin, semaphorin and ephrin functions that impair the structure and function of the brain. The integrative view of the neuronal guidance cues can be relevant in designing new treatments focus on attenuating metabolic and immune disorders in obese patients and reduce the risk of acquiring diseases such as Type 2 diabetes, atherosclerosis, cancer, and neural injuries.

Pathophysiological Features of Obesity and its Impact on Cognition: Exercise Training as a Non-Pharmacological Approach.

BACKGROUND: The number of individuals with obesity is growing worldwide and this is a worrying trend, as obesity has shown to cause pathophysiological changes, which result in the emergence of comorbidities such as cardiovascular disease, diabetes mellitus type 2 and cancer. In addition, cognitive performance may be compromised by immunometabolic deregulation of obesity. Although in more critical cases, the use of medications is recommended, a physically active lifestyle is one of the main foundations for health maintenance, making physical training an important tool to reduce the harmful effects of excessive fat accumulation. AIM: The purpose of this review of the literature is to present the impact of immunometabolic alterations on cognitive function in individuals with obesity, and the role of exercise training as a non-pharmacological approach to improve the inflammatory profile, energy metabolism and neuroplasticity in obesity. METHOD: An overview of the etiology and pathophysiology of obesity to establish a possible link with cognitive performance in obese individuals, with the executive function being one of the most affected cognitive components. In addition, the brain-derived neurotrophic factor (BDNF) profile and its impact on cognition in obese individuals are discussed. Lastly, studies showing regular resistance and/or aerobic training, which may be able to improve the pathophysiological condition and cognitive performance through the improvement of the inflammatory profile, decreased insulin resistance and higher BDNF production are discussed. CONCLUSION: Exercise training is essential for reestablishment and maintenance of health by increasing energy expenditure, insulin resistance reduction, anti-inflammatory proteins and neurotrophin production corroborating to upregulation of body function.

Relationship between Health Costs and Inflammatory Profile in Public Health.

INTRODUCTION: The association between obesity and physical activity level is well established in the literature, as well as its consequences that lead to chronic noncommunicable diseases. In addition, it is also possible to obtain the immunometabolic mechanism that explains the pathway of associations between obesity, chronic noncommunicable diseases and the level of physical activity. It also seems clear that treating illnesses has a financial impact on healthcare systems around the world, so it seems important to assess the financial impact on the healthcare system of individuals with immunometabolic dysfunction. AIM: This study aimed to assess whether there is a correlation between metabolic and inflammatory markers and healthcare costs according to body adiposity and habitual physical activity (HPA). METHODS: This is a cross-sectional study, where the sample includes men and women aged over 50. Participants underwent evaluations that included the following variables: i) immunometabolic markers, ii) healthcare costs, iii) obesity, iv) habitual physical activity, and v) history of personal illness. Statistical significance was set at values lower than 5% and the software used was BioEstat. RESULTS: The correlation between metabolic and inflammatory markers and healthcare costs demonstrated a positive and significant relationship, adjusted for obesity and HPA, between glucose concentrations and exam costs (r = 0.343, p-value = 0.007) and total cost (r = 261; p-value = 0.043); HOMA index and cost of exams (r = 0.267; pvalue = 0.038); and IL-10 and cost of medical consultation (r = 0.297; p-value = 0.020). CONCLUSION: Metabolic and inflammatory markers may be related to the costs of consultations and examinations, independent of obesity and HPA.

Reduced leptin level is independent of fat mass changes and hunger scores from high-intensity intermittent plus strength training.

BACKGROUND: This study aimed to analyze the effects of high-intensity intermittent training (HIIT) plus strength training on body composition, hormone related to energy balance (leptin), and hunger scores in physically active non-obese men. METHODS: Sixteen men were allocated in two different groups, training group (N.=10) performed a combined HIIT (5 km, 1 minute of effort interspersed by 1 minute of rest in passive recovery) followed by strength exercise session (three sets, with load of 8-12 repetition maximum) twice a week, during 8 weeks, while control group (N.=6) did not suffer any intervention. Hunger scores, leptin concentrations and body composition were assessed. Body composition, fasting leptin and hunger score were compared through two-way analysis (group and period) with repeated measures in the second factor while leptin and hunger scores in exercise session pre- and post-8 weeks through two-way analysis (period and time of measurement) with repeated measures in the second factor. RESULTS: The fasting leptin decreased pre- to post-8week in training group (7.7±4.9 to 2.9±2.1 ng/mL; P=0.012). For leptin response to exercise session there was main effect of training period, with higher values pre- (6.5±3.9 ng/mL) than post-training (2.6±2.1 ng/mL; P<0.001). For hunger scores there was effect of time of measurement (P<0.001), decreasing after breakfast and increasing over the experiment. CONCLUSIONS: Combined HIIT plus strength training were able to promote alterations in a hormone related to energy balance independent of body composition and hunger index alterations in physically active non-obese men.

Short-Term High- and Moderate-Intensity Training Modifies Inflammatory and Metabolic Factors in Response to Acute Exercise.

Purpose: To compare the acute and chronic effects of high intensity intermittent training (HIIT) and steady state training (SST) on the metabolic profile and inflammatory response in physically active men. Methods: Thirty recreationally active men were randomly allocated to a control group (n = 10), HIIT group (n = 10), or SST group (n = 10). For 5 weeks, three times per week, subjects performed HIIT (5 km 1-min at 100% of maximal aerobic speed interspersed by 1-min passive recovery) or SST (5 km at 70% of maximal aerobic speed) while the control group did not perform training. Blood samples were collected at fasting (~12 h), pre-exercise, immediately post, and 60 min post-acute exercise session (pre- and post-5 weeks training). Blood samples were analyzed for glucose, non-ester fatty acid (NEFA), and cytokine (IL-6, IL-10, and TNF-α) levels through a three-way analysis (group, period, and moment of measurement) with repeated measures in the second and third factors. Results: The results showed an effect of moment of measurement (acute session) with greater values to TNF-α and glucose immediately post the exercise when compared to pre exercise session, independently of group or training period. For IL-6 there was an interaction effect for group and moment of measurement (acute session) the increase occurred immediately post-exercise session and post-60 min in the HIIT group while in the SST the increase was observed only 60 min post, independently of training period. For IL-10, there was an interaction for training period (pre- and post-training) and moment of measurement (acute session), in which in pre-training, pre-exercise values were lower than immediately and 60 min post-exercise, in post-training period pre-exercise values were lower than immediately post-exercise and immediately post-exercise lower than 60 min post, it was also observed that values immediately post-exercise were lower pre- than post-training, being all results independently of intensity (group). Conclusion: Our main result point to an interaction (acute and chronic) for IL-10 showing attenuation post-training period independent of exercise intensity.

Physiological Acute Response to High-Intensity Intermittent and Moderate-Intensity Continuous 5 km Running Performance: Implications for Training Prescription.

The aim of this study was to investigate the physiological responses to moderate-intensity continuous and high-intensity intermittent exercise. Twelve physically active male subjects were recruited and completed a 5-km run on a treadmill in two experimental sessions in randomized order: continuously (70% sVO2max) and intermittently (1:1 min at sVO2max). Oxygen uptake, excess post-exercise oxygen consumption, lactate concentration, heart rate and rating of perceived exertion data were recorded during and after each session. The lactate levels exhibited higher values immediately post-exercise than at rest (High-Intensity: 1.43 ± 0.25 to 7.36 ± 2.78; Moderate-Intensity: 1.64 ± 1.01 to 4.05 ± 1.52 mmol⋅L-1, p = 0.0004), but High-Intensity promoted higher values (p = 0.001) than Moderate-Intensity. There was a difference across time on oxygen uptake at all moments tested in both groups (High-Intensity: 100.19 ± 8.15L; Moderate-Intensity: 88.35 ± 11.46, p < 0.001). Both exercise conditions promoted increases in excess postexercise oxygen consumption (High-Intensity: 6.61 ± 1.85 L; Moderate-Intensity: 5.32 ± 2.39 L, p < 0.005), but higher values were observed in the High-Intensity exercise protocol. High-Intensity was more effective at modifying the heart rate and rating of perceived exertion (High-Intensity: 183 ± 12.54 and 19; Moderate-Intensity: 172 ± 8.5 and 16, respectively, p < 0.05). In conclusion, over the same distance, Moderate-Intensity and High-Intensity exercise exhibited different lactate concentrations, heart rate and rating of perceived exertion. As expected, the metabolic contribution also differed, and High-Intensity induced higher energy expenditure, however, the total duration of the session may have to be taken into account. Moreover, when following moderate-intensity training, the percentage of sVO2max and the anaerobic threshold might influence exercise and training responses.

Inflammatory Cytokines and BDNF Response to High-Intensity Intermittent Exercise: Effect the Exercise Volume.

The purpose of this study was to compare the effects of two similar high-intensity intermittent exercises (HIIE) but different volume 1.25 km (HIIE1.25) and 2.5 km (HIIE2.5) on inflammatory and BDNF responses. Ten physically active male subjects (age 25.22 ± 1.74 years, body mass 78.98 ± 7.31 kg, height 1.78 ± 0.06 m, VO2peak 59.94 ± 9.38 ml·kg·min-1) performed an incremental treadmill exercise test and randomly completed two sessions of HIIE on a treadmill (1:1 min at vVO2max with passive recovery). Blood samples were collected at rest, immediately and 60-min after the exercise sessions. Serum was analyzed for glucose, lactate, IL-6, IL-10, and BDNF levels. Blood lactate concentrations was higher immediately post-exercise compared to rest (HIIE1.25: 1.69 ± 0.26-7.78 ± 2.09 mmol·L-1, and HIIE2.5: 1.89 ± 0.26-7.38 ± 2.57 mmol·L-1, p < 0.0001). Glucose concentrations did not present changes under the different conditions, however, levels were higher 60-min post-exercise than at rest only in the HIIE1.25 condition (rest: 76.80 ± 11.14-97.84 ± 24.87 mg·dL-1, p < 0.05). BDNF level increased immediately after exercise in both protocols (HIIE1.25: 9.71 ± 306-17.86 ± 8.59 ng.mL-1, and HIIE2.5: 11.83 ± 5.82-22.84 ± 10.30 ng.mL-1). Although both exercises increased IL-6, level percent between rest and immediately after exercise was higher in the HIIE2.5 than HIIE1.25 (30 and 10%; p = 0.014, respectively). Moreover, IL-10 levels percent increase between immediately and 60-min post-exercise was higher in HIIE2.5 than HIIE1.25 (37 and 10%; p = 0.012, respectively). In conclusion, both HIIE protocols with the same intensity were effective to increase BDNF and IL-6 levels immediately after exercise while only IL-10 response was related to the durantion of exercise indicanting the importance of this exercise prescription variable.

Influence to high-intensity intermittent and moderate-intensity continuous exercise on indices of cardio-inflammatory health in men.

The aim of this study was to evaluate the influence to acute exercises performed in different intensities with volume equalized (5 km) on indices of cardio-inflammatory health. Twelve physically active male subjects (age, 23.22±5.47 years; height, 174.75±5.80 m; weight, 75.13±6.61 kg; maximal oxygen uptake, 52.92 mL/kg/min), after determination of peak oxygen uptake (VO2Peak) and the speed associated with VO2Peak (sVO2Peak), completed two randomly experimental trials: high-intensity intermittent exercise (HIIE: 1:1 at 100% sVO2Peak) and moderate-intensity continuous exercise (MICE: 70% sVO2Peak). Brain-derived neurotrophic factor (BDNF), adiponectin and plasminogen inhibitor-1 (PAI-1) data were analyzed pre, immediately, and 60 min after the exercise session. Statistical analysis comparisons between moments and between HIIE and MICE were performed using a mixed model and statistical and significance was set at <5%. PAI-1 presented an effect for time from pre to immediately after exercise moment (P<0.018) and from immediately to 60 min after exercise moment (P<0.001) only in MICE. BDNF presented an effect for time from pre to immediately after exercise to HIIE (P<0.022) and from immediately to 60 min after exercise to MICE (P<0.034). HIIE promotes BDNF increase and that there is negative correlation between PAI-1 concentrations and BDNF in both protocols in healthy sportsmen, favoring an anti-atherogenic profile.

Corrigendum: Inflammatory Cytokines and BDNF Response to High-Intensity Intermittent Exercise: Effect the Exercise Volume.

[This corrects the article on p. 509 in vol. 7, PMID: 27867360.].

Immunometabolic Responses to Concurrent Training: The Effects of Exercise Order in Recreational Weightlifters.

Inoue, DS, Panissa, VLG, Monteiro, PA, Gerosa-Neto, J, Rossi, FE, Antunes, BMM, Franchini, E, Cholewa, JM, Gobbo, LA, and Lira, FS. Immunometabolic responses to concurrent training: the effects of exercise order in recreational weightlifters. J Strength Cond Res 30(7): 1960-1967, 2016-The relationship between immunometabolic response and performance is not well understood. This study evaluated the influence of concurrent strength and high-intensity aerobic sequence of exercise order between sessions on strength performance, metabolic, and inflammatory response. Eleven recreational weightlifters underwent the following 2 randomized sessions: (a) strength-aerobic exercise order (SA) and (b) aerobic-strength exercise order (AS). Blood samples were collected before (Pre) and immediately after the first exercise (Post-1) and the second exercise (Post-2) of each session. The SA condition presented a higher number of repetitions (SA: 54 ± 15 vs. AS: 43 ± 12) and total volume (SA: 7,265 ± 2,323 vs. AS: 5,794 ± 1846 kg) than the AS condition (both p = 0.001). Glucose was higher in Pre when compared with post-1 in both orders (p ≤ 0.05); changes in lactate were time-dependent in the different orders (p ≤ 0.05); however, AS post-2 lactate was lower when compared with SA post-2 (p ≤ 0.05). Interleukin-6 levels showed time-dependent changes for both exercise orders (p ≤ 0.05). Tumor necrosis factor alpha (TNF-α) level was increased only in AS post-1 (AS: pre = 21.91 ± 35.47, post-1 = 26.99 ± 47.69 pg·ml vs. SA: pre = 25.74 ± 43.64, post-1 = 29.74 ± 46.05 pg·ml, p ≤ 0.05). These results suggest that concurrent training order exhibits different immunometabolic responses and, at least in part, can be associated with the acute decline in strength performance induced by concurrent exercise. Our results point to a possible role of TNF-α (post-1 AS condition) as a trigger to restore the energy demand by providing substrates to help maintain contractile activity in skeletal muscle.