Role of physical activity and cardiorespiratory fitness in metabolically healthy obesity: a narrative review.

Obesity has been associated with a multitude of metabolic disorders, often clustering with risk factors of cardiovascular disease and type 2 diabetes mellitus, hypertension, dyslipidaemia. Overall, obesity is a worldwide, growing health concern. However, a subgroup of obese individuals with a low burden of metabolic abnormalities have been identified and described as metabolically healthy obese (MHO). Whether the MHO phenotype is protective against obesity-related metabolic disorders in the long-term is presently unclear, and current research examining the potential transition has yielded inconsistent results. In this current narrative review, we aim to provide insights on the role of physical activity (PA) and cardiorespiratory fitness (CRF) in MHO. Lifestyle factors such as PA and CRF may influence the MHO phenotype. Limited studies have characterised energy expenditure and CRF in MHO and metabolically unhealthy obese. However, higher levels of PA, less sedentary behaviour and higher CRF have been observed in MHO individuals. Considering the multiple benefits of PA, it is high time to advocate this lifestyle change beyond its influence on energy balance in a weight loss programme to improve cardiovascular and metabolic risk factors irrespective of body weight and fat mass changes. Improved CRF via increased PA, especially exercise participation, while avoiding weight gain is not only a realistic goal, but should be the primary intervention for MHO populations to prevent the transition to an abnormal metabolic state.

Frequency of Breakfast Eating and Obesity Prevalence in Primary School Teachers.

There is a lack of research using objective measures about teachers' physical characteristics and lifestyle. The purpose of the study was to evaluate the relationship between frequency of breakfast consumption and body size, body composition, blood pressure and lifestyle factors in teachers from Hungary. The study analyzed data collected from 99 female primary school teachers (50.6 ± 6.6 year) before the COVID-19 pandemic. Anthropometric and resting blood pressure measurements were taken for each participant. Questionnaires were used to assess lifestyle factors (i.e., physical activity level, smoking status and eating breakfast). The frequency of eating breakfast was classified as rarely or never (0-2 days), some days (3-5 days) and regularly (6-7 days). Sixty-five percent of female teachers consumed breakfast 6-7 days/week, and this regular eating habit was positively associated with a lower risk of obesity (OR 0.29; CI: 0.10-0.80). In our sample, a higher frequency of breakfast consumption was not significantly associated with smoking (OR 2.65; CI: 0.17-1.37), hypertension (OR 0.61; CI: 0.23-1.65) and inactivity (OR 2.80; CI: 0.26-1.84). A beneficial effect of eating breakfast regularly was found on body composition in female teachers. Further studies should focus on the health behaviors of teachers and their relationship with physical activity or diagnosed diseases in urban and rural areas.

Characteristics of the athlete's heart in aged hypertensive and normotensive subjects.

BACKGROUND: Both hypertension and age-related impairment of the cardiac condition are known to be improved by regular physical training. As relatively few studies have been reported about the older, hypertensive patients, the aim of this study was to establish cardiac benefits of active lifestyle in these subjects. METHODS: Two-dimensionally guided M-mode, Doppler- and tissue Doppler echocardiography was performed in 199 normo- and hypertensive, active and sedentary older (age >60 years) men (N.=111) and women (N.=88). Results were compared either by ANOVA, or by Kruskall-Wallis test. RESULTS: The Left Ventricular Muscle Index (LVMI), which is higher in young active than in sedentary persons, proved to be smaller in the active than sedentary older subjects: men normotensives: actives 83 vs. sedentary ones 98, hypertensives: actives 88 vs. sedentary ones 107, women normotensives: actives 77 vs. sedentary ones 89 g/m3. Diastolic function was better in the active groups demonstrated both by the ratio of the early to atrial peak blood flow velocities (men: normotensives: actives 1.03 vs. sedentary ones 0.76, women normotensives: actives 1.21 vs. sedentary ones 0.9, hypertensives: actives 1.04 vs. sedentary ones 0.88). The tissue Doppler results were also better in the active groups; the difference between the active and sedentary groups was more marked in the normotensive male groups than in the hypertensive ones. CONCLUSIONS: Active lifestyle prevents age-related pathological LV hypertrophy, and attenuates the LV diastolic dysfunction.

A meta-regression of the effects of resistance training frequency on muscular strength and hypertrophy in adults over 60 years of age.

Resistance training is a commonly used strategy for improving both athletic performance and general health. While the contribution of resistance training intensity and volume to muscle strength and hypertrophy have been extensively investigated, training frequency only recently received sufficient attention, especially in older adults. A meta-regression was conducted to compare muscle strength and hypertrophic adaptations to resistance training programmes performed with different training frequencies in adults over 60 years of age. The systematic literature search identified 14 articles for meta-regression. For each outcome, an effect size (ES) was calculated as the pre-test-post-test change, divided by the pooled pre-test standard deviation (SD). Random-effects meta-regressions for multilevel data structures, using study as the clustering variable, were performed using package metafor in R. Maximal strength shows a significant effect of frequency (p = 0.001), with an increase in effect size of 0.14 for every day increase in frequency (CI: 0.08, 0.21). For muscle hypertrophy, no significant effect of frequency was found (p = 0.67). Considering that muscle hypertrophy was not affected, while maximum strength was only slightly improved with additional training days, it seems unlikely that more than two weekly resistance training sessions would provide any further benefits for older adults.

Physical fitness and physical self-concept of male and female young adults in Qatar.

BACKGROUND: Physical inactivity is high within the Qatari population, particularly within females, and school-based environments, contributing to increased morbidity and mortality. School-based physical activity (PA) outcomes may be mediated by physical self-concept. Low physical self-concept may negatively impact PA engagement, compromising childhood and adolescent physical fitness, which may translate into adulthood. Normative physical fitness data for the Qatari population is unavailable. Stratifying normative physical fitness appears prudent, to not only allow comparisons to be made worldwide, but enable informed decisions for public health policy and future interventions in the Qatari population. PURPOSE: To establish the physical fitness of young adults in Qatar, and examine differences between males and females for physical self-concept, and engagement in school-based and extra-curricular PA. METHOD: 186 (females n = 85) healthy participants [median (minimum-maximum) age: males = 21 (18-26), females = 21 (18-24) y; height: males = 1.74 (1.57-1.99), females = 1.61 (1.46-1.76) m; body mass: males = 71.9 (49.3-145.0), females = 56.8 (35.7-96.4) kg] completed the ALPHA-FIT test battery for adults (one leg stand, figure of eight run, handgrip strength, jump and reach, modified push-up, dynamic sit-up and 2 km walk), physical self-description questionnaire (measuring physical self-concept), and were asked to answer 'yes' or 'no' to whether they participated in school-based and extra-curricular PA. RESULTS: Data is reported as effect size; ±90% confidence limit. Males compared to females most likely performed better for dynamic sit-up (2.2; ±0.76), very likely better for the figure of eight run (0.86; ±0.42) and likely better for handgrip strength (2.1; ±0.75). Males likely had higher physical self-concept for coordination (0.78; ±0.37) and endurance (0.66; ±0.27) compared to females. There were no differences for school-based PA (p ≥ 0.78) or for extra-curricular PA for males (p ≥ 0.26) or females (p ≥ 0.21). CONCLUSION: The data suggests that the young Qatari adult population has variable, yet generally low, physical fitness traits compared to individuals worldwide, likely due to their low PA. The precise aetiology for this is not well documented, yet such data may be prudent to evidence-inform strategies to improve physical fitness through increased PA (synergistic relationship), given the strong association between physical activity/fitness and morbidity/mortality.

The physiological effects of concurrent strength and endurance training sequence: A systematic review and meta-analysis.

We conducted a systematic literature review and meta-analysis to assess the chronic effects of the sequence of concurrent strength and endurance training on selected important physiological and performance parameters, namely lower body 1 repetition maximum (1RM) and maximal aerobic capacity (VO2max/peak). Based on predetermined eligibility criteria, chronic effect trials, comparing strength-endurance (SE) with endurance-strength (ES) training sequence in the same session were included. Data on effect sizes, sample size and SD as well other related study characteristics were extracted. The effect sizes were pooled using, Fixed or Random effect models as per level of heterogeneity between studies and a further sensitivity analyses was carried out using Inverse Variance Heterogeneity (IVHet) models to adjust for potential bias due to heterogeneity. Lower body 1RM was significantly higher when strength training preceded endurance with a pooled mean change of 3.96 kg (95%CI: 0.81 to 7.10 kg). However, the training sequence had no impact on aerobic capacity with a pooled mean difference of 0.39 ml.kg.min-1 (95%CI: -1.03 to 1.81 ml.kg.min-1). Sequencing strength training prior to endurance in concurrent training appears to be beneficial for lower body strength adaptations, while the improvement of aerobic capacity is not affected by training order.

Relationship between the heart rate and E/A ratio in athletic and non-athletic males.

UNLABELLED: To clarify whether the higher E/A quotient of male athletes is a favourable change in the intrinsic relaxation properties of the left ventricle. METHODS: Peak early (E) and atrial blood flow velocities (A) were assessed by Doppler echocardiography at rest in 1237 males (939 athletes) in Hungary. Data were collected between 1993 ­ 2009. Relationship between E/A and resting heart rate (HR), was determined by linear regression analysis. RESULTS: The E/A decreased with age, the rate of decrease was slower in the physically trained subjects, except in children. In children, adolescent-young and young adult subjects E/A against HR equations of the athletic and nonathletic groups were similar, differences between the means were only due to the differences of the HR. In the 31 ­ 44 yr old males, the intercepts of the athletes' regression lines were higher. The oldest (>44 yr) active subjects showed a significant regression while sedentary males did not. CONCLUSIONS: The HR-independent beneficial effect of regular physical training on the diastolic function manifests itself at the older ages. The impact of resting HR should always be taken into consideration when assessing intergroup differences in the E/A ratio, especially when studying the effect of exercise training upon cardiac function.

Resting blood pressure values of adult athletes.

BACKGROUND: Regular physical activity has a favorable effect upon the prevention and treatment of hypertension. Various movements in sports, however, affect blood pressure (BP) differently. METHODS: In the present study, the resting BP data of a large number (3,697) of young men and women (age: 19-40 years) who participated in sports medical examinations were compared according to their sport. Athletes were arranged into definite subgroups based on their different sport activities, i.e. if their movement pattern characteristics were similar and no significant intergroup differences were seen in BP values. RESULTS: BP values were lower in the dynamic type athletes (speed, endurance sports and ball games) than in the static type. Out of the endurance athletes, BP values were not lower in cycle racers, kayakers/canoeists and rowers. In water athletes, BP values were higher than in corresponding dry-land athletes. There was a quite large significant difference between the BP values of athletes involved in static muscular activity (power athletes) and dynamic-type strength athletes (combat competitors). CONCLUSIONS: Although cycling, kayaking/canoeing and competitive water sports increase BP, as leisure time activities they more than likely do not elevate BP.

[Morphological and functional characteristics of the left ventricle in athletes of various ages, and performing at various levels]. / A bal kamra morfológiai és funkcionális edzettségi jelei különbözo korú és színvonalú sportolóknál.

UNLABELLED: One of the most important effects of regular physical training is the adaptation of the cardiovascular system. The basic importance of an "athlete's heart" is manifested in two fields, one is public health, the other competitive sport. AIM: 1. Can the higher E/A quotient of physically active persons be explained by the training bradycardia, or can it be supposed as an independent effect of regular physical exercise? 2. Which training-induced heart characteristics seem to be different in players of various ball-games? 3. How are cardiac data related to the relative aerobic power as most indicative index of endurance performance? METHODS: Two-dimensionally guided M-mode and Doppler echocardiographic data of different athletic and non-athletic subjects were compared with each other, differences between data of different athletic groups were also analysed. RESULTS: 1. E/A quotient characterises left ventricular (LV) diastolic function, but it highly depends on the heart rate. The higher E/A found in young athletes does not seem to be an independent effect of the regular physical training. 2. Investigating the data of different ball-game-players, characteristic differences were seen. In the myocardial hypertrophy and in the resting heart rate water polo players were the best, volleyball players the worst, but the values of the latter were also better than those of non-athletes. 3. In the pooled group of non-athletes and of competitors of several kinds of sports (endurance athletes, ball-game-players, power-and-sprint-events athletes) all measured parameters correlated significantly with the relative maximal oxygen consumption. CONCLUSIONS: 1. The higher E/A in elderly subjects suggests that regular physical training can diminish the age-associated impairment of diastolic function. 2. For the high intensity training and for the long competition period a special endurance training program would be useful for volleyball players. 3. The higher was the proportion of endurance activity in the training and competitive program, the stronger were the correlations with the relative aerobic capacity.

Relationship between relative aerobic power and echocardiographic characteristics in male athletes.

The relationship between relative aerobic power (rel.VO(2)max) as a generally accepted indicator of endurance capacity and certain characteristics of the athlete's heart, such as body-size related (relative) left ventricular (LV) diastolic wall thickness (WTd), internal diameter (LVIDd), muscle mass (MM), WTd/IDd, heart rate (HR), fractional shortening (FS) and E/A ratio, were investigated in 346 young males (18-35 years, 291 athletes of various events and 55 nonathletic control subjects). Rel.VO(2)max was measured by spiroergometry; cardiac characteristics were determined by two-dimensionally guided M-mode and Doppler-echocardiography. When the groups were pooled, correlation of rel.VO(2)max with the cardiac parameters was significant: LVMM.BSA(-1.5)= 0.413, LVWTd.BSA(-0.5)= 0.327, LVIDd.BSA(-0.5)= 0.292, HR =-0.434, E/A = 0.272 (P < 0.001), but no significant relationship was seen with FS and WTd/IDd. In the endurance trained group, rel. VO(2)max correlated significantly with LVMM.BSA(-1.5), LVWT.BSA(-0.5), HR, and E/A, in the ballgame players with LVMM.BSA(-1.5), LVWT.BSA(-0.5), and E/A, in the power-and-sprint event athletes with HR and E/A. In the control group, no significant relationship was observed. Results indicate that in athletes having higher endurance capacity maximal oxygen consumption depends largely on cardiac condition, while in athletes with a lower endurance capacity it can be limited by peripheral conditions.

Echocardiographic data in hungarian top-level water polo players.

PURPOSE: Water polo is a sport involving extremely intense exercise training that might be expected to result in major cardiac adaptations. The purpose of our study was to evaluate cardiac size, determine VO(2max) of top-level water polo players, and compare the findings with those of other top-level athletes. METHODS: Treadmill VO(2max) and 2D guided M-mode and Doppler echocardiographic data were obtained on players (N = 15) of the Olympic champion (Sydney 2000) Hungarian team and compared with data of Hungarian sedentary subjects (N = 19), and top-level endurance (N = 16) and power athletes (N = 15). RESULTS: Aerobic power of the water polo players was significantly lower (57.8 +/- 12.3 mL.min(-1).kg(-1)) than that of endurance athletes (70.9 +/- 8.9), higher than sedentary controls (49.7 +/- 4.3), and not different from that of power athletes (50.5 +/- 6.0). Body size related mean left ventricular wall thickness (LVWT/BSA(0.5)) was the highest in the water polo players (16.8 +/- 1.5 vs 15.9 +/- 1.1 in endurance, 14.5 +/- 1.0 in the power athletes, and 12.8 +/- 0.6 mm.m in nonathletes). Left ventricular muscle mass (LVMM/BSA(1.5)) was higher in the water polo players (115 +/- 22 g.m) than in power athletes (86 +/- 12) or nonathletes (74 +/- 9) and similar to that of endurance athletes (112 +/- 15). Resting heart rate was lower in the water polo players (55.1 +/- 9.7 beats.m(-1)) and endurance athletes (59.3 +/- 10.6) than in power athletes (66.0 +/- 16.1) or in sedentary subjects (72.9 +/- 10.9). CONCLUSIONS: Results indicate that high-level water polo results in marked cardiac hypertrophy that involves predominantly an increase of wall thickness, and in a VO(2max) lower than that of endurance athletes but similar to those of basketball and soccer players.