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Purpose: To investigate the effects of an 8-wk AHIIT-DWR intervention compared with land-based HIT training (LHIIT) on cardiometabolic health, cognitive, and psychological outcomes in inactive elderly women., Methods: Seventy inactive elderly women aged 60 yr or above were randomly assigned into two groups: AHIIT-DWR and LHIIT. The AHIIT-DWR group engaged in DWR sessions comprising 30 min of interval training, consisting of ten 2-min exercise bouts at 80%-90% of their maximal heart rate (HR max ), with 1-min active recovery at 70% HR max between bouts, for two sessions per week, for 8 wk. The LHIIT group performed treadmill running at the same intensity., Results: Both groups showed similar cardiovascular fitness, maximal aerobic capacity (V̇O 2max ), HR max , and RER improvement ( P > 0.05), whereas AHIIT-DWR showed a significant improvement in aerobic capacity minute ventilation (V̇E), metabolic equivalents (METs), and O 2 pulse ( P < 0.05) over the 8-wk intervention. Both AHIIT-DWR and LHIIT significantly decreased triglycerides, total cholesterol, HDL, and LDL postintervention ( P < 0.05). No significant group differences were observed for cognitive function assessed by MMSE and MOCA ( P > 0.05). Both groups showed similar enjoyment levels, self-efficacy scores, and high adherence rates (>90%)., Conclusions: Our study suggests that AHIIT-DWR can elicit a similar improvement in cardiorespiratory health, metabolic blood markers, cognitive function assessed by MMSE and MOCA, and psychological responses as LHIIT in inactive elderly women., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Sports Medicine.)

Objective: Previously, we have found increased carotid-to-femoral pulse wave velocity (cfPWV) among shift workers compared to day workers in industry, and a decline in maximal oxygen uptake (V̇O 2max ) in all 86 workers., Methods: Utilizing all available measurements in 2018, 2021, and 2022, this study investigated associations between V̇O 2max and measures of arterial stiffness. Using a mixed model approach, we analyzed the cross-sectional association between all V̇O 2max (outcome) and measures of arterial stiffness (covariates)., Results: We observed a significant association between V̇O 2max and cfPWV of -1.59 (95% confidence interval [CI], -3.03 to -0.16), and between augmentation pressure (AP) and augmentation index (Aix) of -0.32 (95% CI, -0.58 to -0.06) and -0.12 (95% CI, -0.23 to -0.005), respectively., Conclusions: We found a significant negative association between cardiorespiratory fitness and measures of arterial stiffness. The former and present results pose challenges for shift workers' future macrovascular and microvascular health., Competing Interests: Skogstad, Skare, Mamen, Zardin, and Sirnes have no relationships/conditions/circumstances that present potential conflict of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.)

Purpose: Platelets are key mediators in cardiovascular disease (CVD). Low cardiorespiratory fitness (CRF) is a risk factor for CVD. The purpose of our study was to assess if CRF associates with platelet function., Methods: Platelet assays and cardiopulmonary exercise testing were conducted in the Framingham Heart Study ( N = 3014). Linear mixed effects models estimated associations between CRF (assessed by peak oxygen uptake [V̇O 2 ]) and multiple platelet reactivity assays. Models were adjusted for multiple medications, risk factors, relatedness, and prevalent CVD., Results: Nineteen associations passed the significance threshold in the fully adjusted models, all indicating higher CRF associated with decreased platelet reactivity. Significant traits spanned multiple platelet agonists. Strongest associations were observed in multiplate whole blood testing after TRAP-6 (e.g., velocity, beta = -0.563, 95% CI = -0.735 to -0.391, P = 1.38E-10), ADP (e.g., velocity, beta = -0.514, 95% CI = -0.681 to -0348, P = 1.41E-09), collagen (e.g., velocity, beta = -0.387, 95% CI = -0.549 to -0.224, P = 3.01E-06), ristocetin (e.g., AUC, beta = -0.365, 95% CI = -0.522 to -0.208, P = 5.17E-06) and arachidonic acid stimulation of platelets (e.g., velocity, beta = -0.298, 95% CI = -0.435 to -0.162, P = 3.39E-04), and light transmission aggregometry (LTA) after ristocetin stimulation (e.g., max aggregation, beta = -0.362, 95% CI = -0.540 to -0.184, P = 6.64E-05). One trait passed significance threshold in the aspirin subsample (LTA ristocetin primary slope, beta = -0.733, 95% CI = -1.134 to -0.333, P = 3.30E-04) and another in a model including von Willebrand Factor levels as a covariate (U46619, a thromboxane receptor mimetic, AUC in the Optimul assay, beta = -0.36, 95% CI = -0.551 to -0.168, P = 2.35E-04). No strong interactions were observed between the associations and sex, age, or body mass index in formal interaction analyses., Conclusions: Our findings build on past work that shows CRF to be associated with reduced CVD by suggesting decreased platelet reactivity may play a mechanistic role. We found significant associations with multiple platelet agonists, indicating higher CRF may globally inhibit platelets; however, given multiple strong associations after TRAP-6 and ADP stimulation, PAR-1 and purinergic signaling may be most heavily involved. This is notable because each of these receptor pathways are tied to anticoagulant (DOAC/thrombin inhibitors) and antiplatelet therapies (P2Y12/PAR1/PAR4 inhibitors) for CVD prevention., (Copyright © 2024 by the American College of Sports Medicine.)

Introduction: Overuse musculoskeletal injuries (MSKI) remain a significant medical challenge in military personnel undergoing military training courses; further understanding of the biological process leading to overuse MSKI development and biological signatures for injury risk are warranted. The purpose of this study was to determine the association between overuse MSKI occurrence and physiological characteristics of allostatic load characterized as maladaptive biological responses to chronic stress measured by wearable devices in US Marine Corps officer candidates during a 10-wk training course., Methods: Devices recorded energy expenditure (EE), daytime heart rate (HR), sleeping HR, and sleep architecture (time and percentage of deep, light, rapid eye movement sleep, awake time, total sleep). Flux was calculated as the raw or absolute difference in the average value for that day or night and the day or night beforehand. Linear mixed-effect model analysis accounting for cardiorespiratory fitness assessed the association between overuse MSKI occurrence and device metrics ( α = 0.05)., Results: Sixty-nine participants (23 females) were included. Twenty-one participants (eight females) sustained overuse MSKI. Overuse MSKI occurrence in male participants was positively associated with daytime HR ( β = 5.316, P = 0.008), sleeping HR ( β = 2.708, P = 0.032), relative EE ( β = 8.968, P = 0.001), absolute flux in relative EE ( β = 2.994, P = 0.002), absolute EE ( β = 626.830, P = 0.001), and absolute flux in absolute EE ( β = 204.062, P = 0.004). Overuse MSKI occurrence in female participants was positively associated with relative EE ( β = 5.955, P = 0.026), deep sleep time ( β = 0.664, P < 0.001), and percent deep sleep ( β = 12.564, P < 0.001) and negatively associated with absolute flux in sleeping HR ( β = -0.660, P = 0.009)., Conclusions: Overuse MSKI occurrences were associated with physiological characteristics of allostatic load, including chronically elevated HR and EE and greater time in restorative sleep stages, which may serve as biological signatures for overuse MSKI risk., (Copyright © 2024 by the American College of Sports Medicine.)

Introduction: The study aimed to investigate to what extent acute endurance exercise, especially eccentric exercise and cardiorespiratory fitness, affects the metabolic profile of CD4 + cells., Methods: Fifteen male, healthy adults aged between 20 and 33 yr with a maximal oxygen uptake (V̇O 2max ) between 44 and 63 mL·kg -1 ·min -1 performed a downhill run (DR) and a level run (LR) for 45 min at 70% of their V̇O 2max on a treadmill in a crossover design. Blood samples were taken before (T0), directly after (T1), 3 h after (T3), and 24 h (T24) after each exercise for analyzing leukocyte numbers and cytokine levels. Isolated CD4 + cells were incubated for 4 h in autologous resting versus 3 h after exercise serum (T3 DR and T3 LR), and subsequently, cellular respiration, transcriptomic, and metabolomics profiles were measured., Results: The systemic immune inflammation index increased significantly after DR and LR at T1 and T3 ( P < 0.001). In contrast, the transcriptomic and metabolic profile of CD4 + cells showed no significant alterations after incubation in T3 exercise serum. However, cardiorespiratory fitness positively correlated with the maximal mitochondrial respiration in CD4 + cells after incubation with T3 LR serum ( r = 0.617, P = 0.033) and with gene expression of oxidative phosphorylation and levels of different metabolites. Similarly, V̇O 2max was associated with an anti-inflammatory profile on RNA level. Lower lactate, methylmalonic acid, and d -gluconic acid levels were found in CD4 + cells of participants with a high V̇O 2max ( P < 0.001)., Conclusions: Acute exercise leads to a mild proinflammatory milieu with only small changes in the metabolic homeostasis of CD4 + cells. High cardiorespiratory fitness is associated with a metabolic shift to oxidative phosphorylation in CD4 + cells. Functional relevance of this metabolic shift needs to be further investigated., (Copyright © 2024 by the American College of Sports Medicine.)

Introduction/purpose: As individuals age, the entorhinal cortex (ERC) and hippocampus-crucial structures for memory-tend to atrophy, with related cognitive decline. Simultaneously, lifestyle factors that can be modified, such as exercise and sleep, have been separately linked to slowing of brain atrophy and functional decline. However, the synergistic impact of fitness and sleep on susceptible brain structures in aging adults remains uncertain., Methods: We examined both independent and interactive associations of fitness and subjective sleep quality with regard to ERC thickness and hippocampal volume in 598 middle-aged and older adults from the Human Connectome Lifespan Aging Project. Cardiorespiratory fitness was assessed using the 2-min walk test, whereas subjective sleep quality was measured with the continuous Pittsburgh Sleep Quality Index global score. High-resolution structural magnetic resonance imaging was used to examine mean ERC thickness and bilateral hippocampal volume. Through multiple linear regression analyses, we investigated the moderating effects of subjective sleep quality on the association between fitness and brain structure, accounting for age, sex, education, body mass index, gait speed, and subjective physical activity., Results: We found that greater cardiorespiratory fitness, but not subjective sleep quality, was positively associated with bilateral hippocampal volume and ERC thickness. Notably, significant interaction effects suggest that poor subjective sleep quality was associated with a weaker association between fitness and both hippocampal volume and ERC thickness., Conclusions: Findings suggest the potential importance of both cardiorespiratory fitness and subjective sleep quality in preserving critical, age-vulnerable brain structures. Interventions targeting brain health should consider potential combined effects of sleep and fitness on brain health., (Copyright © 2024 by the American College of Sports Medicine.)

Purpose: Cardiorespiratory fitness (CRF) is a critical marker of overall health and a key predictor of morbidity and mortality, but the existing prediction equations for CRF are primarily derived from general populations and may not be suitable for patients with obesity., Methods: Predicted CRF from different non-exercise prediction equations was compared with measured CRF of patients with obesity who underwent maximal cardiopulmonary exercise testing (CPET). Multiple linear regression was used to develop a population-specific nonexercise CRF prediction model for treadmill exercise including age, sex, weight, height, and physical activity level as determinants., Results: Six hundred sixty patients underwent CPET during the study period. Within the entire cohort, R2 values had a range of 0.24 to 0.46. Predicted CRF was statistically different from measured CRF for 19 of the 21 included equations. Only 50% of patients were correctly classified into the measured CRF categories according to predicted CRF. A multiple model for CRF prediction (mL·min -1 ) was generated ( R2 = 0.78) and validated using two cross-validation methods., Conclusions: Most used equations provide inaccurate estimates of CRF in patients with obesity, particularly in cases of severe obesity and low CRF. Therefore, a new prediction equation was developed and validated specifically for patients with obesity, offering a more precise tool for clinical CPET interpretation and risk stratification in this population., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Sports Medicine.)

Introduction: The skill domains of fundamental movement skills (FMS), emphasizing gross motor movements, including locomotor skills (LMS) and object control skills (OCS), along with process- and product-oriented measures of FMS, may predict cardiorespiratory fitness (CRF) and muscular fitness (MF) differently. This study investigates the longitudinal relationship from early childhood FMS, focusing on process-oriented LMS and OCS and product-oriented FMS, to CRF and MF in late childhood., Methods: The study involved 441 Finnish children (49.9% female; mean age at baseline, 5.5 yr) over a 6-yr period. FMS was evaluated using the Test of Gross Motor Development, third version, for process-oriented LMS and OCS, and the Körperkoordinationstest Für Kinder (KTK) was used to evaluate the product-oriented FMS. CRF was assessed through the total number of laps completed in the 20-m shuttle run test, whereas MF was measured via repetitions of curl-ups and push-ups. Employing a two-level cross-classified regression analysis and Cholesky decomposition, this study aimed to determine the contributions of product-oriented KTK and process-oriented LMS and OCS. Adjustments for variations in age, measurement intervals, and maturation were achieved through residualization. In addition, gender and body mass index were incorporated as covariates in the analysis., Results: The analysis revealed that process-oriented LMS (CRF: Δ R2 = 0.016; MF: Δ R2 = 0.014) significantly predicted later health-related fitness, whereas OCS did not. However, KTK exhibited a better ability to predict both CRF (Δ R2 = 0.092) and MF (Δ R2 = 0.032), overshadowing process-oriented measures., Conclusions: In conclusion, the findings suggest that KTK, which potentially encompasses a broader spectrum of fitness elements along with FMS, more effectively predicts health-related fitness components than process-oriented FMS., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Sports Medicine.)

Background: Limited evidence supports the effects of short-interval high-intensity interval training (HIIT) for improving cardiorespiratory fitness (V̇O 2 peak) after stroke. We aimed to compare the effects of 12 weeks of short-interval HIIT versus moderate-intensity continuous training (MICT) on V̇O 2 peak, cardiovascular risk factors, and mobility outcomes among individuals ≥6 months poststroke., Methods: This study was a multi-site, 12-week randomized controlled trial (NCT03614585) with an 8-week follow-up. Participants were randomized into 3 d/wk of HIIT (10×1 minute 80%-100% heart rate reserve interspersed with 1 minute 30% heart rate reserve [19 minutes]) or MICT (20-30 minutes 40%-60% heart rate reserve). Secondary outcomes of the trial, including V̇O 2 peak, cardiovascular risk factors (carotid-femoral pulse wave velocity, blood pressure, and waist-hip ratio), and mobility (6-minute walk test, 10 m gait speed), were reported. Linear mixed model analyses with a group×study time point interaction evaluated between-group differences., Results: Of the 305 potential participants, 82 consented (mean [SD] age 64.9 [9.3] years, 32 females [39%], 1.8 [1.2] years poststroke) and were randomized to HIIT (n=42, mean [SD] baseline V̇O 2 peak 17.3 [5.9] mL/kg·min) or MICT (n=40, mean [SD] baseline V̇O 2 peak 17.2 [6.0] mL/kg·min). Participants attended 82% of visits (n=2417/2952). No adverse events occurred during the study period. A significant group×study time point interaction was found (χ 2 =8.46; P =0.015) for V̇O 2 peak at 12 weeks (mean difference, 1.81 [95% CI, 0.58-3.04]; P =0.004) whereby the HIIT group had greater gains in V̇O 2 peak (∆3.52 mL/kg·min [95% CI, 2.47-4.57]; P <0.001) compared with the MICT group (∆1.71 mL/kg·min [95% CI, 0.55-2.86]; P =0.001). There was no between-group difference in V̇O 2 peak (mean difference, 1.08 [95% CI, -0.26 to 2.42]; P =0.11) at 8-week follow-up. No group×study time point interactions were found for cardiovascular risk factors or mobility outcomes., Conclusions: Short-interval HIIT may be an effective alternative to MICT for improving V̇O 2 peak at 12 weeks postintervention., Registration: URL: https://clinicaltrials.gov; Unique identifier: NCT03614585., Competing Interests: Dr Moncion and K.S. Noguchi are supported by an Ontario Graduate Scholarship. L. Rodrigues is supported by a Doctoral Scholarship from the Fonds Recherche Santé Québec. Dr Eng is supported by the Canada Research Chairs program. Dr Roig is supported by a Salary Award (Junior II) from Fonds de Recherche Santé Québec. This study is funded by an operating grant from the Canadian Institutes of Health Research (388320). Dr Tang reports grants from Canadian Institutes of Health Research; grants from Physiotherapy Foundation of Canada; and grants from Heart and Stroke Foundation of Canada.

Purpose: Cardiorespiratory fitness (CRF) measured by peak oxygen consumption (V̇O 2peak ) declines with aging and correlates with mortality and morbidity. Cardiopulmonary exercise testing (CPET) is the criterion method to assess CRF, but its feasibility, validity, and reliability in older adults are unclear. Our objective was to design and implement a dependable, safe, and reliable CPET protocol in older adults., Methods: V̇O 2peak was measured by CPET, performed using treadmill exercise in 875 adults ≥70 yr in the Study of Muscle, Mobility and Aging (SOMMA). The protocol included a symptom-limited peak (maximal) exercise and two submaximal walking speeds. An adjudication process was in place to review tests for validity if they met any prespecified criteria (V̇O 2peak <12.0 mL·kg -1 ·min -1 ; maximum heart rate <100 bpm; respiratory exchange ratio <1.05 and a rating of perceived exertion <15). A subset ( N = 30) performed a repeat test to assess reproducibility., Results: CPET was safe and well tolerated, with 95.8% of participants able to complete the V̇O 2peak phase of the protocol. Only 56 (6.4%) participants had a risk alert and only two adverse events occurred: a fall and atrial fibrillation. Mean ± SD V̇O 2peak was 20.2 ± 4.8 mL·kg -1 ·min -1 , peak heart rate 142 ± 18 bpm, and peak respiratory exchange ratio 1.14 ± 0.09. Adjudication was indicated in 47 tests; 20 were evaluated as valid and 27 as invalid (18 data collection errors, 9 did not reach V̇O 2peak ). Reproducibility of V̇O 2peak was high (intraclass correlation coefficient = 0.97)., Conclusions: CPET was feasible, effective, and safe for older adults, including many with multimorbidity or frailty. These data support a broader implementation of CPET to provide insight into the role of CRF and its underlying determinants of aging and age-related conditions., (Copyright © 2024 by the American College of Sports Medicine.)

Objectives: To determine the impact of cardiorespiratory fitness (CRF) on physiological and performance outcomes during a 120-m vertical high-rise ascent in firefighters with CRF levels at or above (higher-fit) and below (lower-fit [LF]) the national recommended minimum physical employment standard (V˙O 2 max 42.3 mL·kg -1 ·min -1 )., Methods: Twenty-eight firefighters completed two high-rise firefighting trials (continuous and discontinuous ascent with predetermined 1-minute rest breaks). Task time, heart rate, ratings of perceived exertion, core body temperature, and thermal comfort were recorded at predetermined elevations., Results: Task time was significantly longer in both trials for the LF group. Ratings of perceived exertion and thermal comfort were also significantly higher in the LF group, with three times more LF firefighters being unable to complete the ascent without sounding their low-air alarm., Conclusions: Higher CRF improves performance and efficiency during stair-climbing in simulated high-rise firefighting tasks., Competing Interests: Conflict of interest: None declared., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

The aim of this study is to gain insight in the cardiorespiratory fitness of persons with lower limb amputation (LLA) during rehabilitation, and in potential factors influencing their cardiorespiratory fitness. We performed a retrospective cohort study using data from cardiopulmonary exercise tests. Included participants were adults with LLA. Main outcome was cardiorespiratory fitness expressed as O 2 peak (ml/min/kg) and was directly determined using breath-by-breath gas analysis. O 2 peak was compared to reference values for able-bodied controls. Multivariate regression analysis was performed to investigate potential factors related to O 2 peak in persons with LLA. Potential factors were age, BMI adjusted, gender, level of amputation, aetiology of amputation, unilateral/bilateral, type of ergometry and use of beta blockers. Data of 74 participants with LLA are presented; 84% male (n = 62), mean age 58.9 (SD 11.6), mean BMI 26.7 (SD 5.6), 44 participants have a LLA above the knee, 30 below the knee. Overall O 2 peak was lower in persons with LLA compared to reference values for able-bodied controls, with mean O 2 peak for the total LLA group of 14.6 ± 4.1 ml/kg/min. In the multivariate regression analysis, only age was a significant predictor for lower O 2 peak (regression coefficient: -0.15, 95% CI [0.23-0.069], r 2  = 0.166). These results indicate that the cardiorespiratory fitness in persons with LLA is low, while they actually need more energy to walk and perform other daily activities. Cardiorespiratory fitness is not closely associated with the analysed demographic or clinical factors and will have to be determined on an individual basis for use in daily practice., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Acute inflammation impairs vascular function in an age-dependent manner and affects cardiovascular event risk. Regular aerobic exercise preserves vascular function with aging and potentially modifies how acute inflammation affects the vasculature. We hypothesize high cardiorespiratory fitness may accompany greater arterial responsiveness post-acute inflammation in older adults., (Copyright © 2024 by the American College of Sports Medicine.)

Aerobic exercise is established to increase cardiorespiratory fitness (CRF), which is linked to reduced morbidity and mortality. However, people with metabolic diseases such as type 1 and type 2 diabetes may be more likely to display blunted improvements in CRF with training. Here, we present evidence supporting the hypothesis that altered skeletal muscle signaling and remodeling may contribute to low CRF with metabolic disease., (Copyright © 2023 by the American College of Sports Medicine.)

Objective: The aim of the study is to measure the association between the physical activity (PA) levels and cardiorespiratory fitness on the firefighters' cardiac autonomic function at rest at the fire station., Methods: Anthropometry, heart rate variability, fitness, and PA levels were assessed at the fire station in 98 career Québec male firefighters., Results: Partial correlations, adjusted for age, waist circumference, and perceived stress revealed that heart rate and several heart rate variability indices were significantly correlated to estimated maximal oxygen consumption and to high-intensity PA but not to moderate-intensity PA., Conclusions: These results suggest that both cardiorespiratory fitness and high-intensity physical training are related to the cardiac autonomic function of firefighters. Therefore, fire department should promote PA programs to improve physical fitness among firefighters., Competing Interests: Conflicts of interest: None declared., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

Objective: It remains unclear which individual or combined strategies are most beneficial for methamphetamine use disorders (MUDs). We compared the effects of aerobic exercise, attentional bias modification, and combined intervention on male patients with MUD., Method: One hundred male patients with MUD were randomly assigned to combined intervention, aerobic exercise, attentional bias modification, or control groups (25 patients per group). The 8-week intervention protocol included three 60-minute sessions of aerobic exercises per week. Primary outcomes included high- and low-frequency heart rate variability, executive function, and cardiorespiratory fitness measured by customized software, computerized tests, and the Harvard step test, respectively. Secondary outcomes included psychiatric symptoms, drug craving, training acceptability, and persistence., Results: Participant characteristics were matched between groups at baseline. Executive function, heart rate variability, cardiorespiratory fitness, drug craving, and most psychiatric symptoms had significant time-group interactions at posttest (p < .05, η2 = .08-.28). Compared with the attentional bias modification and control groups, the combined intervention and aerobic exercise groups improved significantly in executive function, heart rate variability, cardiorespiratory fitness, and most secondary outcomes. In addition, high-frequency heart rate variability and cardiorespiratory fitness in the aerobic exercise group were significantly higher than those in the combined intervention group., Conclusions: Combination strategies showed comparable efficacy to aerobic exercise alone in improving executive function, psychiatric symptoms, and drug craving and significantly exceeded other conditions. For heart rate variability and cardiorespiratory fitness, aerobic exercise alone was the most effective. For acceptability and persistence, combination strategies were preferred over single-domain training and health education intervention., Competing Interests: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article., (Copyright © 2024 International Nurses Society on Addictions.)

Introduction: Given the health benefits and the role of exercise as an anti-inflammatory adjuvant program, this study aimed to determine the effectiveness of a combined exercise program on cardiorespiratory fitness (CRF), body composition, and biochemical levels in adults with schizophrenia (SZ) characterized at baseline as metabolically unhealthy overweight with low CRF., Methods: Participants diagnosed with SZ ( n = 112, 41.3 ± 10.4 yr, 28.7% women) were randomly assigned into a treatment-as-usual control group ( n = 53) or a supervised exercise group ( n = 59, 3 d·wk -1 ). Each combined exercise session consisted of both a low-volume high-intensity interval training (<10 min of high-intensity time per session) and a resistance circuit-training program. All variables were assessed before and after the intervention (20 wk). For the assessment of CRF, a peak cardiopulmonary exercise test on a cycle ergometer was used., Results: After the intervention, participants from the exercise group ( n = 51) showed increases in CRF ( P < 0.001) through peak oxygen uptake (L·min -1 ; Δ = 17.6%; mL·kg -1 ·min -1 , Δ = 19.6%) and the metabolic equivalent of task (Δ = 19%), with no significant changes ( P > 0.05) in body composition and biochemical variables. However, the treatment-as-usual group ( n = 38) did not show any significant change in the study variables ( P > 0.05). Between-group significant differences ( P ≤ 0.05) were observed in CRF, first ventilatory threshold, and heart rate peak after the intervention period, favoring the exercise group., Conclusions: This study demonstrated that a supervised combined exercise program in people with SZ helps to maintain body composition values and improve CRF levels. This could lead to an important clinical change in the characterization from metabolically unhealthy overweight to a metabolically healthy overweight population. Hence, exercise should be considered a co-adjuvant program in the treatment of the SZ population., (Copyright © 2023 by the American College of Sports Medicine.)

Purpose: High-intensity interval training (HIIT) has been shown to improve cardiorespiratory fitness (CRF) and health-related outcomes in various chronic diseases, including cancer. However, data on feasibility and efficacy of HIIT in advanced cancer patients are still sparse, presumably because of safety concerns, like suspected immunosuppression after vigorous exercise. This randomized, sham-intervention controlled study aimed to investigate feasibility, safety, and preliminary efficacy of very low-volume HIIT (LOW-HIIT) in advanced cancer patients., Methods: Twenty-seven patients (55.4 ± 13.2 yr) with different advanced cancers (Union for International Cancer Control [UICC] III/IV) were randomly allocated to LOW-HIIT ( n = 13), consisting of 5 × 1 min cycle ergometer intervals (14 min per session total duration) at 80% to 95% HR peak (two sessions per week for 12 wk), or a sham intervention ( n = 14) performing light physical mobilization exercises (SHAM). Primary outcomes were attrition and attendance rates, with values of ≤25% and ≥80%, respectively, considered acceptable. Secondary outcomes were safety, protocol fidelity, physiological (including CRF measures) and patient-reported outcomes (including fatigue and quality of life)., Results: One of 13 patients (8%) receiving LOW-HIIT dropped out. Mean attendance rate was ~93%. The prescribed minimum exercise intensity was consistently reached by all patients. Low-volume HIIT was well tolerated and not associated with any serious adverse event nor with increased infection susceptibility. There were no biochemical signs of acute immunosuppression after LOW-HIIT. Contrarily, differentiation and degranulation of natural killer cells was acutely increased postexercise. Low-volume HIIT improved CRF measures including peak oxygen uptake, self-reported fatigue, physical, and social functioning. No significant changes occurred in the SHAM group., Conclusions: Low-volume HIIT can be regarded as feasible and safe in advanced cancer patients. Our preliminary data indicate favorable acute effects on NK-cells and beneficial chronic adaptations in CRF, fatigue, and aspects of quality of life., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Sports Medicine.)

Abstract: Obesity affects 600 million people globally and increases the risk of developing cardiovascular disease, stroke, diabetes, and cancer. Bariatric surgery is an increasingly popular therapeutic intervention for morbid obesity to induce rapid weight loss and reduce obesity-related comorbidities. However, some bariatric surgery patients, after what is considered a successful surgical procedure, continue to manifest obesity-related health issues, including weight gain, reduced physical function, persistent elevations in blood pressure, and reduced cardiorespiratory fitness. Cardiorespiratory fitness is a strong predictor of mortality and several health outcomes and could be improved by an appropriate exercise prescription after bariatric surgery. This review provides a broad overview of exercise training for patients after bariatric surgery and discusses cardiorespiratory fitness and other potential physiological adaptations in response to exercise training., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: This study aimed to examine individual exercise response rates across a range of cardiometabolic variables, cardiorespiratory fitness, and body composition in adults., Methods: A retrospective analysis of data from three randomized controlled trials was used in this study. Participants include those who completed the given trial (control, n = 87; intervention, n = 251). Anthropometric (weight, body mass index, waist circumference), cardiorespiratory fitness (V̇O 2peak ), MRI-measured total adipose tissue (AT), abdominal subcutaneous AT, and visceral AT and common cardiometabolic variables were assessed pre- and postintervention using standard methodologies. The technical error (TE), which includes both the day-to-day variability and instrument error, was calculated using pre- and postintervention data from the time-matched control group., Results: On average, all anthropometric, MRI, and V̇O 2peak variables improved significantly after intervention compared with the control group ( P < 0.05). With the exception of glucose disposal rate (37%), after intervention less than 13% of participants improved cardiometabolic outcome measures beyond the day-to-day variability of measurement. In other words, the individual response for 63%-96% of participants fell within the uncertain range (2 TE). Similarly, for absolute V̇O 2peak (L·min -1 ), only 45% of participants improved beyond 2 TE. By comparison, for MRI-derived variables, the majority of participants (77%, 58%, and 51% for total AT, abdominal subcutaneous AT, and visceral AT, respectively) improved beyond 2 TE. The observed reductions beyond 2 TE for WC and body weight were 53% and 63%, respectively., Conclusions: The findings suggest extreme caution when inferring that the cardiometabolic and cardiorespiratory fitness response for a given individual is attributable to the exercise dose prescribed., (Copyright © 2022 by the American College of Sports Medicine.)

Purpose: This study aimed to describe maximal and submaximal cardiorespiratory fitness from early adulthood to midlife and examine differences in maximal fitness at age 20 yr and changes in fitness overtime by subcategories of sociodemographic, behavioral, and health-related factors., Methods: Data include 5018 Coronary Artery Risk Development in Young Adults participants (mean (SD) age, 24.8 (3.7) yr; 53.3% female; and 51.4% Black participants) who completed at least one maximal graded exercise test at baseline and/or the year 7 and 20 exams. Maximal and submaximal fitness were estimated by exercise duration and heart rate at the end of stage 2. Multivariable adjusted linear-mixed models were used to estimate fitness trajectories using age as the mechanism for time after adjustment for covariates. Fitness trajectories from ages 20 to 50 yr in 5-yr increments were estimated overall and by subgroups determined by each factor after adjustment for duration within the less favorable category., Results: Mean (95% confidence interval) maximal fitness at age 20 and 50 yr was 613 (607-616) and 357 (350-362) s; submaximal heart rate during this period also reflected age-related fitness declines (126 (125-127) and 138 (137-138) bpm). Compared with men, women had lower maximal fitness at age 20 yr (P < 0.001), which persisted over follow-up (P < 0.001); differences were also found by race within sex strata (all P < 0.001). Differences in maximal fitness at age 20 yr were noted by socioeconomic, behavioral, and health-related status in young adulthood (all P < 0.05), which persisted over follow-up (all P < 0.001) and were generally consistent in sex-stratified analyses., Conclusions: Targeting individuals experiencing accelerated fitness declines with tailored intervention strategies may provide an opportunity to preserve fitness throughout midlife to reduce lifetime cardiovascular disease risk., (Copyright © 2022 by the American College of Sports Medicine.)

The aim of the HERITAGE Family Study was to investigate individual differences in response to a standardized endurance exercise program, the role of familial aggregation, and the genetics of response levels of cardiorespiratory fitness and cardiovascular disease and diabetes risk factors. Here we summarize the findings and their potential implications for cardiometabolic health and cardiorespiratory fitness. It begins with overviews of background and planning, recruitment, testing and exercise program protocol, quality control measures, and other relevant organizational issues. A summary of findings is then provided on cardiorespiratory fitness, exercise hemodynamics, insulin and glucose metabolism, lipid and lipoprotein profiles, adiposity and abdominal visceral fat, blood levels of steroids and other hormones, markers of oxidative stress, skeletal muscle morphology and metabolic indicators, and resting metabolic rate. These summaries document the extent of the individual differences in response to a standardized and fully monitored endurance exercise program and document the importance of familial aggregation and heritability level for exercise response traits. Findings from genomic markers, muscle gene expression studies, and proteomic and metabolomics explorations are reviewed, along with lessons learned from a bioinformatics-driven analysis pipeline. The new opportunities being pursued in integrative -omics and physiology have extended considerably the expected life of HERITAGE and are being discussed in relation to the original conceptual model of the study., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Sports Medicine.)

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., Competing Interests: Disclosure: The authors have no conflicts of interest to report., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: The aims of this study were twofold: 1) to identify latent physical performance profiles of motor competence (MC) and cardiorespiratory (CF) and muscular fitness (MF) among school-age children and 2) explore transition probabilities in physical performance profiles over a 2-yr period., Methods: The present sample comprised 1148 (583 girls, 565 boys) elementary school students (baseline Mage = 11.27 ± 0.32), and data were collected annually (equal intervals) over a period of 2 yr which resulted in a total of three measurements. The measures used were the throwing-catching combination test, 5-leaps and two-legged jumps from side-to-side test (MC), 20-meter shuttle run test (CF), and curl-up and push-up tests (MF). Latent transition analysis was used to identify and track physical performance profiles derived from the measurements of MC, CF, and MF scores., Results: The key findings were: 1) three physical performance profiles were identified: (a) low (28% of the sample; lowest level in each category), (b) moderate (43% of the sample; higher MC, CF, and MF than low), (c) high (29% of the sample; highest MF); 2) the number of physical performance profiles and probability to belong to a given profile were stable across time; 3) the highest transition probability was found in the high group, where some students had transitioned to the moderate group at T2; and 4) girls were most likely to belong to the low group., Conclusions: Results demonstrated that children's physical performance profiles are stable from late childhood to early adolescence. This study suggests that the early elementary school years are essential for the development of children's MC and health-related fitness., (Copyright © 2021 by the American College of Sports Medicine.)

Purpose: To examine synergistic associations between developmental trajectories of motor competence, perceived motor competence, cardiorespiratory fitness, moderate-to-vigorous physical activity (MVPA), and body mass index (BMI) from late childhood to adolescence., Methods: In this 3-yr follow-up study, motor competence, perceived motor competence, cardiorespiratory fitness, MVPA, and BMI were assessed in 1167 Finnish school-age children (girls = 583, boys = 565; Mage = 11.27 ± 0.33). Moderate-to-vigorous physical activity was measured using hip-mounted accelerometers. Developmental trajectories were analyzed using latent growth curve modeling., Results: The development of motor competence, cardiorespiratory fitness, and BMI was positive over time, whereas the development of perceived motor competence and physical activity was negative. The development of BMI was inversely associated with the development of cardiorespiratory fitness and physical activity., Conclusions: In the transition from late childhood to adolescence, motor competence, cardiorespiratory fitness, and BMI increased, and perceived motor competence and physical activity decreased. However, individual variance in the developmental trajectories was significant. Moreover, children with a greater increase in BMI showed a greater decrease in cardiorespiratory fitness and physical activity from late childhood to adolescence., (Copyright © 2021 by the American College of Sports Medicine.)

Purpose: Whether blood oxygen (O2)-carrying capacity plays a substantial role in determining cardiorespiratory fitness, a strong predictor of mortality, remains uncertain in women and elderly individuals because of the scarcity of experimental investigations. This study experimentally assessed the role of blood O2-carrying capacity on cardiorespiratory fitness in middle-age and older individuals., Methods: Healthy women and men (n = 31, 35-76 yr) matched by age and fitness were recruited. Transthoracic echocardiography, central hemodynamics, and O2 uptake were assessed throughout incremental exercise in (i) control conditions and (ii) after a 10% reduction of blood O2-carrying capacity via carbon monoxide administration, in a blinded manner. Effects on cardiac function, blood pressure, peak O2 uptake, and effective hemoglobin (Hb) were determined with established methods., Results: Blood O2-carrying capacity, represented by effective Hb, was similarly reduced in women (11.8 ± 0.6 vs 10.7 ± 0.6 g·dL-1, P < 0.001) and men (13.0 ± 0.9 vs 11.7 ± 0.6 g·dL-1, P < 0.001) (P for sex effect = 0.580). Reduced O2-carrying capacity did not induce major effects on cardiac function and hemodynamics during exercise, except for a 10%-15% decrement in peak systolic blood pressure in both sexes (P ≤ 0.034). Peak O2 uptake decreased from 35 ± 6 to 31 ± 6 mL·min-1·kg-1, P < 0.001) in women and from 35 ± 9 to 32 ± 9 mL·min-1·kg-1 (P = 0.024) in men in approximate proportion to the reduction of O2-carrying capacity, an effect that did not differ between sexes (P = 0.778)., Conclusions: Blood O2-carrying capacity stands out as a major determinant of cardiorespiratory fitness in healthy mature women and men, with no differential effect of sex., (Copyright © 2021 by the American College of Sports Medicine.)

Abstract: To evaluate the real aerobic capacity is difficult due to impaired limbs function in stroke patients. Oxygen uptake efficiency slope (OUES) could represent the aerobic capacity in submaximal exercise test. Hence, we designed this observational study to investigate the application of the OUES for evaluating aerobic capacity in these patients.Thirty-seven stroke patients were classified into 2 groups according to their Brunnstrom stage of affected lower limbs. Patients underwent cardiopulmonary exercise testing to assess cardiorespiratory fitness. Minute ventilation and oxygen consumption were measured, and OUES was calculated, compared with healthy reference values, and correlated with the peak oxygen consumption. The predictive validity of submaximal OUES was derived.Study participants' OUES (median 566.2 [IQR, 470.0-711.6]) was 60% of healthy reference values and correlated positively with the peak oxygen consumption (r = 0.835) (P < .01). The predictive validity of oxygen uptake efficiency slope at 50% of maximal exercise duration (OUES50) and oxygen uptake efficiency slope at 75% of maximal exercise duration (OUES75) for oxygen uptake efficiency slope at 100% of maximal exercise duration (OUES100) was 0.877 and 0.973, respectively (P < .01). The OUES50, OUES75, and OUES100 groups were not significantly different; agreement of submaximal and maximal OUES values was strong.OUES is a valuable submaximal index for evaluating cardiorespiratory fitness in stroke patients. Moderate-to-high concurrent validity of this parameter with peak oxygen consumption and the high predictive validity of OUES50 and OUES75 for OUES100 suggest maximal exercise testing in stroke patients who cannot reach maximal exercise is unnecessary., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Introduction: Poor sleep is linked to impaired cognitive function, cortical brain atrophy, and lower cortical thickness. Independently, higher cardiovascular endurance has neuroprotective effects. It remains in question, however, whether cardiovascular endurance moderates the relationship between sleep and brain health. The aims of this study included the following: 1) the association between subjective sleep quality and cognitive performance, hippocampus volume, and entorhinal cortex (EC) thickness, and 2) the moderating effects of cardiovascular endurance on the associations of sleep quality with cognitive and magnetic resonance imaging measures in healthy younger adults., Methods: A total of 1095 younger adults (28.8 ± 3.6 yr) from the Human Connectome Project were included in the analyses. The 2-min walk test was used as a proxy of cardiovascular endurance. Self-reported sleep quality was measured using the Pittsburgh Sleep Quality Index. Composite cognitive tests were used to assess global cognition, and T1-weighted structural magnetic resonance imaging data (obtained using Siemens 3T scanner) was used to assess hippocampus volume and EC thickness. Linear regression was used to examine the moderating effects of fitness on the relationships between sleep and each of these neurocognitive outcomes after controlling for age, sex, and education year., Results: Poorer sleep quality was associated with both a lower crystalized intelligence score (B = -0.198, P = 0.034) and lower EC thickness (B = -0.013, P = 0.003). With greater 2-min walk test score, the association between greater Pittsburgh Sleep Quality Index score and lower EC thickness was attenuated (B = 0.0008, P = 0.028)., Conclusions: Higher cardiovascular endurance may mitigate the relationship between poorer subjective sleep quality and lower EC thickness. Future longitudinal studies should examine the interactive effects of sleep and fitness on brain health among older and more vulnerable populations., (Copyright © 2021 by the American College of Sports Medicine.)

Purpose: Cardiorespiratory fitness (CRF) is an independent predictor of mortality, and females typically achieve smaller improvements in CRF than males after exercise-based cardiac rehabilitation. High-intensity interval training (HIIT) has been shown to produce superior improvements in CRF than traditional cardiac rehabilitation, but the sex differences are unknown. The purpose of this systematic review and meta-analysis was to evaluate sex differences for changes in CRF and cardiometabolic health indicators after HIIT in adults with coronary artery disease (CAD)., Methods and Results: A systemic search of five electronic databases for studies examining the effect of HIIT on measured CRF and cardiometabolic health indicators in adults with CAD was performed. Data (published and unpublished) from 14 studies were included in the meta-analyses with approximately eightfold greater male than female participation (n = 836 vs n = 103). Males with CAD achieved a near-significant absolute improvement in CRF (mean difference [MD] = 1.07, 95% confidence interval [CI] = -0.08 to 2.23 mL·kg-1⋅min-1, P = 0.07) after HIIT when compared with control; there were insufficient data to conduct such an analysis in females. Significantly smaller improvements in CRF were experienced by females than males (MD = -1.10, 95% CI = -2.08 to -0.12 mL·kg-1⋅min-1, P = 0.03); there was no sex difference for the relative (percentage) change in CRF after HIIT. Females achieved significantly smaller reductions in body mass index (MD = -0.25, 95% CI = -0.03 to -0.47 kg·m-2, P = 0.02) and fasting blood glucose (MD = -0.38, 95% CI = -0.05 to -0.72, P = 0.03); no sex differences were observed for other cardiometabolic health indicators., Conclusion: There are no sex differences for relative improvements in CRF after HIIT; however, females are greatly underrepresented in trials. Future studies should increase female participation and perform sex-based analyses to determine sex-specific outcomes following HIIT., (Copyright © 2021 by the American College of Sports Medicine.)

Purpose: This study aimed to evaluate the effects of low energy availability (EA) on health and performance indices associated with the Male Athlete Triad and Relative Energy Deficiency in Sport (RED-S) models., Methods: Over an 8-wk period, a male combat sport athlete adhered to a phased body mass (BM) loss plan consisting of 7-wk energy intake (EI) equating to resting metabolic rate (RMR) (1700 kcal·d-1) (phase 1), 5 d of reduced EI (1200-300 kcal·d-1) before weigh-in (phase 2), and 1 wk of ad libitum EI postcompetition (phase 3). EA fluctuated day by day because of variations in exercise energy expenditure. Regular assessments of body composition, RMR, cardiac function, cardiorespiratory capacity, strength and power, psychological state and blood clinical chemistry for endocrine, bone turnover, hydration, electrolyte, renal, liver, and lipid profiles were performed., Results: BM was reduced over the 8-wk period by 13.5% (72.5 to 62.7 kg). No consequences of Male Athlete Triad or RED-S were evident during phase 1, where mean daily EA equated to 20 kcal·kg·fat free mass (FFM)-1·d-1 (range, 7 to 31 kcal·kg FFM-1·d-1) and BM and fat mass (FM) losses were 6.5 and 4.4 kg, respectively. However, consequences did present in phase 2 when mean daily EA was consistently <10 kcal·kg FFM-1·d-1, as evidenced by alterations to endocrine hormones (e.g., testosterone <5 nmol.L-1) and reduced RMR (-257 kcal·d-1)., Conclusion: Data demonstrate that 7 wk of daily fluctuations in EA equating to a mean value of 20 kcal·kg FFM-1·d-1 permits reductions of BM and FM without perturbations to physiological systems associated with the Male Athlete Triad and RED-S. By contrast, a subsequent period of five consecutive days of EA <10 kcal·kg FFM-1·d-1 induced consequences of Male Athlete Triad and RED-S., (Copyright © 2020 by the American College of Sports Medicine.)

Introduction: (Neo-)adjuvant chemotherapy for breast cancer has a deleterious impact on muscle tissue resulting in reduced cardiorespiratory fitness, skeletal muscle mass and function. Physical exercise during treatment may counteract some of these negative effects. However, the effects of resistance training (RT) alone have never been explored. The present study aims to investigate if heavy-load RT during (neo-)adjuvant chemotherapy counteracts deleterious effects on skeletal muscle in women diagnosed with breast cancer. We hypothesize that (neo-)adjuvant treatment with chemotherapy will reduce muscle fiber size, impair mitochondrial function, and increase indicators of cellular stress and that RT during treatment will counteract these negative effects. We also hypothesize that RT during (neo-)adjuvant chemotherapy will increase muscle and blood levels of potential antitumor myokines and reduce treatment-related side effects on muscle strength and cardiorespiratory fitness., Methods: Fifty women recently diagnosed with breast cancer scheduled to start (neo-)adjuvant chemotherapy will be randomized to either randomized to either intervention group or to control group.The intervention group will perform supervised heavy-load RT twice a week over the course of chemotherapy (approximately 16-weeks) whereas the control group will be encouraged to continue with their usual activities. Muscle biopsies from m. vastus lateralis will be collected before the first cycle of chemotherapy (T0), after chemotherapy (T1), and 6 months later (T2) for assessment of muscle cellular outcomes. The primary outcome for this study is muscle fiber size. Secondary outcomes are: regulators of muscle fiber size and function, indicators of cellular stress and mitochondrial function, myokines with potential antitumor effects, muscle strength, and cardiorespiratory fitness., Ethics and Dissemination: Ethical approval has been obtained from the Regional Ethical Review Board in Uppsala, Sweden (Dnr:2016/230/2). Results will be disseminated through presentations at scientific meetings, publications in peer-reviewed journals, social media, and patient organizations., Trial Registration Number: NCT04586517., Competing Interests: The authors have no conflicts of interests to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: Excess fat mass (FM) contributes to poor prostate cancer (PCa) prognosis and comorbidity. However, FM gain is a common side effect of androgen deprivation therapy (ADT). We examined the efficacy of a 12-wk weight loss intervention to reduce FM and maintain lean mass (LM) in ADT-treated obese PCa patients., Methods: Fourteen ADT-treated obese PCa patients (72 ± 9 yr, 39.7% ± 5.4% body fat) were recruited for a self-controlled prospective study, with 11 completing the 6-wk control period, followed by a 12-wk intervention comprising 300 min·wk-1 of exercise including supervised resistance training and home-based aerobic exercise, and dietitian consultations advising a daily energy deficit (2100-4200 kJ) and protein supplementation. Body composition was assessed by dual x-ray absorptiometry. Secondary outcomes included muscle strength (one-repetition maximum), cardiorespiratory fitness (maximal oxygen consumption), and blood biomarkers., Results: There were no significant changes during the control period. Patients attended 89% of supervised exercise sessions and 100% of dietitian consultations. No changes in physical activity or energy intake were observed. During the intervention, patients experienced significant reductions in weight (-2.8 ± 3.2 kg, P = 0.016), FM (-2.8 ± 2.6 kg, P < 0.001), and trunk FM (-1.8 ± 1.4 kg, P < 0.001), with LM preserved (-0.05 ± 1.6 kg, P = 0.805). Muscle strength (4.6%-24.7%, P < 0.010) and maximal oxygen consumption (3.5 ± 4.7 mL·min-1·kg-1, P = 0.041) significantly improved. Leptin significantly decreased (-2.2 (-2.7 to 0.5) ng·mL-1, P = 0.016) with no other changes in blood biomarkers such as testosterone and lipids (P = 0.051-0.765); however, C-reactive protein (rs = -0.670, P = 0.024) and triglycerides (r = -0.667, P = 0.025) were associated with individual changes in LM., Conclusions: This study shows preliminary efficacy for an exercise and nutrition weight loss intervention to reduce FM, maintain LM, and improve muscle strength and cardiorespiratory fitness in ADT-treated obese PCa patients. The change in body composition may affect blood biomarkers associated with obesity and PCa progression; however, further research is required., (Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Sports Medicine.)

Purpose: This study aimed to review traditional and new perspectives in the interpretation of the development of youth cardiorespiratory fitness (CRF)., Methods: We analyzed data from (i) the literature which for 80 yr has been traditionally based on interpretations of peak oxygen uptake (V˙O2) in ratio with body mass (BM) and (ii) recent multilevel allometric models founded on 994 (475 from girls) determinations of 10- to 16-yr-olds' peak V˙O2 with measures of age, maturity status, and morphological covariates (BM and fat-free mass), and from 10 to 13 yr, 110 peak V˙O2 determinations of maximum cardiovascular covariates (stroke volume, cardiac output, and arteriovenous oxygen difference)., Results: The application of ratio scaling of physiological variables requires satisfying specific statistical assumptions that are seldom met. In direct conflict with the ratio-scaled data interpretation of CRF, multilevel allometric modeling shows that with BM controlled, peak V˙O2 increases with age but the effect is smaller in girls than boys. Maturity status exerts a positive effect on peak V˙O2, in addition to those of age and BM. Changes in maximum cardiovascular covariates contribute to explaining the development of CRF, but fat-free mass (as a surrogate for active muscle mass) is the most powerful single influence. With age, maturity status, morphological covariates, and maximum cardiovascular covariates controlled, there remains an unexplained ~4% to ~9% sex difference in peak V˙O2., Conclusions: The traditional interpretation of peak V˙O2 in ratio with BM is fallacious and leads to spurious correlations with other health-related variables. Studies of the development of CRF require analyses of sex-specific, concurrent changes in age- and maturation-driven morphological and maximum cardiovascular covariates. Multilevel allometric modeling provides a rigorous, flexible, and sensitive method of data analysis.

Introduction: Cardiorespiratory fitness (CRF) measured by oxygen consumption (V˙O2) during exercise is an important marker of health. The traditional method of indexing V˙O2 to total body mass is suboptimal because skeletal muscle mass (SMM), rather than fat and extracellular fluid, is the main contributor to CRF. The traditional estimating equations for peak V˙O2 in youth do not account for this. Bioelectric impedance analysis (BIA) is a noninvasive method to accurately measure body composition. The objectives of this study were to 1) examine the relationship of body composition indices and peak V˙O2 in healthy children, adolescents, and young adults, and 2) derive an optimized estimating equation incorporating BIA and compare its performance with traditional estimating equations., Methods: A retrospective, cross-sectional, single-center study of patients <21 yr old referred for exercise testing who did not have underlying cardiovascular disease. All patients underwent BIA immediately before exercise testing. Univariable and multivariable linear regression models were constructed and tested for model performance., Results: A total of 165 young healthy people (mean age 14 yr, 48% male) were studied. There was a strong and linear relationship between peak V˙O2 and SMM (R = 0.79). The sex difference in SMM explained the most variability in CRF between boys and girls. A generalized equation using SMM (peak V˙O2 = 302 - (23.7 × age) - (50.3 × [female = 1, male = 0]) + (81.8 × SMM)) had superior performance (R = 0.80) compared with estimating equations currently used in clinical practice (R = 0.67)., Conclusions: SMM is a stronger correlate of CRF than is total body mass in youth and may be a better scaling variable to estimate expected peak V˙O2.

Objective: The 6-Min Manual Wheelchair Propulsion Test is proposed to easily and rapidly assess aerobic fitness among long-term (≥3 mos) manual wheelchair users with spinal cord injury. However, aerobic responses to this test have not been established. This study aimed (1) to characterize aerobic responses during the 6-Min Manual Wheelchair Propulsion Test, (2) to establish parallel reliability between the 6-Min Manual Wheelchair Propulsion Test and the Maximal Arm Crank Ergometer Test, and (3) to quantify the strength of association between the total distance traveled during the 6-Min Manual Wheelchair Propulsion Test and peak oxygen consumption., Design: Twenty manual wheelchair users with a spinal cord injury completed both tests. Aerobic parameters were measured before, during, and after the tests. Main outcome measures were peak oxygen consumption and total distance traveled., Results: Progressive cardiorespiratory responses, consistent with guidelines for exercise testing, were observed during both tests. Similar peak oxygen consumption values were obtained during both tests (6-Min Manual Wheelchair Propulsion Test: 20.2 ± 4.9 ml/kg·min; Maximal Arm Crank Ergometer Test: 20.4 ± 5.0 ml/kg·min), were highly correlated (r = 0.92, P < 0.001), and had a good agreement (mean absolute difference = 0.21, 95% confidence interval = -0.70 to 1.11, P = 0.639). The peak oxygen consumption and total distance traveled (mean = 636.6 ± 56.9 m) during the 6-Min Manual Wheelchair Propulsion Test were highly correlated (r = 0.74, P < 0.001)., Conclusions: The 6-Min Manual Wheelchair Propulsion Test induces progressive aerobic responses consistent with guidelines for exercise testing and can be used to efficiently estimate aerobic fitness in manual wheelchair users with a spinal cord injury., To Claim Cme Credits: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Explain how to administer the Six-Minute Manual Wheelchair Propulsion Test in long-term manual wheelchair users with a spinal cord injury; (2) Contrast how the workload is developed between the Six-Minute Manual Wheelchair Propulsion Test and the Maximal Arm Crank Ergometry Test and recognize how these differences may affect physiological responses; and (3) Explain why caution is advised regarding the use of the Six-Minute Manual Wheelchair Propulsion Test if aiming to estimate aerobic fitness., Level: Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Purpose: This study aimed to determine whether change in estimated cardiorespiratory fitness (eCRF) is associated with change in measured cardiorespiratory fitness (mCRF) independent of exercise amount and intensity over 24 wk., Methods: Participants were 163 sedentary adults with abdominal obesity (mean ± SD waist circumference, 109.9 ± 11.5 cm) randomly assigned to (i) no-exercise control (n = 42); (ii) low-amount, low-intensity exercise (LALI; n = 39); (iii) high-amount, low-intensity exercise (HALI; n = 51); and (iv) high-amount, high-intensity exercise (HAHI; n = 31). mCRF was measured using a maximal treadmill test at baseline, 8, 16, and 24 wk. eCRF was calculated using a published nonexercise equation with the following variables: sex, age, waist circumference, resting heart rate, and self-selected physical activity., Results: Participants attended 115 of 120 exercise sessions prescribed (96.0% ± 4.0% adherence). eCRF change from baseline to 8, 16, and 24 wk was not different from mCRF change for control, LALI, or HALI (P = 0.03). In HAHI, eCRF change was significantly greater than mCRF change at all time points (P < 0.001). Further analysis revealed that change in eCRF systematically overestimated and underestimated small and large changes in mCRF, respectively, in all groups (P < 0.001)., Conclusions: eCRF change was associated with mCRF change at 24 wk independent of exercise amount but not intensity. Systematic variation between eCRF and mCRF highlights a possible limitation when using eCRF to follow change in mCRF, specifically that eCRF does not capture the individual variability of the mCRF response.

Purpose: Cardiorespiratory fitness (CRF) is known to be directly related to fat-free mass (FFM), therefore, it has been suggested that normalizing CRF to FFM (V˙O2peakFFM) may be the most accurate expression of CRF as related to exercise performance and cardiorespiratory function. However, the influence of V˙O2peakFFM (mL·kg FFM·min) on predicting mortality has been largely unexplored. This study aimed to primarily assess the relationship between V˙O2peakFFM and all-cause and disease-specific mortality risk in apparently healthy adults. Further, this study sought to compare the predictive ability of V˙O2peakFFM to V˙O2peak normalized to total body weight (V˙O2peakTBW) for mortality outcomes., Methods: Participants included 2905 adults (1555 men, 1350 women) who completed a cardiopulmonary exercise test between 1970 and 2016 to determine CRF. Body composition was assessed using the skinfold method to estimate FFM. Cardiorespiratory fitness was expressed as V˙O2peakTBW and V˙O2peakFFM. Participants were followed for 19.0 ± 11.7 yr after their cardiopulmonary exercise test for mortality outcomes. Cox-proportional hazard models were performed to determine the relationship of V˙O2peakFFM with mortality outcomes. Parameter estimates were assessed to compare the predictive ability of CRF expressed as V˙O2peakTBW and V˙O2peakFFM., Results: Overall, V˙O2peakFFM was inversely related to all-cause, cardiovascular disease, and cancer mortality, with a 16.2%, 8.4%, and 8.0% lower risk per 1 mL·kg FFM·min improvement, respectively (P < 0.01). Further, assessment of the parameter estimates showed V˙O2peakFFM to be a significantly stronger predictor of all-cause mortality than V˙O2peakTBW (parameter estimates, -0.49 vs -0.16)., Conclusions: Body composition is an important factor when considering the relationship between CRF and mortality risk. Clinicians should consider normalizing CRF to FFM when feasible, because it will strengthen the predictive power of the measure.

Purpose: A single bout of aerobic or resistance exercise improves executive function. We sought to determine whether menstrual cycle variations in ovarian hormone concentrations differentially influence the expression and/or magnitude of a postexercise executive benefit., Methods: Eumenorrheic female participants completed 20-min single bouts of aerobic exercise (via cycle ergometer) at a moderate intensity (i.e., 80% of estimated lactate threshold) during the early follicular and midluteal phases of their menstrual cycle. Pre- and postexercise executive function was examined via antisaccades-an executive task requiring a saccade mirror-symmetrical to a visual stimulus. Antisaccades are an ideal tool for examining postexercise executive changes because the task is mediated via the same frontoparietal networks as modified following single-bout and chronic exercise., Results: Antisaccade reaction times decreased from the pre- to postexercise assessments by an average of 22 ms (P = 0.003), and this benefit was independent of changes in directional errors or end point accuracy (P's > 0.26). In other words, participants did not decrease their postexercise reaction times at the cost of increased planning times or execution errors. Most notably, the postexercise antisaccade benefit did not vary in magnitude across follicular or luteal phases (P = 0.33) and a two one-sided test statistic (i.e., equivalence testing) provided support for the null hypothesis (P = 0.008)., Conclusions: A postexercise executive benefit is independent of hormonal variations in the menstrual cycle. Further, our results evince that the phase of a female participant's menstrual cycle should not be a limiting factor in determining their inclusion in exercise neuroscience research.

Introduction: This study examines the role of nutritional status during exercise training in patients with type 2 diabetes mellitus by investigating the effect of endurance-type exercise training in the fasted versus the fed state on clinical outcome measures, glycemic control, and skeletal muscle characteristics in male type 2 diabetes patients., Methods: Twenty-five male patients (glycated hemoglobin (HbA1c), 57 ± 3 mmol·mol (7.4% ± 0.3%)) participated in a randomized 12-wk supervised endurance-type exercise intervention, with exercise being performed in an overnight-fasted state (n = 13) or after consuming breakfast (n = 12). Patients were evaluated for glycemic control, blood lipid profiles, body composition and physical fitness, and skeletal muscle gene expression., Results: Exercise training was well tolerated without any incident of hypoglycemia. Exercise training significantly decreased whole-body fat mass (-1.6 kg) and increased high-density lipoprotein concentrations (+2 mg·dL), physical fitness (+1.7 mL·min·kg), and fat oxidation during exercise in both groups (PTIME < 0.05), with no between-group differences (PTIME × GROUP > 0.05). HbA1c concentrations significantly decreased after exercise training (PTIME < 0.001), with a significant greater reduction after consuming breakfast (-0.30% ± 0.06%) compared with fasted state (-0.08% ± 0.06%; mean difference, 0.21%; PTIME × GROUP = 0.016). No interaction effects were observed for skeletal muscle genes related to lipid metabolism or oxidative capacity., Conclusions: Endurance-type exercise training in the fasted or fed state do not differ in their efficacy to reduce fat mass, increase fat oxidation capacity, and increase cardiorespiratory fitness and high-density lipoprotein concentrations or their risk of hypoglycemia in male patients with type 2 diabetes. HbA1c seems to be improved more with exercise performed in the postprandial compared with the postabsorptive state.

Purpose: This study assessed the cardiorespiratory capacity and running economy (RE) of a 59-yr-old ex-Olympian athlete who ran a marathon in 2:30:15 in 2019. The athlete retired from running at 32 yr old (best marathon performance: 2:13:59) for a 16-yr period after his participation at the Olympics., Methods: Heart rate (HR), oxygen uptake (V˙O2), ventilation (VE), blood lactate concentration (La), step frequency, and RE were measured during a treadmill-running test., Results: His HRmax, VEmax, Lamax, and V˙O2max were 165 bpm, 115 L·min, 5.7 mmol·L, and 65.4 mL·kg·min, respectively. At his marathon pace, his RE was 210 mL·kg·min with a step frequency of 199 ± 0.55 s·min, and his V˙O2 corresponded to 91% of his V˙O2max., Conclusion: This study shows that despite a 16-yr break in training, this 59-yr-old former Olympian marathoner has managed to limit the age-related decline in performance to ~5% per decade. More generally, these data suggest that high-level endurance masters athletes can limit the age-related decline in endurance performance at least until the age of 60 yr and can preserve their ability to sustain high-intensity effort (>90% of V˙O2max) for long-duration (2-3 h) exercises.

Background: Extracellular vesicles (EV) are purported to mediate type 2 diabetes and CVD risk and development. Physical activity and a balanced diet reduce disease risk, but no study has tested the hypothesis that short-term interval (INT) training would reduce EV compared with continuous (CONT) exercise in adults with prediabetes., Methods: Eighteen obese adults (age, 63.8 ± 1.5 yr; body mass index, 31.0 ± 1.3 kg·m) were screened for prediabetes using American Diabetes Association criteria (75 g oral glucose tolerance test). Subjects were randomized to INT (n = 10, alternating 3-min intervals at 90% and 50% HRpeak, respectively) or CONT (n = 8, 70% HRpeak) training for 12 supervised sessions over 13 d for 60 min·d. Cardiorespiratory fitness (V˙ O2peak), weight (kg), as well as ad libitum dietary intake were assessed and arterial stiffness (augmentation index via applanation tonometry) was calculated using total AUC during a 75-g oral glucose tolerance test performed 24 h after the last exercise bout. Total EV, platelet EV (CD31/CD41), endothelial EV (CD105; CD31/ CD41), platelet endothelial cell adhesion molecule (PECAM) (CD31), and leukocyte EV (CD45; CD45/CD41) were analyzed via imaging flow cytometry preintervention/postintervention., Results: The INT exercise increased V˙O2peak (P = 0.04) compared with CONT training. Although training had no effect on platelet or leukocyte EV, INT decreased Annexin V- endothelial EV CD105 compared with CONT (P = 0.04). However, after accounting for dietary sugar intake, the intensity effect was lost (P = 0.18). Increased ad libitum dietary sugar intake after training was linked to elevated AV+ CD105 (r = 0.49, P = 0.06) and AV- CD45 (r = 0.59, P = 0.01). Nonetheless, increased V˙O2peak correlated with decreased AV+ CD105 (r = -0.60, P = 0.01)., Conclusions: Interval exercise training decreases endothelial-derived EV in adults with prediabetes. Although increased sugar consumption may alter EV after a short-term exercise intervention, fitness modifies EV count.

Purpose: This case study examined the recovery after radical prostatectomy (RP) of an endurance-trained 65-yr-old man., Methods: A maximal incremental exercise test and a 1-h steady-state test were performed just before and 3 months after robotic RP to determine maximal oxygen consumption (V˙O2max) and other cardiorespiratory variables. The patient recorded his training as he prepared for an endurance event that was to occur 3 months after RP, the Norwegian Foot March, a 30-km road march carrying 11.4 kg., Results: In the month before RP, the patient performed 2 to 3 h of vigorous-intensity aerobic exercise per week, fast walking carrying an 11.4-kg pack, with the longest individual session being a 16-km road march. Just before surgery, V˙O2max was 36.7 mL·min·kg, HR during 30 min at 7.2 km·h and 0% grade was 77% of HR reserve (HRR), and during 30 min at 5.3 km·h and 10% grade was 92% HRR. On postsurgery day 44, he did a 19-km road march carrying 11.4 kg, exceeding the training level of the month presurgery. Three months postsurgery, V˙O2max was 42.7 mL·min·kg, and HR during the flat and uphill 30-min sessions at the same absolute intensity as presurgery were 70% and 83% HRR, respectively. He completed the Norwegian Foot March 93 d postsurgery in 4:24:37, with an average HR of 72% HRR., Conclusions: This case study demonstrates that an aerobically trained prostate cancer patient can return to high-level aerobic training in as little as 7 wk post-RP, and even exceed presurgery fitness. This finding has implications for prognosis given the beneficial effect of vigorous-intensity exercise on prostate cancer progression.

Introduction and Purpose: To examine the effect of cardiorespiratory fitness (CRF) and muscle power output (MPO) on bone mass of prepubertal and pubertal children using lean mass (LM) and percentage of fat mass (%FM) as mediator variables. The hypothesis was that both LM and %FM would be independent mediators of the relationships during the sexual maturation period., Methods: We analyzed 200 children (88 boys and 112 girls [11.5 ± 2.0 yr]). Body composition was analyzed by bone densitometry, and indirect calorimetry and cycle ergometer were used to calculate V˙O2peak (mL·kg·min) and MPO (W) during an incremental exercise test. Sample was divided by pubertal status., Results: In the prepubertal group, LM and %FM acted independently as mediators in the relationship between bone mass and CRF or MPO (22%-25% for LM and 37%-50% for %FM, respectively). In pubertal children, LM acted as mediator at 37%., Conclusions: Although the independent mediator role of LM and %FM in the associations between CRF or MPO and bone mass was present during the prepubertal stage, only LM remain its mediator role in these associations during the postpubertal period. Therefore, with growth and sexual maturation, the full effect of LM seems to increase, whereas the influence of %FM seems to disappear.

Background: No previous systematic review has examined the effect of high-intensity interval training (HIIT) interventions on body composition, cardiometabolic risk factors and cardiorespiratory fitness (CRF) in healthy schoolchildren from 5 to 12 years old., Methods: This study will be conducted by following the guideline of the preferred reporting items for systematic review and meta-analysis protocols. An electronic search in MEDLINE (via PubMed), EMBASE (via Scopus), SPORTDiscus, Cochrane Library and Web of Science databases of all dates from inception will be conducted. We will include randomized controlled trials aimed to assess the effectiveness of HIIT to improve cardiometabolic risk factors, body composition, and CRF in children. Two authors will perform the study selection and data collection; disagreements will be solved by a third reviewer. The methodological quality of studies will be assessed by the Cochrane Collaboration's tool for assessing risk of bias (RoB2). Data analysis and synthesis will be performed by Comprehensive Meta-analysis Software and StataSE software, version 15., Conclusion: The results should be disseminated through publication in a peer-reviewed journal. Since the data used in systematic reviews of this type will be extracted exclusively from published studies, approval form and ethics committee will not be required.

Purpose: To investigate the effects of 8 wk of upright water-based exercise training in people with type 2 diabetes., Methods: Thirteen participants with type 2 diabetes (54% male; 60.9 ± 9.6 yr, mean ± standard deviation) completed 8 wk of upright water-based exercise training at a moderate intensity (60%-80% of exercise test-derived maximum HR), for 1 h, three times a week (TG). Fourteen participants (64% male; 63.9 ± 9.8 yr) acted as a control group (CG) who maintained their usual activities. Preintervention and postintervention, participants performed cardiopulmonary exercise testing to determine V˙O2peak and one-repetition maximum testing to assess muscular strength. Blood profiles were assessed with standard assays. Body mass index and waist/hip ratio were employed as measures of anthropometry. Endothelium-dependent (brachial artery flow-mediated dilation) and independent (glyceryl trinitrate-mediated) function were assessed using vascular ultrasound., Results: Water-based training increased V˙O2peak (18.5 ± 4.3 mL·kg·min to 21.5 ± 5.4 mL·kg·min) (P = 0.002), overall muscle strength (123 ± 44 kg to 139 ± 43 kg) and leg strength (92 ± 28 kg to 104 ± 29 kg), compared with the CG (P = 0.001). The effect on pectoral strength (31 ± 17 kg to 35 ± 16 kg) was not significantly different to the CG (24 ± 12 kg to 26 ± 14 kg) (P = 0.08). No change was observed in anthropometry, blood profiles, or glyceryl trinitrate-mediated vascular function. Flow-mediated dilation was increased after training (6.1% ± 2.4% to 6.5% ± 3.0%), compared with controls who demonstrated a slight decrease (6.2% ± 1.6% to 5.4% ± 1.6%) (P = 0.002)., Conclusions: Water-based circuit training was well tolerated and appears to be an effective exercise modality for improving aerobic fitness, strength, and vascular function in people with type 2 diabetes.

Purpose: To examine the impact of a community-based exercise training intervention on cardiometabolic outcomes in African American men who have a family history of type 2 diabetes., Methods: The Aerobic Plus Resistance Training and Insulin Sensitivity in African American Men (ARTIIS) study randomized participants into either an exercise training intervention or an information only control group for 5 months. The exercise training intervention consisted of 150 min of moderate intensity aerobic activity and 2 d of resistance training per week, consistent with the current federal physical activity guidelines. Participants in the control group received monthly newsletters featuring topics focused heavily on type 2 diabetes education and prevention. Outcome data were analyzed using repeated-measures ANCOVA models and incorporating both intention-to-treat and per-protocol principles., Results: Adherence to the aerobic and resistance training prescriptions were between 77% and 79%. Despite significant within group improvements in glucose and insulin levels (fasting, 2 h, 2 h minus baseline) and Homeostatic Model 2-Insulin Resistance, there were not significant between group differences. There was a marginally significant between group difference for Homeostatic Model 2-Beta (P < 0.06), and significant between group differences in peak cardiorespiratory fitness (P < 0.001) and waist circumference (P = 0.03)., Conclusions: These findings suggest that exercise training in accordance with the current national recommendations is effective in improving some health parameters in middle-age African American men who have a family history of type 2 diabetes, but did not have a significant impact on glycemic status.

Purpose: This study aimed to assess 16-wk improvements of physical fitness, metabolic, and psychological parameters in people living with HIV (PLWH) exercising with the support of a smartphone application, as compared with a control group exercising without application., Methods: This was a randomized, open-label, pilot study enrolling PLWH in a 16-wk protocol consisting of moderate physical activity three times per week, which included an initial coach-supervised period of 4 wk, followed by 12 wk where participants trained independently. Participants were allocated to either an experimental group that trained using a smartphone application (APP) or a control group that practiced following a hard copy training program (No-APP). At baseline (BL) and after 16 wk (W16), patients were assessed for cardiorespiratory fitness, body composition, blood lipid profile, and POMS., Results: Forty-eight PLWH were screened and 38 were eligible: 20 were allocated to the APP group and 18 to the No-APP group. Two APP and two No-APP participants were lost to follow-up. Intention-to-treat analysis showed a W16 improvement from BL of ≥15% V˙ O2peak in 13 (72%) of 18 in APP, but only in 3 (19%) of 16 in No-APP participants (P = 0.025). Significant W16 improvements were observed in APP, but not in No-APP participants, in V˙O2peak; fat mass and fat-free mass percent; total cholesterol, LDL cholesterol, and triglycerides; vigor; and total mood by POMS. Accordingly, significant percent change differences between the APP and the No-APP groups were observed in V˙O2peak; fat and fat-free mass percent; total cholesterol, LDL cholesterol, and triglycerides; and depression, vigor, anger, and total mood by POMS., Conclusions: Exercising using a smartphone application improved cardiorespiratory fitness, body composition, cholesterol profiles, and psychological outcomes in PLWH.

Purpose: To evaluate the effects of the combination of exercise training (ET) and statins in people living with human immunodeficiency virus., Methods: This was a randomized, double-blind, placebo-controlled clinical trial. Eighty-three people living with human immunodeficiency virus were assigned to either placebo (PL), statins (STA), PL + ET (PLET) or STA + ET (STAET) groups. Volunteers assigned to STA and STAET groups were administered 10 mg of rosuvastatin, whereas the PL and PLET groups were administered a placebo. The PLET and STAET groups performed ET three times a week. Before and after the 12-wk follow-up, the volunteers underwent to anthropometric assessment and blood collection to evaluate lipid profile, cardiovascular markers, inflammatory profile; a Doppler ultrasound examination, muscle strength (MS) and cardiorespiratory fitness (CF) tests were performed., Results: There was a decrease in total cholesterol, triglycerides, low-density lipoprotein, C-reactive protein, fibrinogen, interleukin (IL)-1β and right carotid intima-media thickness in the STA, PLET, and STAET groups compared with PL group (P < 0.001). Furthermore, there was a decrease in total cholesterol, triglycerides, low-density lipoprotein, IL-1β, IL-6, and IL-8 levels and in left and right carotid intima-media thickness and an increase in HDL-c levels in the STAET groups compared with the STA (P ≤ 0.001) and PLET groups (P ≤ 0.001). There was an increase in IL-10 levels, peak-systolic velocity, end-diastolic velocity, wall shear rate in the PLET and STAET groups compared with the PL (P ≤ 0.001) and STA groups (P ≤ 0.001). The PLET and STAET groups reduced body fat mass, body fat percentage and increased lean body mass, MS and CF compared with PL (P ≤ 0.001) and STA (P ≤ 0.001) groups., Conclusions: The combination of ET and statins is useful to enhance lipid and inflammatory profiles, reduce cardiovascular disease markers, and improve Doppler ultrasound findings, MS and CF in people living with HIV.

Background: The relationship between the frequency of high-intensity interval training (HIIT) and the resultant adaptations is largely unclear., Purpose: This study compared the effects of different frequencies of HIIT with those of moderate-intensity continuous training (MICT) on body composition in overweight or obese adults., Methods: Fifty-six overweight or obese (body mass index = 26.4 ± 2.9) men between 18 and 30 yr old (age = 22.8 ± 3.1 yr) were randomly assigned to the following groups: no-intervention control (CON; n = 14), MICT performed thrice weekly (MICT×3/wk; n = 9), HIIT performed thrice weekly (HIIT×3/wk; n = 14), HIIT performed twice weekly (HIIT×2/wk; n = 10), and HIIT performed once weekly (HIIT×1/wk; n = 9). Each HIIT session consisted of 12 × 1-min bouts at 90% heart rate reserve, interspersed with 11 × 1-min bouts at 70% heart rate reserve. Aerobic capacity, body composition, resting heart rate, vascular function, insulin resistance, and biomarkers of metabolic syndrome risk factor were examined at baseline, after 4 wk, and after 8 wk of intervention., Results: Aerobic capacity and percent fat-free mass significantly increased in all exercise groups compared with those in the CON group (CON vs all exercise groups, P < 0.05), whereas body fat mass and systolic blood pressure significantly decreased after 8 wk of intervention in all exercise groups compared with those in the CON group (CON vs all exercise groups, P < 0.05). Body fat mass significantly decreased after 4 wk in all HIIT groups compared with those in the CON group (CON vs all HIIT groups, P < 0.05) but not in the MICT×3/wk group., Conclusion: These novel results demonstrated that performing HIIT once weekly, even with a lower weekly volume of exercise, improved cardiorespiratory fitness, body composition, and blood pressure in overweight/obese adults. Low-frequency HIIT might be a feasible and effective strategy for the prescription of an initial exercise program for inactive, overweight, or obese young men.

Introduction: Cardiorespiratory fitness is one of the most important markers of cardiometabolic health and is a strong predictor of cardiovascular disease and all-cause mortality across the lifespan. However, little is known regarding the relationship of area-level socioeconomic environment on cardiorespiratory fitness during childhood and adolescence., Purpose: To examine the relationship between area-level socioeconomic environment and cardiorespiratory fitness in a diverse sample of school-age youth; and to determine the extent to which grade level, sex, race/ethnicity, and student poverty status moderate this relationship., Methods: South Carolina FitnessGram data for school year 2015 to 2016 were obtained for 44,078 youth. Cardiorespiratory fitness was determined using Progressive Aerobic Cardiovascular Endurance Run or 1-mile run/walk test. Area-level socioeconomic environment was expressed as a composite index score at the census tract level using data from the American Community Survey. Multilevel logistic regression analyses were conducted, controlling for individual-level characteristics and nesting within schools and districts. Interaction terms were then introduced to the model to examine their effect of multiple sociodemographic moderators., Results: Approximately half of the sample had inadequate cardiorespiratory fitness for health. The odds of achieving the Healthy Fitness Zone for cardiorespiratory fitness decreased by approximately 25% to 34% with increasing deprivation of the area-level socioeconomic environment, after controlling for covariates. The association between area-level socioeconomic environment and cardiorespiratory fitness also varied significantly by sex, grade level, and race/ethnicity subgroups., Conclusions: Cardiorespiratory fitness was positively associated with area-level socioeconomic environment; however, the relationship varied by demographic characteristics. These results highlight the importance of examining the influence of area-level socioeconomic environment on health across the life span. Additional research is needed to explore how area-level socioeconomic environment may impact evidence-based efforts to improve youth cardiorespiratory fitness levels.