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Effectiveness of HIIE versus MICT in Improving Cardiometabolic Risk Factors in Health and Disease: A Meta-analysis.
Mattioni Maturana, F, Martus, P, Zipfel, S, NIEß, AM
Medicine and science in sports and exercise. 2021;(3):559-573
Abstract
PURPOSE We aimed to investigate differences between high-intensity interval exercise (HIIE, including high-intensity interval training and sprint interval training) and moderate-intensity continuous training (MICT) on physical fitness, body composition, blood pressure, blood lipids, insulin and glucose metabolism, inflammation, and endothelial function. METHODS Differences between HIIE and MICT were summarized using a random-effects meta-analysis on the effect size (Cohen's d). A meta-regression was conducted using the following subgroups: population, age, training duration, men ratio, exercise type, baseline values (clinical relevant ranges), and type of HIIE. Studies were included if at least one of the following outcomes were reported: maximal oxygen uptake (V˙O2max), flow-mediated dilation (FMD), body mass index (BMI), body mass, percent body fat, systolic and diastolic blood pressure, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, total cholesterol, C-reactive protein (CRP), fasting glucose and insulin, glycated hemoglobin (HbA1c), and insulin resistance (HOMA-IR). A total of 55 studies were included. RESULTS Overall, HIIE was superior to MICT in improving V˙O2max (d = 0.40, P < 0.001) and FMD (d = 0.54, P < 0.05). Oppositely, MICT was superior to HIIE in improving HbA1c (d = -0.27, P < 0.05). No differences were observed in BMI (d = -0.02), body mass (d = -0.05), percent body fat (d = 0.04), systolic blood pressure (d = -0.04), diastolic blood pressure (d = 0.03), HDL (d = -0.05), LDL (d = 0.08), triglycerides (d = 0.03), total cholesterol (d = 0.14), CRP (d = -0.11), fasting insulin (d = 0.02), fasting glucose (d = 0.02), and HOMA-IR (d = -0.04). Moderator analyses indicated that the difference between HIIE and MICT was affected by different subgroups. CONCLUSION Overall, HIIE showed to be more effective in improving cardiovascular health and cardiorespiratory fitness, whereas MICT was superior in improving long-term glucose metabolism. In the process of personalized training counseling, health-enhancing effects of exercise training may be improved by considering the individual risk profiles.
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Broad-spectrum physical fitness benefits of recreational football: a systematic review and meta-analysis.
Milanović, Z, Pantelić, S, Čović, N, Sporiš, G, Mohr, M, Krustrup, P
British journal of sports medicine. 2019;(15):926-939
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Abstract
BACKGROUND A previous meta-analysis showed that maximal oxygen uptake increased by 3.51 mL/kg/min (95% CI 3.07 to 4.15) during a recreational football programme of 3-6 months in comparison with continuous moderate-intensity running, strength training or a passive control group. In addition, narrative reviews have demonstrated beneficial effects of recreational football on physical fitness and health status. OBJECTIVE The purpose of this systematic review and meta-analysis was to evaluate the magnitude of effects of recreational football on blood pressure, body composition, lipid profile and muscular fitness with reference to age, gender and health status. DESIGN Systematic review and meta-analysis. DATA SOURCES MEDLINE, PubMed, SPORTDiscus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Google Scholar were searched prior to 1 February 2017. In addition, Google Scholar alerts were set up in January 2012 to identify potential papers with the following key terms: recreational football, recreational soccer, street football and street soccer. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised and matched controlled trials with participants allocated to a recreational football group or any other type of exercises or passive control group were included. Training programmes had to last at least 2 weeks to meet the inclusion criteria. The primary outcome measures were blood pressure, resting heart rate, body composition, muscular fitness, and blood lipids and glucose tolerance. A total of 31 papers met the inclusion criteria and were included. RESULTS The effect of recreational football on systolic blood pressure (SBP) versus no-exercise controls was most likely extremely largely beneficial (effect size (ES)=4.20 mm Hg; 95% CI 1.87 to 6.53). In addition, a most likely very large beneficial (ES=3.89 mm Hg; 95% CI 2.33 to 5.44) effect was observed for diastolic blood pressure (DBP), when compared with non-active groups. Furthermore, a most likely extremely large beneficial effect was shown for SBP and DBP in participants with mild hypertension (11 and 7 mm Hg decrease, respectively) and participants with prehypertension (10 and 7 mm Hg decrease, respectively). Meta-analysis of recreational football determined the impact on resting heart rate as most likely extremely largely beneficial (ES=6.03 beats/min; 95% CI 4.43 to 7.64) when compared with non-active groups. The observed recreational football effect on fat mass was most likely largely beneficial (ES=1.72 kg; 95% CI 0.86 to 2.58) and the effect on countermovement jump (CMJ) performance was most likely very largely beneficial (ES=2.27 cm; 95% CI 1.29 to 3.25) when compared with non-active groups. Possibly beneficial decreases were found in low-density lipoprotein levels (ES=0.21 mmol/L; 95% CI 0.06 to 0.36). Possibly largely beneficial effect was observed for DBP in comparison with continuous running training. Small harmful and unclear results were noted for SBP, fat and lean body mass, body mass index, as well as muscular fitness when compared with running and Zumba training. CONCLUSION The present meta-analysis demonstrated multiple broad-spectrum benefits of recreational football on health-related physical fitness compared with no-exercise controls, including improvements in blood pressure, resting heart rate, fat mass, low-density lipoprotein cholesterol and CMJ performance. Additionally, recreational football is efficient and effective as Zumba and continuous running exercise regimens with highlighted social, motivational and competitive components.
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High-intensity interval training in overweight and obese children and adolescents: systematic review and meta-analysis.
Thivel, D, Masurier, J, Baquet, G, Timmons, BW, Pereira, B, Berthoin, S, Duclos, M, Aucouturier, J
The Journal of sports medicine and physical fitness. 2019;(2):310-324
Abstract
INTRODUCTION While High Intensity Interval Training is praised in many populations for its beneficial effects on body composition and cardiometabolic health, its use among obese youth remain uncertain. This study aimed at determining whether HIIT is effective to improve aerobic fitness and reduce cardiometabolic risk factors in overweight and obese youth. EVIDENCE ACQUISITION A systematic search was conducted and articles reporting studies that investigated the effects of HIIT in 6 to 18-year-old youth were eligible. Meta-analyses were performed when appropriate. EVIDENCE SYNTHESIS Fifteen studies were included for the systematic review and meta-analyses. HIIT significantly improves maximal oxygen uptake (1.117 [95% CI: 0.528 to 1.706], P<0.001), and reduces body mass (-0.295 [95% CI: -0.525 to -0.066], P<0.05), body fat (-0.786 [95% CI: -1.452 to -0.120], P<0.05), systolic and diastolic blood pressure (-1.026 [95% CI: -1.370 to -0.683], P<0.001; -0.966 [95% CI: -1.628 to -0.304], P<0.01 respectively), and the HOMA-IR (-1.589 [95% CI: -2.528 to -0.650], P<0.01). However, there is significant heterogeneity, and low to high inconsistency for most cardiometabolic risk factors and aerobic fitness. CONCLUSIONS Although few studies have reported cardiometabolic risks, HIIT may also be as effective as traditional endurance continuous training to decrease blood pressure and insulin resistance. HIIT is effective to improve aerobic fitness, body composition, and cardiometabolic risk factors in obese youth, but data are insufficient to determine whether it is more effective than traditional continuous submaximal intensity exercise training.
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Physical activity and fitness among pediatric cancer survivors: a meta-analysis of observational studies.
Antwi, GO, Jayawardene, W, Lohrmann, DK, Mueller, EL
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2019;(9):3183-3194
Abstract
PURPOSE The number of pediatric cancer survivors has increased dramatically over recent decades. Prior studies involving pediatric cancer survivors have reported reduced physical activity and fitness levels. Thus, the aim of this meta-analysis was to synthesize previous findings on physical activity and fitness levels of pediatric cancer survivors, who had completed cancer treatment and are in complete remission compared with age-matched, non-athletic healthy controls with no history of cancer diagnosis. METHODS Three electronic databases (PubMed, Web of Science, and EBSCO) were searched using a combination of 24 terms. Observational studies examining the post-treatment physical activity and/or fitness levels of pediatric cancer survivors compared with that of non-cancer controls and published in peer-reviewed, English-language journals before August 22, 2018 were eligible. Random-effect models were used in Comprehensive Meta-Analysis software for effect-size estimations of eight studies for physical activity and eight for fitness. RESULTS The studies included a total sample of 2628; 1413 pediatric cancer survivors and 1215 non-cancer controls. Both physical activity and fitness were significantly lower in childhood cancer survivors than in non-cancer controls (g = - 0.889; 95% confidence interval [CI] = - 1.648 - 0.130; p = 0.022) and (g = - 1.435; 95% CI = - 2.615 - 0.225; p = 0.017), respectively, with high heterogeneity. CONCLUSIONS Pediatric cancer sequelae and its treatment may limit participation in physical activity and fitness activities by survivors of pediatric cancer. Accentuating the need to incorporate physical activity and fitness into treatment protocols and post-treatment recommendations may improve pediatric cancer survivors' health and well-being.
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Supplemental protein from dairy products increases body weight and vitamin D improves physical performance in older adults: a systematic review and meta-analysis.
Dewansingh, P, Melse-Boonstra, A, Krijnen, WP, van der Schans, CP, Jager-Wittenaar, H, van den Heuvel, EGHM
Nutrition research (New York, N.Y.). 2018;:1-22
Abstract
The purpose of these systematic review and meta-analysis was to assess the effectiveness of dairy components on nutritional status and physical fitness in older adults, as evidence for efficacy of the supplementation of these components is inconclusive. Scopus and MEDLINE were searched. Main inclusion criteria for articles were as follows: double-blind, randomized, placebo-controlled trials including participants aged ≥55 years who received dairy components or a placebo. Outcome measures were nutrient status (body weight and body mass index) and physical fitness (body composition, muscle strength, and physical performance). Thirty-six trials with 4947participants were included. Most trials investigated protein and vitamin D supplementation and showed no effect on the outcomes. Meta-analysis on the effect of protein on body weight showed a significant increase in mean difference of 1.13 kg (95% confidence interval, 0.59-1.67). This effect increased by selecting trials with study a duration of 6 months in which less nourished and physically fit participants were included. Trials where the participants were (pre-)frail, inactive older adults or when supplementing ≥20 g of protein per day tended to increase lean body mass. Only small significant effects of vitamin D supplementation on Timed Up and Go (mean difference -0.75 seconds; 95% confidence interval -1.44 to -0.07) were determined. This effect increased when vitamin D doses ranged between 400 and 1000 IU. Additional large randomized controlled trials of ≥6 months are needed regarding the effect of dairy components containing an adequate amount of vitamin D (400-1000 IU) and/or protein (≥20 g) on nutritional status and physical fitness in malnourished or frail older adults.
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Effect of Breastfeeding in Early Life on Cardiorespiratory and Physical Fitness: A Systematic Review and Meta-Analysis.
Heshmati, J, Sepidarkish, M, Shidfar, F, Shokri, F, Vesali, S, Akbari, M, Omani-Samani, R
Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine. 2018;(4):248-258
Abstract
BACKGROUND Numerous studies have reported the associations between the type of feeding during infancy and subsequent chronic diseases. OBJECTIVE The objective of this systematic review is to synthesize the available literature concerning the effect of breastfeeding in infancy on physical and cardiorespiratory fitness in children and adolescents. MATERIALS AND METHODS We performed a comprehensive search of medical bibliographic databases to identify observational studies reporting the association between breastfeeding and cardiorespiratory or physical fitness. Random effects model was used for calculating the pooled estimates. RESULTS Three studies with 2,792 children were included in the meta-analysis. The mean value of VO2max was similar between formula-fed and 1-3 months breastfed participants (standardized mean difference [SMD]: 0.1, 95% confidence intervals [CI]: -0.09 to 0.29, p = 0.31). There was no difference between 3 and 6 months breastfed (SMD: 0.17, 95% CI: -0.01 to 0.35, p = 0.06), >6 months breastfed (SMD: 0.37, 95% CI: -0.03 to 0.78, p = 0.07), and formula-fed children. The pooled SMD in handgrip strength was 0.09 (95% CI: -0.04 to 0.23; p = 0.17) between 1 and 3 months breastfed and formula-fed children .Nevertheless, 3-6 months (SMD: 0.13; 95% CI: 0.03-0.24) and >6 months (SMD: 0.19; 95% CI: 0.01-0.37) breastfeeding was associated with higher handgrip strength compared with formula-fed children. Breastfeeding for 1-3 (SMD: 0.20; 95% CI: 0.12-0.28), 3-6 (SMD: 0.27; 95% CI: 0.18-0.37), and >6 months (SMD: 0.34; 95% CI: 0.11-0.58) led to a significantly higher standing long-jump performance compared with formula feeding. CONCLUSIONS Breastfeeding shows beneficial effects on physical fitness, but further well-designed studies need to clarify effects of breastfeeding on cardiorespiratory fitness.
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Comparison of Training Intensity Patterns for Cardiorespiratory, Speed, and Strength Exercise Programs.
Vetter, RE, Yu, H, Foose, AK, Adam, PJ, Dodd, RK
Journal of strength and conditioning research. 2017;(12):3372-3395
Abstract
Vetter, RE, Yu, H, Foose, AK, Adam, PJ, and Dodd, RK. Comparison of training intensity patterns for cardiorespiratory, speed, and strength exercise programs. J Strength Cond Res 31(12): 3372-3395, 2017-Designing effective exercise training programs is important for novice, regular, and elite individuals desiring improvements in physical fitness and performance outcomes without experiencing deleterious physiological or performance effects. The purpose of this research was to understand the impact of training intensity on the effectiveness of training program outcomes. Synthesized analyses of 31 studies provided an overall magnitude for the impact of training program intensity on effect size (ES). Meta-analyses were performed using meta-regression models to assess the impact of training program intensity and the other moderators of training frequency, training weeks, age, ability level, and type of physical exercise training. Inclusion criteria were (a) pretest and posttest outcomes, group size, and mean and SDs were given, (b) only human participants, age 17 or older, and healthy being free of disease, injury, or pregnancy, (c) no supplements or dietary interventions were used, (d) a minimum 4-week training intervention was used, and (e) training protocols included training intensity as its focus. Of the research reviewed, there were 31 studies representing 292 cases used to calculate ES, which met the inclusion criteria. Training frequency, training weeks, age, and ability level did not consistently affect the effectiveness of the different training programs. Intensity level influenced ES across the types of physical training programs: cardiorespiratory, muscular strength, or speed. An aggregated model had a curvilinear effect on training programs with an estimated critical average value of 74%. Muscular strength training using intensities greater than estimated 87.29% resulted in diminishing returns.
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High-intensity interval training for improving health-related fitness in adolescents: a systematic review and meta-analysis.
Costigan, SA, Eather, N, Plotnikoff, RC, Taaffe, DR, Lubans, DR
British journal of sports medicine. 2015;(19):1253-61
Abstract
BACKGROUND High-intensity interval training (HIIT) may be a feasible and efficacious strategy for improving health-related fitness in young people. The objective of this systematic review and meta-analysis was to evaluate the utility of HIIT to improve health-related fitness in adolescents and to identify potential moderators of training effects. METHODS Studies were considered eligible if they: (1) examined adolescents (13-18 years); (2) examined health-related fitness outcomes; (3) involved an intervention of ≥4 weeks in duration; (4) included a control or moderate intensity comparison group; and (5) prescribed high-intensity activity for the HIIT condition. Meta-analyses were conducted to determine the effect of HIIT on health-related fitness components using Comprehensive Meta-analysis software and potential moderators were explored (ie, study duration, risk of bias and type of comparison group). RESULTS The effects of HIIT on cardiorespiratory fitness and body composition were large, and medium, respectively. Study duration was a moderator for the effect of HIIT on body fat percentage. Intervention effects for waist circumference and muscular fitness were not statistically significant. CONCLUSIONS HIIT is a feasible and time-efficient approach for improving cardiorespiratory fitness and body composition in adolescent populations.
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Physical activity and physical self-concept in youth: systematic review and meta-analysis.
Babic, MJ, Morgan, PJ, Plotnikoff, RC, Lonsdale, C, White, RL, Lubans, DR
Sports medicine (Auckland, N.Z.). 2014;(11):1589-601
Abstract
BACKGROUND Evidence suggests that physical self-concept is associated with physical activity in children and adolescents, but no systematic review of this literature has been conducted. OBJECTIVE The primary aim of this systematic review and meta-analysis was to determine the strength of associations between physical activity and physical self-concept (general and sub-domains) in children and adolescents. The secondary aim was to examine potential moderators of the association between physical activity and physical self-concept. METHODS A systematic search of six electronic databases (MEDLINE, CINAHL, SPORTDiscus, ERIC, Web of Science and Scopus) with no date restrictions was conducted. Random effects meta-analyses with correction for measurement were employed. The associations between physical activity and general physical self-concept and sub-domains were explored. A risk of bias assessment was conducted by two reviewers. RESULTS The search identified 64 studies to be included in the meta-analysis. Thirty-three studies addressed multiple outcomes of general physical self-concept: 28 studies examined general physical self-concept, 59 examined perceived competence, 25 examined perceived fitness, and 55 examined perceived appearance. Perceived competence was most strongly associated with physical activity (r = 0.30, 95% CI 0.24-0.35, p < 0.001), followed by perceived fitness (r = 0.26, 95% CI 0.20-0.32, p < 0.001), general physical self-concept (r = 0.25, 95% CI 0.16-0.34, p < 0.001) and perceived physical appearance (r = 0.12, 95% CI 0.08-0.16, p < 0.001). Sex was a significant moderator for general physical self-concept (p < 0.05), and age was a significant moderator for perceived appearance (p ≤ 0.01) and perceived competence (p < 0.05). No significant moderators were found for perceived fitness. CONCLUSION Overall, a significant association has been consistently demonstrated between physical activity and physical self-concept and its various sub-domains in children and adolescents. Age and sex are key moderators of the association between physical activity and physical self-concept.
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Physical activity: from epidemiological evidence to individualized patient management.
Charansonney, OL, Vanhees, L, Cohen-Solal, A
International journal of cardiology. 2014;(3):350-7
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BACKGROUND Physical activity (PA), physical fitness (PF), and even a few sedentary behaviors (SB) are strongly and independently linked to improved survival rate. However, key questions remain: what are the physiological interrelationships between SB, PA, and PF? How should we differently emphasize promoting PA, increasing PF with exercise, and decreasing SB among other prevention measures? What are the interrelationships of both PA and SB levels with drug treatment efficacy? METHODS To address these questions we developed an integrated patient-centric model combining physiology with epidemiological evidence to characterize the individual risk attached to PA level, PF, and SB. Epidemiological data were collected by extensive literature review. RESULTS Nine meta-analyses, 198 cohort studies (3.8 million people), and 13 controlled trials were reviewed. 1. A high level of SB induces chronic stress and increases the risk of both chronic disease and mortality. 2. Vigorous PA increases PF and physiological reserve, thereby improving survival rate. This effect is not mediated by improved traditional risk factors. The risk for most individuals is a mix of high SB, low to mild PA, and low to mild PF. This model can improve the individualized prescription of PA modalities. Furthermore, the benefit of treatments such as statins or beta-blockers can be cancelled out if a decrease in PA or an increase in SB is induced by drug related side effects. CONCLUSIONS To improve patient management both types of therapeutic interventions and dose should be carefully chosen for each individual in order to maintain/increase PA level while decreasing SB.