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Different modalities of exercise to reduce visceral fat mass and cardiovascular risk in metabolic syndrome: the RESOLVE randomized trial.
Dutheil, F, Lac, G, Lesourd, B, Chapier, R, Walther, G, Vinet, A, Sapin, V, Verney, J, Ouchchane, L, Duclos, M, et al
International journal of cardiology. 2013;(4):3634-42
Abstract
BACKGROUND Opinions differ over the exercise modalities that best limit cardiovascular risk (CVR) resulting from visceral obesity in individuals with metabolic syndrome (MetS). As little is known about the combined effects of resistance and endurance training at high volumes under sound nutritional conditions, we aimed to analyze the impact of various intensities of physical activity on visceral fat and CVR in individuals with MetS. METHODS 100 participants, aged 50-70 years, underwent a diet restriction (protein intake 1.2g/kg/day) with a high exercise volume (15-20 h/week). They were randomized to three training groups: moderate-resistance-moderate-endurance (re), high-resistance-moderate-endurance (Re), or moderate-resistance-high-endurance (rE). A one-year at-home follow-up (M12) commenced with a three-week residential program (Day 0 to Day 21). We measured the change in visceral fat and body composition by DXA, MetS parameters, fitness, the Framingham score and carotid-intima-media-thickness. RESULTS 78 participants completed the program. At D21, visceral fat loss was highest in Re (-18%, p<.0001) and higher in rE than re (-12% vs. -7%, p<.0001). Similarly, from M3, visceral fat decreased more in high-intensity-groups to reach a visceral fat loss of -21.5% (Re) and -21.1% (rE)>-13.0% (re) at M12 (p<.001). CVR, MetS parameters and fitness improved in all groups. Visceral fat loss correlated with changes in MetS parameters. CONCLUSION Increased intensity in high volume training is efficient in improving visceral fat loss and carotid-intima-media-thickness, and is realistic in community dwelling, moderately obese individuals. High-intensity-resistance training induced a faster visceral fat loss, and thus the potential of resistance training should not be undervalued (ClinicalTrials.gov number: NCT00917917).
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2.
[Age and effects of long-term cardiac training in patients with ischemic heart disease].
Kałka, D, Sobieszczańska, M, Marciniak, W, Markuszewski, L, Popielewicz-Kautz, A, Bak, A, Korzeniowska, J, Rusiecki, L, Janczak, J, Adamus, J
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 2007;(128):90-4
Abstract
UNLABELLED Ongoing with age decline of physical capacity reflects permanent processes of aging occurring in organism. It leads to a successive reduction of physical activity level, resulting with time in restrictions of independent life ability, which then causes anxiety and progressing social isolation. THE AIM Evaluation of relation between age and effort tolerance in patients with chronic ischemic heart disease and comparison of cardiac rehabilitation effects in two patient groups at significantly various age. MATERIAL AND METHOD The study comprised 103 patients (69 males and 34 females) at the mean age of 61.2 +/- 0,8 years. The patients were referred to rehabilitation because of undergone invasive treatment of IHD, using CABG (44 pts) and PTCA (48 pts), or acute coronary syndromes (11 pts). The study group was divided to the two subgroups, "A" and "B", differing significantly (p < 0.01) from each other by age. "A" group was constituted by 30 the youngest patients, with the mean age of 51.6 +/- 0.5 yrs, whereas "B" group comprised 30 the oldest patients, with the mean age of 70.9 +/- 0.6 yrs. The examined groups were comparable as to the drug treatment, clinical status, echocardiographic parameters and BMI values. During the observation period no changes in treatment and diet were made. The all patients were subjected to six-month cardiac rehabilitation, consisting of cycle ergometer training (3 times/week) and generally improving exercises (2 times/week). The parameters analyzed were the values of metabolic equivalent (MET) obtained at the initial and the final exercise treadmill test, likewise the delta of MET. RESULTS For a population of 103 patients with IHD, the negative, statistically significant correlation Pearson's coefficient between age and MET values of initial and final exercise tests and insignificant Pearson's coefficient between age and values of MET delta were obtained. Comparison analysis of the mean MET of initial and final exercise test and the mean MET delta did not show any significant differences between the both examined "A" (young) and "B" (old) groups. CONCLUSIONS In the examined patients with IHD, there were observed a negative, significant correlation between age and effort tolerance before and after the cardiac rehabilitation cycle, and a lack of significant correlation between age and delta of effort tolerance. There was found no considerable difference concerning a delta of effort tolerance between the patients with IHD falling into the young and the old groups.
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Evolution and variability in fitness test performance of Asian children and adolescents.
Macfarlane, DJ, Tomkinson, GR
Medicine and sport science. 2007;:143-167
Abstract
Although Asia represents well over half of the world's population, the comparative lack of resources and infrastructure in many of these countries is likely to have contributed to only sporadic data being available to examine secular changes and geographical variability in the fitness test performances of Asian children and adolescents. Given the concerns that currently exist in the development of childhood obesity including, in many Asian countries, knowledge on the secular changes in nutrition and physical fitness and activity would seem germane to developing proactive public health strategies. The aim of this study therefore was to summarize existing literature reporting explicitly on secular changes in the fitness test performance of Asian children and adolescents, and where possible, comment on the geographical variability of such performances. Using a meta-analytical strategy, this study summarizes the secular changes in power, speed and cardiovascular endurance test performance of over 23.5 million 6- to 19-year-olds from seven Asian countries, tested between 1917 and 2003. In addition, it summarizes the geographic variability in fitness test performance of Asian children and adolescents within, and outside of, Asia. There has been very little change in the power and speed test performances of Asian children and adolescents in recent decades, yet alarmingly, there have been consistent declines in cardiovascular endurance fitness performance across all studied Asian nations over the past 10-15 years. Given the association between cardiovascular endurance fitness and numerous degenerative conditions (e.g. diabetes, obesity and metabolic syndrome), recent declines in cardiovascular endurance fitness performance of Asian children and adolescents should be an issue of major concern for public health authorities throughout Asia.
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Hemorheologic effects of low intensity endurance training in sedentary patients suffering from the metabolic syndrome.
Aloulou, I, Varlet-Marie, E, Mercier, J, Brun, JF
Clinical hemorheology and microcirculation. 2006;(1-2):333-9
Abstract
Hemorheologic effects of exercise training ("hemorheologic fitness") are very different according to the mode and the intensity of this training. We previously reported that low intensity endurance training in sedentary patients suffering from the metabolic syndrome sumultaneously improved blood rheology, body composition and lipid oxidation at exercise. We aimed at analyzing the link among these improvements in 24 patients submitted to a 2 months targeted training designed for increasing exercise lipid oxidation. Variations of whole blood viscosity at high shear rate (etab 1000 s(-1)) were explained here by two statistically independent determinants: hematocrit and red cell rigidity. etab decreased in 16 subjects, but increased in 8, due to a rise in hematocrit. Changes in RBC rigidity appeared to reflect weight loss and decrease in LDL cholesterol. Plasma viscosity was related to cholesterol and its training-induced changes are related to those of VO2 max ) but not to lipid oxidation. Red cell aggregability (Myrenne) reflected both the circulating lipids (Chol, HDL and LDL) and the ability to oxidize lipids at exercise. Factors associated to a post-training decrease in aggregability (M1) were weight loss and more precisely decrease in fat mass, improvement in lipid oxidation, rise in HDL-Chol, and decrease in fibrinogen. On the whole the major determinant of hemorheologic improvement was an increase in cardiorespiratory fitness (VO2 max ), correlated with a decrease in plasma viscosity, rather than an improvement in lipid metabolism, although RBC aggregability and deformability exhibited clear relationships with lipid metabolism. For which reason Hct increased in 30% of the patients during this kind of training remains unclear.
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Biochemical aspects of overtraining in endurance sports : the metabolism alteration process syndrome.
Petibois, C, Cazorla, G, Poortmans, JR, Déléris, G
Sports medicine (Auckland, N.Z.). 2003;(2):83-94
Abstract
Recent studies have shown that endurance overtraining could result from successive and cumulative alterations in metabolism, which become chronic during training. The onset of this process is a biochemical alteration in carbohydrate (saccharide) metabolism. During endurance exercises, the amount of saccharide chains from two blood glycoproteins (alpha(2)-macroglobulin and alpha(1)-acid glycoprotein) was found to have decreased, i.e. concentrations of these proteins remained unchanged but their quality changed. These saccharide chains were probably used for burning liver glycogen stores during exercise. This step was followed by alterations in lipid metabolism. The most relevant aspect of this step was that the mean chain length of blood fatty acids decreased, i.e. the same amount of fatty acids were found within the blood, but overtrained individuals presented shorter fatty acids than well-trained individuals. This suggests that alterations appeared in the liver synthesis of long-chain fatty acids or that higher peroxidation of blood lipoparticles occurred. For the final step of this overtraining process, it was found that these dysfunctions in carbohydrate/lipid metabolism led to the higher use of amino acids, which probably resulted from protein catabolism. The evolution of three protein concentrations (alpha(1)-acid glycoprotein, alpha(2)-macroglobulin and IgG(3)) correlated with this amino acid concentration increase, suggesting a specific catabolism of these proteins. At this time only, overtraining was clinically diagnosed through conventional symptoms. Therefore, this process described successive alterations in exercise metabolism that shifted from the main energetic stores of exercise (carbohydrates and lipids) towards molecular pools (proteins) normally not substantially used for the energetic supply of skeletal muscles. Now, a general biochemical model of the overtraining process may be proposed which includes most of the previously identified metabolic hypotheses.
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Association of the metabolic syndrome with both vigorous and moderate physical activity.
Rennie, KL, McCarthy, N, Yazdgerdi, S, Marmot, M, Brunner, E
International journal of epidemiology. 2003;(4):600-6
Abstract
BACKGROUND Cross-sectional relationships between moderate and vigorous physical activity and the metabolic syndrome (MS) were examined in the Whitehall II study of civil servants (age 45-68 years). We assessed cardiovascular fitness and body mass index (BMI) as possible mediators of the observed association. METHODS Measures of 2-hour glucose, systolic blood pressure, fasting triglycerides, waist-hip ratio, and high density lipoprotein (HDL) cholesterol were obtained in 5153 white European participants. Participants in the most adverse sex-specific quintile for three or more of these risk factors were classified as having MS. Self-reported leisure-time physical activity was categorized into separate moderate and vigorous activity classes. BMI and resting heart rate (HR) were used to estimate body fatness and cardiovascular fitness respectively. RESULTS The odds ratios (95% CI) for having the metabolic syndrome in the top categories of vigorous and moderate activity were 0.52 (95% CI: 0.40, 0.67) and 0.78 (95% CI: 0.63, 0.96) respectively, adjusted for age, sex, smoking, alcohol intake, socioeconomic status, and other activity. Adjustment for BMI and resting HR substantially attenuated both of the above associations. CONCLUSIONS Moderate and vigorous physical leisure-time activity are each associated with reduced risk of being classified with MS independently of age, smoking, and high alcohol intake. Both vigorous and moderate activities may be beneficial to the MS cluster of risk factors among middle-aged populations. Reduced BMI and increased cardiovascular fitness may be important mediators of this association for both intensities of activity.
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[Skeletal muscles, physical activity and health].
Saltin, B, Helge, JW
Der Orthopade. 2000;(11):941-7
Abstract
The metabolic capacity of skeletal muscle plays a significant role for insulin sensitivity and the blood lipid profile. The metabolic capacity of the muscle is a function of the individual's physical activity level. This is also true for the content of type IIa muscle fibres, which is reduced, and the number of capillaries, which is elevated with muscle usage. Several of these skeletal muscle features are risk factors for or linked with life-style induced diseases such as type II diabetes, hypertension, hyperlipemia and obesity. The central role of the skeletal muscle and its functional metabolic capacity for life style diseases highlights the importance of people maintaining daily physical activity. This article focuses on the link between the metabolic capacity of skeletal muscle and the metabolic syndrome and briefly discusses the explanations for this relationship. As one important aspect if skeletal muscle has a high capacity for lipid oxidation, then more saturated fatty acids are oxidised and more unsaturated fatty acids are built in the phospholipid fraction of the plasma membrane, giving it more fluidity and improved insulin sensitivity. Moreover, the article points at the role of these fatty acids in activating genes via the PPAR-receptor system essential for enzyme and transport proteins in the lipid metabolism.