Effects of resistance training performed to repetition failure or non-failure on muscular strength and hypertrophy: A systematic review and meta-analysis

Purpose:We aimed to perform a systematic review and meta-analysis of the effects of training to muscle failure or non-failure on muscular strength and hypertrophy.Methods:Meta-analyses of effect sizes(ESs)explored the effects of training to failure vs.non-failure on strength and hypertrophy.Subgroup meta-analyses explored potential moderating effects of variables such as training status(trained vs.untrained),training volume(volume equated vs.volume non-equated),body region(upper vs.lower),exercise selection(multi-vs.single-joint exercises(only for strength)),and study design(independent vs.dependent groups).Results:Fifteen studies were included in the review.All studies included young adults as participants.Meta-analysis indicated no significant difference between the training conditions for muscular strength(ES=-0.09,95%confidence interval(95%CI):-0.22 to 0.05)and for hypertrophy(ES=0.22,95%CI:-0.11 to 0.55).Subgroup analyses that stratified the studies according to body region,exercise selection,or study design showed no significant differences between training conditions.In studies that did not equate training volume between the groups,the analysis showed significant favoring of non-failure training on strength gains(ES=-0.32,95%CI:-0.57 to-0.07).In the subgroup analysis for resistance-trained individuals,the analysis showed a significant effect of training to failure for muscle hypertrophy(ES=0.15,95%CI:0.03-0.26).Conclusion:Training to muscle failure does not seem to be required for gains in strength and muscle size.However,training in this manner does not seem to have detrimental effects on these adaptations,either.More studies should be conducted among older adults and highly trained individuals to improve the generalizability of these findings.     

Factors that affect heart rate variability following acute resistance exercise: A systematic review and meta-analysis

BackgroundThere is controversial evidence regarding the effect of acute resistance exercise (ARE) on heart rate variability (HRV) parameters, which indicates the activities of the cardiac autonomic nervous system. The aim of this study was to perform a systematic review and meta-analysis of the literature on the effect of ARE on HRV parameters and identify its possible moderating factors.MethodsThe PubMed–Medline, Web of Science, SPORTDiscus, and Cochrane Library databases were searched. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) declaration was followed, and the methodological quality of the studies was evaluated. The level of significance was set at p ≤ 0.05. Twenty-six studies met the inclusion criteria. Main effect analyses between pre- and post-test interventions demonstrated an increase in normalized units low frequency (p < 0.001; standardized mean difference (SMD) = 0.78; 95% confidence interval (95%CI): 0.46?1.11) and low frequency/high frequency ratio (p < 0.001; SMD = 0.82; 95%CI: 0.64?0.99) and a decrease in standard deviation of the normal-to-normal (NN) interval (p < 0.001; SMD = –0.58; 95%CI: –0.85 to –0.30), root mean square of the successive differences (p < 0.001; SMD = –1.01; 95%CI: –1.29 to –0.74), and normalized units high frequency (p < 0.001; SMD: –1.08; 95%CI: –1.43 to –0.73) following ARE in healthy individuals range: 15 ± 1 to 48 ± 2 years; mean ± SD).ResultsThere were differences between the subgroups in the number of sets used in an exercise (p = 0.05) for root mean square of the successive differences, as well as for exercise intensity (p = 0.01) and rest between sets (p = 0.05) for normalized units high frequency. Interestingly, there were differences between the subgroups in training volume for root mean square of the successive differences (p = 0.01), normalized units high frequency (p = 0.003) and normalized units low frequency (p = 0.02).ConclusionOverall, there was a withdrawal of cardiac parasympathetic and activation of cardiac sympathetic modulations following ARE, and these changes were greater with higher training volume ～30 min after ARE in healthy individuals. Furthermore, the number of sets, intensity, and rest between sets affected HRV parameters. However, gender, body mass index, and training status did not influence the changes in HRV parameters as a response to ARE.     

Cardiorespiratory fitness measured with cardiopulmonary exercise testing and mortality in patients with cardiovascular disease: A systematic review and meta-analysis

BackgroundCardiorespiratory fitness (CRF) is inversely associated with mortality in apparently healthy subjects and in some clinical populations, but evidence for the association between CRF and all-cause and/or cardiovascular disease (CVD) mortality in patients with established CVD is lacking. This study aimed to quantify this association.MethodsWe searched for prospective cohort studies that measured CRF with cardiopulmonary exercise testing in patients with CVD and that examined all-cause and CVD mortality with at least 6 months of follow-up. Pooled hazard ratios (HRs) were calculated using random-effect inverse-variance analyses.ResultsData were obtained from 21 studies and included 159,352 patients diagnosed with CVD (38.1% female). Pooled HRs for all-cause and CVD mortality comparing the highest vs. lowest category of CRF were 0.42 (95% confidence interval (95%CI): 0.28–0.61) and 0.27 (95%CI: 0.16–0.48), respectively. Pooled HRs per 1 metabolic equivalent (1-MET) increment were significant for all-cause mortality (HR = 0.81; 95%CI: 0.74–0.88) but not for CVD mortality (HR = 0.75; 95%CI: 0.48–1.18). Coronary artery disease patients with high CRF had a lower risk of all-cause mortality (HR = 0.32; 95%CI: 0.26–0.41) than did their unfit counterparts. Each 1-MET increase was associated with lower all-cause mortality risk among coronary artery disease patients (HR = 0.83; 95%CI: 0.76–0.91) but not lower among those with heart failure (HR = 0.69; 95%CI: 0.36–1.32).ConclusionA better CRF was associated with lower risk of all-cause mortality and CVD. This study supports the use of CRF as a powerful predictor of mortality in this population.     

The association of grip strength with cardiovascular diseases and all-cause mortality in people with hypertension: Findings from the Prospective Urban Rural Epidemiology China Study

BackgroundBoth hypertension and grip strength (GS) are predictors of mortality and cardiovascular disease (CVD), but whether these risk factors interact to affect CVD and all-cause mortality is unknown. This study sought to investigate the associations of GS with the risk of major CVD incidence, CVD mortality, and all-cause mortality in patients with hypertension.MethodsGS was measured using a Jamar dynamometer (Sammons Preston, Bolingbrook, IL, USA) in participants aged 35–70 years from 12 provinces included in the Prospective Urban Rural Epidemiology China Study. Cox frailty proportional hazards models were used to examine the associations of GS and hypertension and the outcomes of all-cause mortality and CVD incidence/mortality.ResultsAmong 39,862 participants included in this study, 15,964 reported having hypertension, and 9095 had high GS at baseline. After a median follow-up of 8.9 years (interquartile range, 6.7–9.9 years), 1822 participants developed major CVD, and 1250 deaths occurred (388 as a result of CVD). Compared with normotensive participants with high GS, hypertensive patients with high GS had a higher risk of major CVD incidence (hazard ratio (HR) = 2.39; 95% confidence interval (95%CI): 1.86–3.06; p < 0.001) or CVD mortality (HR = 3.11; 95%CI: 1.59–6.06; p < 0.001) but did not have a significantly increased risk of all-cause mortality (HR = 1.24; 95%CI: 0.92–1.68; p = 0.159). These risks were further increased if hypertensive participants whose GS level was low (major CVD incidence, HR = 3.31, 95%CI: 2.60–4.22, p < 0.001; CVD mortality, HR = 4.99, 95%CI: 2.64–9.43, p < 0.001; and all-cause mortality, HR = 1.93, 95%CI: 1.47–2.53, p < 0.001).ConclusionThe present study demonstrates that low GS is associated with the highest risk of major CVD incidence, CVD mortality, and all-cause mortality among hypertensive patients. High levels of GS appear to mitigate long-term mortality risk among hypertensive patients.     

Immediate effect of high-intensity exercise on brain-derived neurotrophic factor in healthy young adults: A systematic review and meta-analysis

BackgroundAlthough brain-derived neurotrophic factor (BDNF) has been identified as a molecular biomarker of the neurophysiological effects induced by exercise, the acute effects of high-intensity exercise (HIE) on BDNF levels are inconclusive. This study aims to estimate the immediate effects of HIE on BDNF levels in healthy young adults.MethodsA systematic search was conducted in the MEDLINE, Scopus, Cochrane CENTRAL, and SPORTDiscuss databases up to December 2020. Randomized controlled trials (RCTs) and non-RCTs reporting pre–post changes in serum or plasma BDNF after an acute intervention of HIE compared to a control condition were included. Pooled effect sizes (p-ESs) and 95% confidence intervals (95%CIs) were calculated for RCTs using a random effects model with Stata/SE (Version 15.0; StataCorp., College Station, TX, USA). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. PROPERO registration number: CRD42020221047.ResultsA total of 22 studies with 552 individuals (age range: 20–31 years; 59.1% male) were included. The meta-analysis included 10 RCTs that reported valid outcome data. Higher BDNF levels were observed when HIE interventions were compared with non-exercise (p-ES = 0.55, 95%CI: 0.12–0.98; I² = 25.7%; n = 4 studies) and light-intensity exercise (p-ES = 0.78, 95%CI: 0.15–1.40; I² = 52.4%; n = 3 studies) but not moderate-intensity exercise (p-ES = 0.93, 95%CI: –0.16 to 2.02; I² = 88.5%; n = 4 studies) conditions.ConclusionIn comparison to non-exercise or light-intensity exercises, an immediate increase in BDNF levels may occur when young adults perform HIE. Given the benefits obtained maximizing circulating BDNF when performing HIE and its potential effects on brain health, our findings suggest that HIE could be recommended by clinicians as a useful exercise strategy to healthy adults.     

Effects of exercise by type and duration on quality of life in patients with digestive system cancers: A systematic review and network meta-analysis

BackgroundThere is scant evidence regarding the effects of exercise type and duration on quality of life (QoL) in digestive system cancer (DSC) survivors. We aim to investigate the optimal type and duration of exercise to improve QoL for DSC survivors through a systematic review and network meta-analysis.MethodsA systematic literature search of PubMed, Embase, and Web of Science was performed. Eligibility for study inclusion was limited to studies that were randomized controlled trials involving all kinds of exercise in adult patients with DSCs, and the comparator was in standard care or other types of exercise. The primary outcome was QoL, including general health, physical health, mental health, and role function. Secondary outcomes included cancer-related symptoms such as fatigue, insomnia, depression, anxiety, and duration of hospital stay. The network meta-analyses were performed using a random-effect model.ResultsThe analysis included 32 eligible articles and a total of 2558 participants. Our primary outcome indicated that short-term aerobic exercise significantly enhanced general health (standardized mean difference (SMD) = 0.66, 95% credible intervals (CrIs): 0.05 to 1.30), and also contributed to a better mental health (SMD = 0.38, 95%CrI: –0.05 to 0.81) and role function (SMD = 0.48, 95%CrI: –0.27 to 1.20). Although without significant changes, short-term resistance exercise tended to increase the physical health of patients with DSCs (SMD = 0.69, 95%CrI: –0.07 to 1.50) and effective in alleviating fatigue (SMD = –0.77, 95%CrI: –1.50 to 0.01). Short-term aerobic exercise was related to a lower score of insomnia (SMD = –1.20, 95%CrI: –2.40 to 0.06), depression (SMD = –0.51, 95%CrI: –1.50 to 0.45), and anxiety (SMD = –0.45, 95%CrI: –1.30 to 0.34). All types of exercise related to a trend of declined hospital stays (–0.87 to –5.00 day). Long-term resistance exercise, however, was negatively associated with general health (SMD = –0.33, 95%CrI: –1.70 to 1.00), physical health (SMD = –0.18, 95%CrI: –1.30 to 0.90), and role function (SMD = –1.20, 95%CrI: –2.50 to 0.11).ConclusionThis study suggests that short-term aerobic exercise, with or without resistance exercise programs, enhances QoL (especially for general health) as well as relieves cancer-related symptoms for DSC survivors, while long-term resistance exercise may have negative effects, and thus should be adopted cautiously. These results provide important evidence for the management of DSCs.     

The potential of a year-round school calendar for maintaining children's weight status and fitness: Preliminary outcomes from a natural experiment

PurposeTo evaluate the potential of a year-round school calendar (180-day school year distributed across 12 months) as an intervention compared to a traditional school calendar (180-day school year distributed across 9 months) for mitigating children's weight gain and fitness loss via a natural experiment.MethodsHeight, weight, and cardiorespiratory fitness (CRF) (i.e., Fitnessgram Progressive Aerobic Cardiovascular Endurance Run) were measured in children (5–12 years old) in 3 schools (2 traditional, 1 year-round, n = 990 students, age = 8.6 ± 2.4 years, 53.1% male, 68.9% African American) from 1 school district. Structure (represented by the presence of a school day) was the independent variable. Changes in body mass index (BMI), age- and sex-specific BMI z-scores (zBMI), BMI percentile, percent of overweight or obese children, and CRF (Progressive Aerobic Cardiovascular Endurance Run laps completed) were assessed for summer 2017 (May–August 2017), school year 2017/2018 (August 2017–May 2018), and summer 2018 (May–August 2018). Primary analyses examined the overall change in weight and CRF from summer 2017 until summer 2018 via multilevel mixed effects regression, with group (traditional vs. year-round calendar), time, and a group-by-time interaction as the independent variables. Secondary regression analyses estimated differences in change within and between groups during each time period, separately.ResultsYear-round students gained less BMI (difference in ∆ = –0.44, 95% confidence interval (CI): –0.67 to –0.03) and less CRF (difference in ∆ = –1.92, 95%CI: –3.56 to –0.28) than students attending a traditional school overall. Compared with traditional students, during both summers, year-round students gained less BMI (summer 2017 difference in ∆ = –0.15, 95%CI: –0.21 to –0.08; summer 2018 difference in ∆ = –0.16, 95%CI: –0.24 to –0.07) and zBMI (summer 2017 difference in ∆ = –0.032, 95%CI: –0.050 to –0.010; summer 2018 difference in ∆ = –0.033, 95%CI: –0.056 to –0.009), and increased CRF (summer 2017 difference in ∆ = 0.40, 95%CI: 0.02–0.85; summer 2018 difference in ∆ = 0.23, 95%CI: –0.25 to 0.74). However, the opposite was observed for the school year, with traditional students gaining less BMI and zBMI and increasing CRF compared with year-round students (difference in BMI ∆ = 0.05, 95%CI: 0.03–0.07; difference in zBMI ∆ = 0.012, 95%CI: 0.005–0.019; difference in Progressive Aerobic Cardiovascular Endurance Run laps ∆ = –0.43, 95%CI: –0.58 to –0.28).ConclusionThe year-round school calendar had a small beneficial impact on children's weight status but not CRF. It is unclear if this benefit to children's weight would be maintained because gains made in the summer were largely erased during the school year. Trajectories of weight and CRF gain/loss were consistent with the structured days hypothesis.     

Metabolic response to 6-week aerobic exercise training and dieting in previously sedentary overweight and obese pre-menopausal women: A randomized trial

BackgroundThe aim of this study was to compare 6 weeks short-term moderate intensity aerobic exercise and dieting on serum metabolomics and cardio-metabolic risk factors in pre-menopausal women.MethodsNinety previously inactive overweight and obese (BMI 25–35 kg/m²) women (age 41.5 ± 7.6 years) were randomized to either a 6-week Nordic walking exercise program (EX, n = 45) or dietary counseling group (DI, n = 45). Body composition, serum glucose, insulin and lipids were measured. Serum low-molecular-weight metabolites and lipid constituents were analyzed by nuclear magnetic resonance spectroscopy. Measurements were done at baseline and 7 days after the last training session.ResultsSix weeks aerobic exercise program yielded reductions in serum free fatty acids (−34.7%, 95% confidence interval (CI), −50 to −18, p < 0.001), glucose (−9.6%, 95%CI, −15 to −4, p < 0.001) and homeostasis model assessment of insulin resistance (HOMA-IR) (−28.7%, 95%CI, −48 to −10, p = 0.005) without changes in body weight or fat mass. Diet counseling resulted in loss of body weight (1.5%, 95%CI, −2.3 to −0.7, p = 0.001) but no changes in free fatty acids, fasting glucose, or HOMA-IR were found.ConclusionOur results indicate that small weight loss does not produce measurable health benefits, whereas short-term regular aerobic exercise can improve glucose and lipid metabolism even in the absence of weight loss in previously sedentary overweight and obese women.     

Exercise attenuates bone mineral density loss during diet-induced weight loss in adults with overweight and obesity: A systematic review and meta-analysis

BackgroundWeight-loss-induced fat loss improves cardiometabolic health in individuals with overweight and obesity; however, weight loss can also result in bone loss and increased fracture risk. Weight-loss-induced bone loss may be attenuated with exercise. Our aim was to compare changes in bone mineral density (BMD) in adults with overweight and obesity who undertook diet-induced weight loss alone or in combination with exercise.MethodsWe included randomized controlled trials (RCTs) in adults with overweight or obesity (aged ≥18 years; body mass index ≥25 kg/m²) that prescribed diet-induced weight loss alone or in combination with supervised exercise, and measured any bone structural parameters. Risk of bias was assessed using the Cochrane Risk of Bias tool. Random-effects meta-analyses determined mean changes and net mean differences (95% confidence intervals (95%CIs)) in the percentage of areal BMD (aBMD) change between groups.ResultsWe included 9 RCTs. Diet-induced weight loss led to significant losses in femoral neck aBMD (mean change: −1.73% (95%CI: −2.39% to −1.07%), p < 0.001) and total hip aBMD (−2.19% (95%CI: −3.84% to −0.54%), p = 0.009). Femoral neck aBMD losses were significantly greater in the diet-induced weight loss group compared to the exercise plus diet-induced weight loss group (net difference: −0.88% (95%CI: −1.73% to −0.03%)); however, there were no differences in aBMD changes at any other skeletal site: total hip (−1.96% (95%CI: −4.59% to 0.68%)) and lumbar spine (−0.48% (95%CI: −1.81% to 0.86%)). aBMD changes did not differ significantly according to exercise modality (resistance exercise, aerobic exercise, or a combination of the two) during diet-induced weight loss.ConclusionDiet-induced weight loss led to greater femoral neck bone loss compared to diet-induced weight loss plus exercise. Bone loss at the total hip and lumbar spine was not attenuated by exercise during diet-induced weight loss. The lack of consistent skeletal benefits may be due to the insufficient duration and/or training intensities of most exercise interventions. Additional RCTs with appropriate, targeted exercise interventions should be conducted.     

The effects of plyometric jump training on lower-limb stiffness in healthy individuals: A meta-analytical comparison

PurposeThis study aimed to examine the effects of plyometric jump training (PJT) on lower-limb stiffness.MethodsSystematic searches were conducted in PubMed, Web of Science, and Scopus. Study participants included healthy males and females who undertook a PJT programme isolated from any other training type.ResultsThere was a small effect size (ES) of PJT on lower-limb stiffness (ES = 0.33, 95% confidence interval (95%CI): 0.07–0.60, z = 2.47, p = 0.01). Untrained individuals exhibited a larger ES (ES = 0.46, 95%CI: 0.08–0.84, p = 0.02) than trained individuals (ES = 0.15, 95%CI: ‒0.23 to 0.53, p = 0.45). Interventions lasting a greater number of weeks (>7 weeks) had a larger ES (ES = 0.47, 95%CI: 0.06–0.88, p = 0.03) than those lasting fewer weeks (ES = 0.22, 95%CI: ‒0.12 to 0.55, p = 0.20). Programmes with ≤2 sessions per week exhibited a larger ES (ES = 0.39, 95%CI: 0.01–0.77, p = 0.04) than programmes that incorporated >2 sessions per week (ES = 0.20, 95%CI: –0.10 to 0.50, p = 0.18). Programmes with <250 jumps per week (ES = 0.50, 95%CI: 0.02–0.97, p = 0.04) showed a larger effect than programmes with 250–500 jumps per week (ES = 0.36, 95%CI: 0.00–0.72, p = 0.05). Programmes with >500 jumps per week had negative effects (ES = –0.22, 95%CI: –1.10 to 0.67, p = 0.63). Programmes with >7.5 jumps per set showed larger effect sizes (ES = 0.55, 95%CI: 0.02–1.08, p = 0.04) than those with <7.5 jumps per set (ES = 0.32, 95%CI: 0.01–0.62, p = 0.04).ConclusionPJT enhances lower-body stiffness, which can be optimised with lower volumes (<250 jumps per week) over a relatively long period of time (>7 weeks).     

Cardiorespiratory fitness,white blood cell count,and mortality in men and women

BackgroundWe examined the associations of cardiorespiratory fitness (CRF) and white blood cell count (WBC) with mortality outcomes.MethodsA total of 52,056 apparently healthy adults completed a comprehensive health examination, including a maximal treadmill test and blood chemistry analyses. CRF was categorized as high, moderate, or low by age and sex; WBC was categorized as sex-specific quartiles.ResultsDuring 17.8 ± 9.5 years (mean ± SD) of follow-up, a total of 4088 deaths occurred. When regressed jointly, significantly decreased all-cause mortality across CRF categories was observed within each quartile of WBC in men. Within WBC Quartile 1, all-cause mortality hazard ratios (HRs) with a 95% confidence interval (95%CI) were 1.0 (referent), 1.29 (95%CI: 1.06?1.57), and 2.03 (95%CI: 1.42?2.92) for high, moderate, and low CRF categories, respectively (p for trend < 0.001). Similar trends were observed in the remaining 3 quartiles. With the exception of cardiovascular disease (CVD) mortality within Quartile 1 (p for trend = 0.743), there were also similar trends across CRF categories within WBC quartiles in men for both CVD and cancer mortality (p for trend < 0.01 for all). For women, there were no significant trends across CRF categories for mortality outcomes within Quartiles 1–3. However, we observed significantly decreased all-cause mortality across CRF categories within WBC Quartile 4 (HR = 1.05 (95%CI: 0.76?1.44), HR = 1.63 (95%CI:1.20?2.21), and HR = 1.87 (95%CI:1.29?2.69) for high, moderate, and low CRF, respectively (p for trend = 0.002)). Similar trends in women were observed for CVD and cancer mortality within WBC Quartile 4 only.ConclusionThere are strong joint associations between CRF, WBC, and all-cause, CVD, and cancer mortality in men; these associations are less consistent in women.     

No independent associations between physical activity and clinical outcomes among hospitalized patients with moderate to severe COVID-19

BackgroundRegular physical activity (PA) has been postulated to improve, or at least maintain, immunity across the life span. However, the link between physical (in)activity and coronavirus disease 2019 (COVID-19) remains to be established. This small-scale prospective cohort study is nested within a randomized controlled trial aimed to investigate the possible associations between PA levels and clinical outcomes among hospitalized patients with moderate to severe COVID-19.MethodsHospitalized patients with COVID-19 (mean age: 54.9 years) were recruited from the Clinical Hospital of the School of Medicine of the University of Sao Paulo (a quaternary referral teaching hospital) and from Ibirapuera Field Hospital, both located in Sao Paulo, Brazil. PA level was assessed using the Baecke Questionnaire of Habitual Physical Activity. The primary outcome was hospital length of stay. The secondary outcomes were mortality, admission to the intensive care unit (ICU), and mechanical ventilation requirement.ResultsThe median hospital length of stay was 7.0 ± 4.0 days, median ± IQR; 3.3% of patients died, 13.8% were admitted to the ICU, and 8.6% required mechanical ventilation. Adjusted linear regression models showed that PA indices were not associated with hospital length of stay (work index: β = –0.57 (95% confidence interval (95%CI): –1.80 to 0.65), p = 0.355; sport index: β = 0.43 (95%CI: –0.94 to 1.80), p = 0.536; leisure-time index: β = 1.18 (95%CI: –0.22 to 2.59), p = 0.099; and total activity index: β = 0.20 (95%CI: –0.48 to 0.87), p = 0.563). None of the PA indices were associated with mortality, admission to the ICU, or mechanical ventilation requirement (all p > 0.050).ConclusionAmong hospitalized patients with COVID-19, PA did not independently associate with hospital length of stay or any other clinically relevant outcomes. These findings should be interpreted as meaning that, among already hospitalized patients with more severe forms of COVID-19, being active is a potential protective factor likely outweighed by a cluster of comorbidities (e.g., type 2 diabetes, hypertension, weight excess) and older age, suggesting that the benefit of PA against the worsening of COVID-19 may vary across stages of the disease.     

A physically active lifestyle is related to a lower level of skin autofluorescence in a large population with chronic-disease (LifeLines cohort)

Background:Physical activity(PA)has substantial health benefits and is important in combatting chronic diseases,which have been associated with elevated levels of advanced glycation endproducts(AGEs).AGEs play a role in the aging process,and an association between PA and AGEs has been reported.We aimed to investigate the relationship between PA and AGE accumulation in a general population and in a population with chronic diseases.Methods:This large cross-sectional population study used data from adult participants in the LifeLines project,with participant information drawn from the LifeLines database as well data from patients with diabetes mellitus or renal and/or cardiovascular diseases.Tissue AGE accumulation was assessed non-invasively by skin-autofluorescence(SAF)using an AGE reader(DiagnOptics Technologies BV,Groningen,the Netherlands).PA was assessed using the short questionnaire to assess health-enhancing physical activity(SQUASH).Multivariate linear regression analyses were adjusted for age,body mass index,sex,and smoking status.Results:Data from 63,452 participants(general population n=59,177,chronic disease n=4275)were analyzed.The general population was significantly younger(43.58±11.77 years,mean±SD)and had significantly lower SAF(1.90±0.42 arbitrary units(AU))compared to the population with chronic disease(age:55.51±12.07 years;SAF:2.27±0.51 AU).In the group with chronic disease,more hours of moderate to vigorous physical activities per week were associated with lower SAF(β=-0.002,95%confidence interval(95%CI):-0.002 to-0.001).For the general population,there was no association between hours of moderate to vigorous activity and SAF(β=3.2×10^-5,95%CI:0.000-0.001,p=0.742).However,there was an association in the general population between total hours of PA per week and SAF(β=4.2×10^-4,95%CI:0.000-0.001,p<0.001),but this association was not found in the chronic disease population(β=-3.2×10^-4,95%CI:-0.001 to 0.000,p=0.347).Conclusion:Our study demonstrates that an inverse relationship exists between PA and AGE accumulation in the population with chronic disease.More hours of moderate to vigorous activity is associated a significantly decreased SAF.More PA is associated a lower SAF,even after for the established predictors(age,body mass index,smoking status,and sex).Our findings could help to promote health and prolong longevity.     

The effect of exercise interventions on resting metabolic rate: A systematic review and meta-analysis

ABSTRACT

The systematic review and meta-analysis evaluated the effect of aerobic, resistance and combined exercise on RMR (kCal·day^-1) and performed a methodological assessment of indirect calorimetry protocols within the included studies. Subgroup analyses included energy/diet restriction and body composition changes. Randomized control trials (RCTs), quasi – RCTs and cohort trials featuring a physical activity intervention of any form and duration excluding single exercise bouts were included. Participant exclusions included medical conditions impacting upon RMR, the elderly (≥65 years of age) or pregnant, lactating or post-menopausal women. The review was registered in the International Prospective Register of Systematic Reviews (CRD 42,017,058,503). 1669 articles were identified; 22 were included in the qualitative analysis and 18 were meta-analysed. Exercise interventions (aerobic and resistance exercise combined) did not increase resting metabolic rate (mean difference (MD): 74.6 kCal·day^-1[95% CI: ?13.01, 161.33], P = 0.10). While there was no effect of aerobic exercise on RMR (MD: 81.65 kCal·day^-1[95% CI: ?57.81, 221.10], P = 0.25), resistance exercise increased RMR compared to controls (MD: 96.17 kCal·day^-1[95% CI: 45.17, 147.16], P = 0.0002). This systematic review effectively synthesises the effect of exercise interventions on RMR in comparison to controls; despite heterogenous methodologies and high risk of bias within included studies.     

Prevalence of meeting 24-Hour Movement Guidelines from pre-school to adolescence: A systematic review and meta-analysis including 387,437 participants and 23 countries

BackgroundMeeting the 24-Hour Movement Guidelines (physical activity, screen time, and sleep duration) has been associated with positive health indicators. However, there are no previous meta-analyses that have examined the overall adherence to the 24-Hour Movement Guidelines from pre-school to adolescence across the world. Therefore, the main purpose of this systematic review and meta-analysis was to examine the overall (non)adherence to the 24-Hour Movement Guidelines among preschoolers, children, and adolescents worldwide.MethodsFour electronic databases (MEDLINE, Scopus, Web of Science, and Cochrane Database of Systematic Reviews) were searched for quantitative studies published in Spanish and English between January 2016 and May 2021. Studies that were conducted with apparently healthy participants and reported the overall (non)adherence to the 24-Hour Movement Guidelines in preschoolers and/or children and/or adolescents were included.ResultsSixty-three studies comprising 387,437 individuals (51% girls) aged 3–18 years from 23 countries were included. Overall, 7.12% (95% confidence interval (95%CI): 6.45%–7.78%) of youth met all three 24-Hour Movement Guidelines, and 19.21% (95%CI: 16.73%–21.69%) met none of the 3 recommendations. Concerning sex, adherence to all recommendations was significantly lower in girls (3.75%, 95%CI: 3.23%–4.27%) than in boys (6.89%, 95%CI: 5.89%–7.89%) (p < 0.001). However, there were no sex differences regarding adherence to any of the 3 individual recommendations (girls, 15.66%, 95%CI: 8.40%–22.92%; boys, 12.95%, 95%CI: 6.57%–19.33%). In terms of age group, adherence to the 3 recommendations was 11.26% (95%CI: 8.68%–13.84%), 10.31% (95%CI: 7.49%–13.12%), and 2.68% (95%CI: 1.78%–3.58%) in preschoolers, children, and adolescents, respectively. Conversely, 8.81% (95%CI: 5.97%–11.64%) of preschoolers, 15.57% (95%CI: 11.60%–19.54%) of children, and 28.59% (95%CI: 22.42%–34.75%) of adolescents did not meet any of the recommendations. South America was the region with the lowest adherence (all: 2.93%; none: 31.72%). Overall adherence to the 24-Hour Movement Guidelines was positively related to country Human Development Index (β = –0.37, 95%CI: –0.65 to –0.09; p = 0.010).ConclusionMost young people fail to meet the three 24-Hour Movement Guidelines, particularly adolescents, girls, and those who are from countries with a lower Human Development Index. Moreover, 1 in 5 young people did not meet any of these recommendations. Therefore, these results highlight the need to develop age- and sex-specific strategies to promote these movement behaviors from the early stages of life.     

Can physical activity eliminate the mortality risk associated with poor sleep? A 15-year follow-up of 341,248 MJ Cohort participants

BackgroundThis study examined the joint associations of sleep patterns and physical activity (PA) with all-cause, cardiovascular disease (CVD), and cancer mortality.MethodsA total of 341,248 adults (mean age = 39.7 years; men: 48.3%) were included in the study, with a 15-year follow-up. Participants reported sleep duration and disturbances (difficulty falling asleep, easily awakened, or use of sleeping medication). PA was classified into 4 levels: <7.5, 7.5–14.9, 15.0–29.9, and ≥30.0 metabolic equivalent hours per week (MET-h/week). To understand the joint associations of sleep patterns and PA with mortality, Cox proportional hazard models were conducted, with exposure variables combining sleep duration/disturbances and PA.ResultsCompared with the reference group (sleeping 6–8 h/day), individuals who slept >8 h/day had higher risk for all-cause mortality (hazard ratio (HR) = 1.307, 95% confidence interval (95%CI): 1.248–1.369), CVD mortality (HR = 1.298, 95%CI: 1.165–1.445), and cancer mortality (HR = 1.128, 95%CI: 1.042–1.220). Short sleep duration was not associated with mortality risk. Increased risk of all-cause and CVD mortality was found in participants who had difficulty falling asleep (HR = 1.120, 95%CI: 1.068–1.175; HR = 1.163, 95%CI: 1.038–1.304, respectively), and used sleeping medication (HR = 1.261, 95%CI: 1.159–1.372; HR = 1.335, 95%CI: 1.102–1.618, respectively) compared with those who slept well. Long sleep duration and sleep disturbances were not associated with risk of all-cause and CVD mortality among individuals achieving a PA level of ≥15 MET-h/week, and in particular among those achieving ≥30 MET-h/week.ConclusionLong sleep duration, difficulty falling asleep, and use of sleeping medication were related to a higher risk of death. Being physically active at a moderate intensity for 25–65 min/day eliminated these detrimental associations.     

The effects of a 20-week exercise program on blood-circulating biomarkers related to brain health in overweight or obese children: The ActiveBrains project

BackgroundEmerging research supports the idea that exercise positively affects neurodevelopment. However, the mechanisms linking exercise with brain health are largely unknown. We aimed to investigate the effect of exercise on (a) blood biomarkers selected based on previous evidence (brain-derived neurotrophic factor, β-hydroxybutyrate (BHB), cathepsin B (CTSB), kynurenine, fibroblast growth factor 21 (FGF21), soluble vascular cell adhesion molecule-1 (sVCAM-1)); and (b) a panel of 92 neurology-related proteins (discovery analysis). We also investigated whether changes in these biomarkers mediate the effects of exercise on brain health (hippocampal structure and function, cognitive performance, and mental health).MethodsWe randomized 81 overweight/obese children (10.1 ± 1.1 years, 41% girls) into 2 groups: either 20 weeks of aerobic plus resistance exercise or control. Candidate biomarkers were assessed using enzyme-linked immunosorbent assay (ELISA) for kynurenine, FGF21, and CTSB; colorimetry for β-hydroxybutyrate; and XMap for brain-derived neurotrophic factor and soluble vascular cell adhesion molecule-1. The 92 neurology-related proteins were analyzed by an antibody-based proteomic analysis.ResultsOur intervention had no significant effect on candidate biomarkers (all p > 0.05). In the discovery analysis, a reduction in circulating macrophage scavenger receptor type-I was observed (standardized differences between groups = –0.3, p = 0.001). This effect was validated using ELISA methods (standardized difference = –0.3, p = 0.01). None of the biomarkers mediated the effects of exercise on brain health.ConclusionsOur study does not support a chronic effect of exercise on candidate biomarkers. We observed that while chronic exercise reduced the levels of macrophage scavenger receptor type-I, it did not mediate the effects of exercise on brain health. Future studies should explore the implications of this novel biomarker for overall health.     

Adolescents’ perspectives on a school-based physical activity intervention: A mixed method study

PurposeTo examine adolescent experiences and perspectives of the GoActive intervention (ISRCTN31583496) using mixed methods process evaluation to determine satisfaction with intervention components and interpret adolescents’ experiences of the intervention process in order to provide insights for future intervention design.MethodsParticipants (n = 1542; 13.2 ± 0.4 years, mean ± SD) provided questionnaire data at baseline (shyness, activity level) and post-intervention (intervention acceptability, satisfaction with components). Between-group differences (boys vs. girls and shy/inactive vs. others) were tested with linear regression models, accounting for school clustering. Data from 16 individual interviews (shy/inactive) and 11 focus groups with 48 participants (mean = 4; range 2–7) were thematically coded. Qualitative and quantitative data were merged in an integrative mixed methods convergence matrix, which denoted convergence and dissonance across datasets.ResultsEffect sizes for quantitative results were small and may not represent substantial between-group differences. Boys (vs. girls) preferred class-based sessions (β = 0.2, 95% confidence interval (CI): 0.1–0.3); qualitative data suggested that this was because boys preferred competition, which was supported quantitatively (β = 0.2, 95%CI: 0.1–0.3). Shy/inactive students did not enjoy the competition (β = –0.3, 95%CI: –0.5 to –0.1). Boys enjoyed trying new activities more (β = 0.1, 95%CI: 0.1–0.2); qualitative data indicated a desire to try new activities across all subgroups but identified barriers to choosing unfamiliar activities with self-imposed choice restriction leading to boredom. Qualitative data highlighted critique of mentorship; adolescents liked the idea, but older mentors did not meet expectations.ConclusionWe interpreted adolescent perspectives of intervention components and implementation to provide insights into future complex interventions aimed at increasing young people's physical activity in school-based settings. The intervention component mentorship was liked in principle, but implementation issues undesirably impacted satisfaction; competition was disliked by girls and shy/inactive students. The results highlight the importance of considering gender differences in preference of competition and extensive mentorship training.     

The association between watching football matches and the risk of cardiovascular events: A meta-analysis

ABSTRACT

To comprehensively shed light on whether viewing football games is associated with a higher risk of cardiovascular disease (CVD). Electronic databases were searched through 17 May 2018. All studies focusing on the association between viewing football matches and the fatal or non-fatal CVD were identified. Viewing football matches was associated with a higher risk of fatal overall CVD (RR: 1.06, 95%CI: 1.01–1.12) in both men (RR: 1.13, 95%CI: 1.004–1.28) and women (RR: 1.08, 95%CI: 1.01–1.15). Subgroup analysis showed that failure of the team has a higher risk of fatal overall CVD (RR: 1.29, 95%CI: 1.15–1.45). However, lower risk of fatal overall CVD from spectators was observed when team obtained a victory (RR: 0.80, 95%CI: 0.66–0.96). For non-fatal CVD, viewing football matches was associated with a higher risk of non-fatal overall CVD (RR: 1.24, 95%CI: 1.09–1.41) in both men (RR: 1.73, 95%CI: 1.12–2.69) and women (RR: 1.25, 95%CI: 1.08–1.45). Subgroup analysis showed that viewing football matches was associated with a higher risk of non-fatal myocardial infarction (RR: 1.20, 95%CI: 1.04–1.38) in both men and women (RR: 1.51, 95%CI: 0.99–2.28; RR: 1.21, 95%CI: 1.08–1.36, respectively). No significant increase was found in fatal or non-fatal stroke. Viewing football matches was associated with a higher risk of the fatal and non-fatal CVD, especially in male spectators. The victory of team could have a lower risk of fatal CVD. Therefore, precautionary measures should be required for the reduction of healthcare burden in football matches.     

Acute cardiovascular responses to interval exercise: A systematic review and meta-analysis

ABSTRACT

Interval exercise training is increasingly recommended to improve health and fitness; however, it is not known if cardiovascular risk is different from continuous exercise protocols. This systematic review with meta-analyses assessed the effect of a single bout of interval exercise on cardiovascular responses that indicate risk of cardiac fibrillation and infarction compared to continuous exercise. Electronic databases Medline, CINAHL, Embase, Scopus and Cochrane were searched. Key inclusion criteria were: (1) intervals of the same intensity and duration followed by a recovery period and (2) reporting at least one of blood pressure, heart rate variability, arterial stiffness or function. Cochrane Risk of Bias tool and GRADE approach were used. Meta-analyses found that systolic blood pressure responses to interval exercise did not differ from responses to continuous exercise immediately (MD 8 mmHg [95% CI ?32, 47], p = 0.71) or at 60 min following exercise (MD 0 mmHg [95% CI ?2, 1], p = 0.79). However, reductions in diastolic blood pressure and flow-mediated dilation with interval exercise were observed 10–15 min post-exercise. The available evidence indicates that interval exercise does not convey higher cardiovascular risk than continuous exercise. Further investigation is required to establish the safety of interval exercise for clinical populations.