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.     

Effects of small-volume soccer and vibration training on body composition,aerobic fitness,and muscular PCr kinetics for inactive women aged 20–45

PurposeThe present study investigated the effects of 16 weeks of small-volume, small-sided soccer training soccer group (SG, n = 13) and oscillating whole-body vibration training vibration group (VG, n = 17) on body composition, aerobic fitness, and muscle PCr kinetics in healthy inactive premenopausal women in comparison with an inactive control group (CO, n = 14).MethodsTraining for SG and VG consisted of twice-weekly 15-min sessions with average heart rates (HRs) of ∼155 and 90 bpm respectively. Pre- and post-measurements of body composition (DXA), phosphocreatine (PCr) on- and off-kinetics, and HR measurements during standardised submaximal exercise were performed.ResultsAfter 16 weeks of training in SG, fat percentage was lowered (p = 0.03) by 1.7% ± 2.4% from 37.5% ± 6.9% to 35.8% ± 6.2% and the PCr decrease in the quadriceps during knee-extension ramp exercise was attenuated (4% ± 8%, p = 0.04), with no changes in VG or CO (time-group effect: p = 0.03 and p = 0.03). Submaximal exercise HR was also reduced in SG after 16 weeks of training (6% ± 5% of HR_max, p = 0.01).ConclusionShort duration soccer training for 16 weeks appears to be sufficient to induce favourable changes in body composition and indicators of aerobic fitness and muscle oxidative capacity in untrained premenopausal women.     

Sleep quality improved following a single session of moderate-intensity aerobic exercise in older women: Results from a pilot study

BackgroundPoor sleep quality is associated with adverse effects on health outcomes. It is not clear whether exercise can improve sleep quality and whether intensity of exercise affects any of the effects.MethodsFifteen healthy, non-obese (body mass index = 24.4 ± 2.1 kg/m², mean ± SD), sedentary (<20 min of exercise on no more than 3 times/week) older women (66.1 ± 3.9 years) volunteered for the study. Peak oxygen consumption (VO_2peak) was evaluated using a graded exercise test on a treadmill with a metabolic cart. Following a 7-day baseline period, each participant completed two exercise sessions (separated by 1 week) with equal caloric expenditure, but at different intensities (60% and 45% VO_2peak, sequence randomized) between 9:00 and 11:00 am. A wrist ActiGraph monitor was used to assess sleep at baseline and two nights following each exercise session.ResultsThe average duration of the exercise was 54 and 72 min, respectively at 60% (moderate-intensity) and 45% VO_2peak (light-intensity). Wake time after sleep onset was significantly shorter (p = 0.016), the number of awakenings was less (p = 0.046), and total activity counts were lower (p = 0.05) after the moderate-intensity exercise compared to baseline no-exercise condition.ConclusionOur data showed that a single moderate-intensity aerobic exercise session improved sleep quality in older women.     

Validity of long-term and short-term recall of occupational sitting time in Finnish and Chinese office workers

BackgroundAs sedentary behavior is a global health issue, there is a need for methods of self-reported sitting assessment. The accuracy and reliability of these methods should also be tested in various populations and different cultural contexts. This study examined the validity of long-term and short-term recall of occupational sitting time in Finnish and Chinese subgroups.MethodsTwo cohort groups of office-based workers (58.6% female, age range 22–67 years) participated: a Finnish group (FIN, n = 34) and a Chinese group (CHI, n = 36). Long-term (past 3-month sitting) and short-term (daily sitting assessed on 5 consecutive days) single-item measures were used to assess self-reported occupational sitting time. Values from each participant were compared to objectively measured occupational sitting time assessed via thigh-mounted accelerometers, with Spearman's rho (ρ) used to assess validity and the Bland-Altman method used to evaluate agreement. Coefficients of variation depicted day-to-day variability of time spent on sitting at work.ResultsIn the total study sample, the results showed that both long-term and short-term recall correlated with accelerometer-derived sitting time (ρ = 0.532, 95% confidence intervals (CI): 0.336–0.684, p < 0.001; ρ = 0.533, 95%CI: 0.449–0.607, p < 0.001, respectively). Compared to objectively measured sitting time, self-reported occupational sitting time was 2.4% (95%CI: −0.5% to 5.3%, p = 0.091) and 2.2% (95%CI: 0.7%–3.6%, p = 0.005) greater for long-term and short-term recall, respectively. The agreement level was within the range −21.2% to 25.9% for long-term recall, and −24.2% to 28.5% for short-term recall. During a 5-day work week, day-to-day variation of sitting time was 9.4% ± 11.4% according to short-term recall and 10.4% ± 8.4% according to accelerometry-derived occupational sitting time.ConclusionOverall, both long-term and short-term self-reported instruments provide acceptable measures of occupational sitting time in an office-based workplace, but their utility at the individual level is limited due to large variability.     

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.     

Is device-measured vigorous physical activity associated with health-related outcomes in children and adolescents? A systematic review and meta-analysis

ObjectiveThis study sought to analyze the prospective association between vigorous-intensity physical activity (VPA) and health-related outcomes in children and adolescents.MethodsStudies reporting associations between device-measured VPA and health-related factors in children and adolescents aged 3–18 years were identified through database searches (MEDLINE, EMBASE, and SPORTDiscus). Correlation coefficients were pooled if outcomes were reported by at least 3 studies, using DerSimonian-Laird random effects models.ResultsData from 23 studies including 13,674 participants were pooled using random effects models. Significant associations were found between VPA at baseline and overall adiposity (r = −0.09, 95% confidence interval (95%CI): –0.15 to –0.03; p = 0.002; I² = 89.8%), cardiometabolic risk score (r = –0.13, 95%CI: –0.24 to –0.02, p = 0.020; I² = 69.6%), cardiorespiratory fitness (r = 0.25, 95%CI: 0.15−0.35; p < 0.001; I² = 57.2%), and total body bone mineral density (r = 0.16, 95%CI: 0.06 to 0.25; p = 0.001; I² = 0%).ConclusionVPA seems to be negatively related to adiposity and cardiometabolic risk score and positively related to cardiorespiratory fitness and total body bone mineral density among children and adolescents at follow-up. Therefore, our findings support the need to strengthen physical activity recommendations regarding VPA due to its health benefits in children and adolescents.     

Longitudinal associations of physical activity and pubertal development with academic achievement in adolescents

Objective: We sought to investigate the longitudinal associations of moderate-to-vigorous physical activity(MVPA) and pubertal development with academic achievement in adolescents.Methods: A total of 635 adolescents(283 boys, 352 girls) aged 11-13 years participated in the study. MVPA was assessed by the Health Behaviour in School-aged Children study questionnaire, and pubertal development was assessed by the Pubertal Development Scale at beginning of the 6 th grade(baseline) and end of the 7 th grade(follow-up). Grade point average(GPA) at the end of Grades 5 and 7 was computed from data acquired from the school registers. The data were analyzed using linear regression and analyses of covariance.Results: In boys, MVPA was positively associated with GPA at baseline after adjustment for age(b = 0.144, 95% confidence interval(CI):0.028-0.260, p = 0.028). In girls, the Pubertal Development Scale was positively associated with GPA at baseline(b = 0.104, 95%CI: -0.004 to0.211, p = 0.058) and follow-up(b = 0.104, 95%CI: -0.002 to 0.211, p = 0.055) after adjustment for age, and these associations strengthened after further adjustment for MVPA(p < 0.05). Adolescents who were inactive at baseline or at baseline and follow-up had lower GPA during followup than their continuously highly active peers(mean difference = -0.301, 95%CI: -0.543 to -0.058, p = 0.009) and all other adolescents(mean difference = -0.247, 95%CI: -0.475 to -0.019, p = 0.029). These differences were greater in girls than in boys.Conclusion: Lower levels of MVPA were associated with lower GPA in boys at baseline. Girls who were continuously inactive had lower GPA over the follow-up period than those who were continuously active. Finally, earlier pubertal development was associated with better academic achievement in girls.     

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.     

Overweight and obesity in young adults with patellofemoral pain: Impact on functional capacity and strength

PurposeThis study aimed to (a) investigate the proportion of overweight/obesity in a cohort of young adults with patellofemoral pain (PFP) and (b) explore the association of body mass index (BMI), body fat, and lean mass with functional capacity and hip and knee strength in people with PFP.MethodsWe included a mixed-sex sample of young adults (18−35 years old) with PFP (n = 100). Measurements for BMI, percentage of body fat, and lean mass (assessed by bioelectrical impedance) were obtained. Functional capacity was assessed by the Anterior Knee Pain Scale, plank test, and single-leg hop test. Strength of the knee extensors, knee flexors, and hip abductors was evaluated isometrically using an isokinetic dynamometer. The proportion of overweight/obesity was calculated based on BMI. The association between BMI, body fat, and lean mass and functional capacity and strength was investigated using partial correlations, followed by hierarchical regression analysis, adjusted for covariates (sex, bilateral pain, and current pain level).ResultsA total of 38% of our cohort had their BMI categorized as overweight/obese. Higher BMI was associated with poor functional capacity (ΔR² = 0.06−0.12, p ≤ 0.001) and with knee flexion strength only (ΔR² = 0.04, p = 0.030). Higher body fat was associated with poor functional capacity (ΔR² = 0.05−0.15, p ≤ 0.015) and reduced strength (ΔR² = 0.15−0.23, p < 0.001). Lower lean mass was associated with poor functional capacity (ΔR² = 0.04−0.13, p ≤ 0.032) and reduced strength (ΔR² = 0.29− 0.31, p < 0.001).ConclusionBMI, body fat, and lean mass should be considered in the assessment and management of young people with PFP because it may be detrimental to function and strength.     

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.     

Assessment of causal effects of physical activity on neurodegenerative diseases: A Mendelian randomization study

BackgroundPhysical activity has been hypothesized to play a protective role in neurodegenerative diseases. However, effect estimates previously derived from observational studies were prone to confounding or reverse causation.MethodsWe performed a two-sample Mendelian randomization (MR) analysis to explore the causal association of accelerometer-measured physical activity with 3 common neurodegenerative diseases: Alzheimer''s disease (AD), Parkinson''s disease (PD), and amyotrophic lateral sclerosis (ALS). We selected genetic instrumental variants reaching genome-wide significance (p < 5 × 10⁻⁸) from 2 largest meta-analyses of about 91,100 UK Biobank participants. Summary statistics for AD, PD, and ALS were retrieved from the up-to-date studies in European ancestry led by the international consortia. The random-effect, inverse-variance weighted MR was employed as the primary method, while MR pleiotropy residual sum and outlier (MR-PRESSO), weighted median, and MR-Egger were implemented as sensitivity tests. All statistical analyses were performed using the R programming language (Version 3.6.1; R Foundation for Statistical Computing, Vienna, Austria).ResultsPrimary MR analysis and replication analysis utilized 5 and 8 instrumental variables, which explained 0.2% and 0.4% variance in physical activity, respectively. In each set, one variant at 17q21 was significantly associated with PD, and MR sensitivity analyses indicated them it as an outlier and source of heterogeneity and pleiotropy. Primary results with the removal of outlier variants suggested odds ratios (ORs) of neurodegenerative diseases per unit increase in objectively measured physical activity were 1.52 for AD (95% confidence interval (95%CI): 0.88–2.63, p = 0.13) and 3.35 for PD (95%CI: 1.32–8.48, p = 0.01), while inconsistent results were shown in the replication set for AD (OR = 1.06, 95%CI: 1.01–1.12, p = 0.02) and PD (OR = 0.99, 95%CI: 0.88–0.12, p = 0.97). Similarly, the beneficial effect of physical activity on ALS (OR = 0.51, 95%CI: 0.29–0.91, p = 0.02) was not confirmed in the replication analysis (OR = 0.96, 95%CI: 0.91–1.02, p = 0.22).ConclusionGenetically predicted physical activity was not robustly associated with risk of neurodegenerative disorders. Triangulating evidence across other studies is necessary in order to elucidate whether enhancing physical activity is an effective approach in preventing the onset of AD, PD, or ALS.     

Cardiorespiratory fitness and cancer in women: A prospective pilot study

PurposeTo assess the association between cardiorespiratory fitness (CRF) and the incidence and mortality from cancer in women, and to evaluate the potential public health implications for cancer prevention.MethodsMaximal exercise testing was performed in a pilot cohort of 184 women (59.3 ± 15.2 years) who were followed for 12.0 ± 6.9 years. Cox hazard models adjusted for established cancer risk factors and accounting for competing events were analyzed for all-type cancer incidence and mortality from cancer. Population-attributable risks and exposure impact number were determined for low CRF (<5 metabolic equivalents (METs)) as a risk factor.ResultsDuring the follow-up, 11.4% of the participants were diagnosed with cancer and 3.2% died from cancer. CRF was inversely and independently associated with cancer outcomes. For every 1-metabolic equivalent increase in CRF, there was a 20% decrease in the risk of cancer incidence (hazard ratio (HR) = 0.80, 95% confidence interval (CI): 0.69–0.92; p = 0.001) and a 26% reduction in risk of cancer mortality (HR = 0.74, 95%CI: 0.61–0.90; p = 0.002). The population-attributable risks of low CRF were 11.6% and 14% for incidence and mortality of cancer, respectively, and the respective exposure impact numbers were 8 and 20.ConclusionGreater CRF was independently associated with a lower risk of incidence and mortality from cancer in women. Screening for low CRF as a cancer risk factor and referring unfit individuals to a supervised exercise program could be a public health strategy for cancer prevention in middle-age women.     

Tai Ji Quan as antihypertensive lifestyle therapy: A systematic review and meta-analysis

BackgroundProfessional health organizations are not currently recommending Tai Ji Quan alongside aerobic exercise to treat hypertension. We aimed to examine the efficacy of Tai Ji Quan as antihypertensive lifestyle therapy.MethodsTai Ji Quan interventions published in English and Chinese were included when they involved healthy adults, reported pre- and post-intervention blood pressure (BP), and had a non-exercise/non-diet control group. We systematically searched 11 electronic databases for studies published through July 31, 2018, yielding 31 qualifying controlled trials. We (1) evaluated the risk of bias and methodological study quality, (2) performed meta-regression analyses following random-effects assumptions, and (3) generated additive models representing the largest possible clinically relevant BP reductions.ResultsParticipants (n = 3223) were middle-aged (56.6 ± 15.1 years of age, mean ± SD) adults with prehypertension (systolic BP (SBP) = 136.9 ± 15.2 mmHg, diastolic BP (DBP) = 83.4 ± 8.7 mmHg). Tai Ji Quan was practiced 4.0 ± 1.4 sessions/week for 54.0 ± 10.6 min/session for 22.3 ± 20.2 weeks. Overall, Tai Ji Quan elicited significant reductions in SBP (–11.3 mmHg, 95%CI: –14.6 to –8.0; d₊ = –0.75) and DBP (–4.8 mmHg, 95%CI: –6.4 to –3.1; d₊ = –0.53) vs. control (p < 0.001). Controlling for publication bias among samples with hypertension, Tai Ji Quan trials published in English elicited SBP reductions of 10.4 mmHg and DBP reductions of 4.0 mmHg, which was half the magnitude of trials published in Chinese (SBP reductions of 18.6 mmHg and DBP reductions of 8.8 mmHg).ConclusionOur results indicate that Tai Ji Quan is a viable antihypertensive lifestyle therapy that produces clinically meaningful BP reductions (i.e., 10.4 mmHg and 4.0 mmHg of SBP and DBP reductions, respectively) among individuals with hypertension. Such magnitude of BP reductions can lower the incidence of cardiovascular disease by up to 40%.     

Effects of aerobic training on serum omentin-1 and cardiometabolic risk factors in overweight and obese men

Abstract

Omentin-1 is a newly discovered protein expressed and secreted from visceral adipose tissue that increases insulin sensitivity. We examined the effects of 12 weeks of aerobic training on serum omentin-1 concentrations together with cardiovascular risk factors in overweight and obese men. Eighteen overweight and obese participants (age 43.1 ± 4.7 years, BMI ≥25 kg · m^?2) were assigned to exercise training (n = 9) and control (n = 9) groups. A matched control group of normal weight participants (n = 8; age 42.2 ± 3.8 years, BMI <25 kg · m^?2) were also recruited for baseline comparison. The obese exercise group participated in 12 weeks of progressive aerobic training 5 days a week. Measures of serum omentin-1, insulin resistance, lipid profiles, blood pressure, and body composition were obtained before and after the 12 weeks. At baseline, normal weight participants had significantly higher serum omentin-1 concentrations than overweight and obese participants, and there were inverse correlations between omentin-1 and each of waist circumference, fasting glucose, insulin resistance, total cholesterol, triglyceride, and systolic blood pressure (P < 0.05). After the aerobic training, waist circumference, percent body fat, fasting glucose, insulin resistance, triglyceride, total cholesterol, low-density lipoprotein cholesterol, and systolic blood pressure were all significantly decreased (P < 0.05). In contrast, serum omentin-1 concentration was significantly increased after the aerobic programme (P < 0.05), and correlated with changes in insulin resistance (r = ?0.67, P = 0.04), glucose (r = ?0.65, P = 0.05), waist circumference (r = ?0.70, P = 0.03), and aerobic fitness r = ?0.68, P = 0.04). Aerobic training resulted in an improvement in cardiometabolic risk factors in obese participants, and this improvement was accompanied by increased omentin-1 concentrations.     

The effect of acute aerobic exercise on central arterial stiffness,wave reflections,and hemodynamics in adults with diabetes: A randomized cross-over design

BackgroundIndividuals with diabetes have greater central arterial stiffness, wave reflections, and hemodynamics, all of which promote the accelerated cardiovascular pathology seen in this population. Acute aerobic exercise has been shown to be an effective strategy for reducing central arterial stiffness, wave reflections, and hemodynamics in healthy individuals; however, the effects of acute aerobic exercise in reducing these outcomes is not well established in people with diabetes. Recently, implementation of high-intensity interval exercise (HIIE) has shown superior improvements in cardiovascular health outcomes when compared to traditional aerobic exercise. Yet, the effect of HIIE on the aforementioned outcomes in people with diabetes is not known. The purpose of this study was to (i) describe the central arterial stiffness, wave reflections, and hemodynamic responses to a bout of HIIE and moderate-intensity continuous exercise (MICE) in adults with diabetes; and (ii) compare the effects of HIIE and MICE on the aforementioned outcomes.MethodsA total of 24 adult men and women (aged 29–59 years old) with type 1 (n = 12) and type 2 (n = 12) diabetes participated in a randomized cross-over study. All participants completed the following protocols: (i) HIIE: cycling for 4 × 4 min at 85%–95% of heart rate peak (HR_peak), interspersed with 3 min of active recovery at 60%–70%HR_peak; (ii) MICE: 33 min of continuous cycling at 60%–70%HR_peak; and (iii) control (CON): lying quietly in a supine position for 30 min.ResultsA significant group × time effect was found for changes in central systolic blood pressure (F = 3.20, p = 0.01) with a transient reduction for the HIIE group but not for the MICE or CON groups. There was a significant group × time effect for changes in augmentation index at a heart rate of 75 beats/min (F = 2.32, p = 0.04) with a decrease following for HIIE and MICE but not for CON. For all other measures of central arterial stiffness and hemodynamics, no significant changes were observed (p > 0.05).ConclusionA bout of HIIE appears to lead to a greater transient reduction in central systolic blood pressure than the reduction observed following MICE; however, both HIIE and MICE improved augmentation index at a heart rate of 75 beats/min in people with diabetes. There was no significant difference in response to HIIE and MICE in all outcomes. This provides preliminary evidence on the role of HIIE on such outcomes in people with diabetes.     

Handgrip strength and health outcomes: Umbrella review of systematic reviews with meta-analyses of observational studies

PurposeThe aim of the present study was to assess both the credibility and strength of evidence arising from systematic reviews with meta-analyses of observational studies on handgrip strength and health outcomes.MethodsAn umbrella review of systematic reviews with meta-analyses of observational studies was conducted. We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values, 95% prediction intervals, heterogeneity, small-study effects, and excess significance. We graded the evidence from convincing (Class I) to weak (Class IV).ResultsFrom 504 articles returned in a search of the literature, 8 systematic reviews were included in our review, with a total of 11 outcomes. Overall, nine of the 11 of the outcomes reported nominally significant summary results (p < 0.05), with 4 associations surviving the application of the more stringent p value (p < 10⁻⁶). No outcome presented convincing evidence. Three associations showed Class II evidence (i.e., highly suggestive): (1) higher handgrip values at baseline were associated with a minor reduction in mortality risk in the general population (n = 34 studies; sample size = 1,855,817; relative risk = 0.72, 95% confidence interval (95%CI): 0.67–0.78), (2) cardiovascular death risk in mixed populations (n = 15 studies; relative risk = 0.84, 95%CI: 0.78–0.91), and (3) incidence of disability (n = 7 studies; relative risk = 0.76, 95%CI: 0.66–0.87).ConclusionThe present results show that handgrip strength is a useful indicator for general health status and specifically for early all-cause and cardiovascular mortality, as well as disability. To further inform intervention strategies, future research is now required to fully understand mechanisms linking handgrip strength scores to these health outcomes.     

Prevalence and correlates of meeting the muscle-strengthening exercise recommendations among Chinese children and adolescents: Results from 2019 Physical Activity and Fitness in China—The Youth Study

PurposeThis study aimed to describe the national prevalence of Chinese children and adolescents who met the World Health Organization muscle-strengthening exercise (MSE) recommendations and identify correlates of meeting the MSE recommendations.MethodsCross-sectional data from the 2019 Physical Activity and Fitness in China—The Youth Study, a nationally representative sample of Chinese children and adolescents (n = 80,413; mean age = 13.7 years; 53.9% girls) and their parents, were analyzed. Children and adolescents who reported engaging ≥3 days (up to 7 days) of MSE per week were classified as meeting the MSE recommendations. MSE, demographics, lifestyle behaviors (sport participation, moderate-to-vigorous physical activity, screen time, and sleep duration), exercise intention, peer and parental support, and parental MSE participation were assessed through self-reports. Logistic regression models were used to determine the correlates of meeting the MSE recommendations. The analyses were completed in 2020.ResultsOverall, 39.3% of children and adolescents met the MSE recommendations. Girls, 10th–12th graders, minorities, those from lower income households and those from families with lower parental education were less likely to meet the MSE recommendations. Children and adolescents who were proficient in ≥2 sports were more likely to meet the MSE recommendations (adjusted odds ratio (aOR) = 1.44, 95% confidence interval (95%CI): 1.26–1.65), as were those with more moderate-to-vigorous physical activity (aOR = 1.57, 95%CI: 1.53–1.61). Additionally, children and adolescents with high exercise intention (aOR = 1.60, 95%CI: 1.51–1.69), those whose parents met the adult MSE recommendations (aOR = 1.46, 95%CI: 1.40–1.52), and those who received high peer (aOR = 1.27, 95%CI: 1.20–1.34) and parental support (aOR = 1.07, 95%CI: 1.04–1.12) were more likely to meet the MSE recommendations.ConclusionLess than two-fifths of Chinese children and adolescents met the World Health Organization MSE recommendations. The correlates identified in our study can help inform the development of school and community based strategies and policies to enhance participation in MSE and improve muscular fitness of all Chinese children and adolescents.     

Temporal trends in 6-minute walking distance for older Japanese adults between 1998 and 2017

BackgroundThe 6-minute walking distance (6MWD) is an excellent measure of both functional endurance and health. The primary aim of this study was to estimate temporal trends in 6MWD for older Japanese adults between 1998 and 2017; the secondary aim was to estimate concurrent trends in body size (i.e., height and mass) and self-reported participation in exercise/sport.MethodsAdults aged 65–79 years were included. Annual nationally representative 6MWD data (n = 103,505) for the entire period were obtained from the Japanese Ministry of Education, Culture, Sports, Science and Technology. Temporal trends in means (and relative frequencies) were estimated at the gender–age level by best-fitting sample-weighted linear/polynomial regression models, with national trends estimated by a post-stratified population-weighting procedure. Temporal trends in distributional variability were estimated as the ratio of coefficients of variation.ResultsBetween 1998 and 2017 there was a steady, moderate improvement in mean 6MWD (absolute = 45 m (95% confidence interval (95%CI): 43–47); percent = 8.0% (95%CI: 7.6%–8.4%); effect size = 0.51 (95%CI: 0.48–0.54)). Gender- and age-related temporal differences in means were negligible. Variability in 6MWD declined substantially (ratio of coefficients of variation = 0.89, 95%CI: 0.87–0.92), with declines larger for women compared to men, and for 75–79-year-olds compared to 65–74-year-olds. Correspondingly, there were moderate and negligible increases in mean height and mass, respectively, and negligible increases in the percentage who participated in exercise/sport at least 3 days per week and at least 30 min per session.ConclusionThere has been a steady, moderate improvement in mean 6MWD for older Japanese adults since 1998, which is suggestive of corresponding improvements in both functional endurance and health. The substantial decline in variability indicates that the temporal improvement in mean 6MWD was not uniform across the distribution. Trends in 6MWD are probably influenced by corresponding trends in body size and/or participation in exercise/sport.