Effects of prolonged exercise versus multiple short exercise sessions on risk for metabolic syndrome and the atherogenic index in middle-aged obese women: a randomised controlled trial

Effect of high-intensity interval training and moderate-intensity continuous training on cardiovascular risk factors in adolescents: Systematic review and meta-analysis of randomized controlled trials

BACKGROUND

In recent years, cardiovascular diseases in adolescents have become more serious. High intensity interval training (HIIT) and moderate intensity continuous training (MICT) have been shown to improve cardiovascular diseases in adolescents. Meta-analysis was conducted to compare the effects of HIIT and MICT on cardiovascular risk factors in adolescents.

METHODS

Randomised controlled trials of HIIT and MICT for cardiovascular risk factors in adolescents up to January 2023 were searched using authoritative databases such as CNKI, Web of Science, PubMed, and EBSCO. Data analysis was performed using Review Manage 5.4 and Stata 14.0.

RESULTS

A total of 12 studies involving 468 participants, mean age 15.19±4.35, were included in the study. The findings showed that compared with MICT, HIIT reduced adolescents' body weight (SMD=-0.18, 95 %CI=-0.58, 0.21) and increased maximal oxygen uptake (SMD=0.56, 95 %CI=0.20, 0.93) and high-density lipoprotein (SMD=-0.47, 95 % CI=-1.11, 0.17), and improved systolic blood pressure (SMD=-0.35, 95 %CI=-0.78, 0.09), glucose (SMD=-1.53, 95 %CI=-2.93, -0.13), and insulin (SMD=-0.66, 95 % CI=-1.73, 0.41), p<0.05. HIIT and MICT improved BMI, fat mass, diastolic blood pressure, triglycerides, total cholesterol, and LDL, with no significant difference between these training types.

CONCLUSION

HIIT was better than MICT for improving cardiovascular health in adolescents, with better effects on body weight, BMI, fat mass, systolic blood pressure, diastolic blood pressure, maximal oxygen uptake, triglyceride, total cholesterol, LDL, HDL, glucose, and insulin levels.

Effect of fixed 7.5 minutes' moderate intensity exercise bouts on body composition and blood pressure among sedentary adults with prehypertension in Western-Kenya

Prehypertension is a modifiable risk factor for cardiovascular disease observed to affect an estimated 25-59% of global population and closely associated with body composition. Without appropriate interventions, one-third of individuals with prehypertension would develop full-blown hypertension within 4 years. The existing exercise recommendations need substitutes that appeal more yet accord similar or better outcomes in desire to halt this progression. This study evaluated the effect of Fixed 7.5-minute Moderate Intensity Exercise (F-7.5m-MIE) bouts on Body Composition and Blood Pressure (BP) among sedentary adults with prehypertension in Western-Kenya in a Randomized Control Trial (RCT) performed throughout the day compared to the single-continuous 30-60-minute bouts performed 3 to 5 times weekly. This RCT, with three arms of Experimental Group1 (EG1) performing the F-7.5m-MIE bouts, Experimental Group 2 (EG2) performing current World Health Organization (WHO) recommendation of ≥30-min bouts, and, control group (CG), was conducted among 665 consenting pre-hypertensive sedentary adults enrolled from western Kenya. EG1 and EG2 performed similar weekly cumulative minutes of moderate intensity exercises. Adherence was determined using activity monitors and exercise logs. Data regarding demographic characteristics, heart rate, BP, and anthropometric measures were collected at baseline and 12th week follow-up. Data regarding univariate, bivariate and multivariate (repeated measurements between and within groups) analysis were conducted using STATA version 13 at 5% level of significance. The study revealed that males (92.1% in EG1, 92% in EG2 and 96.3% in CG) and females (94.6% in EG1, 89.3% in EG2 and 95% in CG) in the three arms completed the exercise at follow-up respectively. At 12th week follow-up from all exercise groups, males' and females' measurements for waist-hip-ratio, waist-height-ratio, systolic BP (SBP), heart rate and pulse pressure showed significant drops from baseline, while diastolic BP (DBP) and body mass index (BMI) reported mixed results for males and females from the various treatments. Both treatments demonstrated favourable outcomes. However, differences in the change between baseline and endpoint yielded mixed outcomes (SBP; p<0.05 for both males and females, DBP; p<0.05 for males and females, waist-height-ratio; p = 0.01 and <0.05 for males and females respectively, waist-hip-ratio; P = 0.01 and >0.05 for males and females respectively, BMI; p>0.05 for both males and females, heart rate; p<0.05 for males and females and pulse pressure; p = 0.01 and >0.05 for males and females respectively). The study design however could not test for superiority. The study demonstrated that the F-7.5m- MIE treatment programme and the WHO recommended 3-5 times weekly bouts of 30-60 minutes regime produced comparably similar favourable outcomes in adherence and BP reductions with improved body composition. Trial registration: Trial registered with Pan African Clinical Trial Registry (www.pactr.org): no. PACTR202107584701552. (S3 Text).

Mediterranean-Type Dietary Pattern and Physical Activity: The Winning Combination to Counteract the Rising Burden of Non-Communicable Diseases (NCDs)

Non-communicable diseases (NCDs) (mainly cardiovascular diseases, cancers, chronic respiratory diseases and type 2 diabetes) are the main causes of death worldwide. Their burden is expected to rise in the future, especially in less developed economies and among the poor spread across middle- and high-income countries. Indeed, the treatment and prevention of these pathologies constitute a crucial challenge for public health. The major non-communicable diseases share four modifiable behavioral risk factors: unhealthy diet, physical inactivity, tobacco usage and excess of alcohol consumption. Therefore, the adoption of healthy lifestyles, which include not excessive alcohol intake, no smoking, a healthy diet and regular physical activity, represents a crucial and economical strategy to counteract the global NCDs burden. This review summarizes the latest evidence demonstrating that Mediterranean-type dietary pattern and physical activity are, alone and in combination, key interventions to both prevent and control the rise of NCDs.

Low-grade chronic inflammation is attenuated by exercise training in obese adults through down-regulation of ASC gene in peripheral blood: a pilot study

Background

Obesity is characterized by low-grade chronic inflammation and an excess of adipose tissue. The ASC gene encodes a protein that is part of the NLRP3 inflammasome, a cytosolic multiprotein complex that is associated with inflammation and metabolic alterations. To our knowledge, there is no evidence regarding ASC gene activity in obese adults in response to lifestyle modifications.

Purpose

To evaluate the effect of hypocaloric diet and moderate-intensity structured exercise intervention on ASC gene expression and inflammatory markers in obese adults.

Methods

Thirty-seven obese individuals aged 25 to 50 years were randomized to the hypocaloric diet exercise group or hypocaloric diet group. The participants underwent a 4-month follow-up. Electrical bioimpedance was used for body composition analysis. Biochemical data were analyzed by dry chemistry and insulin levels by ELISA. ASC gene expression from peripheral blood was performed using real-time PCR. Dietary data was collected through questionnaires and analyzed using the Nutritionist Pro™ software. Quantification of cytokines was conducted using Bio-Plex Pro™ Human cytokine. The Astrand-Ryhming test was used to estimate the maximum oxygen volume and design the moderate-intensity structured exercise program ~ 75% heart rate (HR)

Results

After the intervention, both study groups significantly improved body composition (decreased weight, fat mass, waist circumference and abdominal obesity, p < 0.05). Besides, the diet-exercise group significantly decreased ASC mRNA expression, MCP-1, and MIP-1β inflammatory cytokines compared to the diet group (p < 0.05). While in the diet group, MCP-1 and IL-8 exhibited significantly decreased levels (p < 0.05). In the diet-exercise group, a positive correlation between the atherogenic index and waist circumference was found (r = 0.822, p = 0.011), and a negative correlation was observed between the delta of ASC mRNA expression and IL-10 levels at the end of the intervention (r = − 0.627, p = 0.019).

Conclusion

Low-grade chronic inflammation was attenuated through individualized exercise prescription and our findings highlight the role of the ASC gene in the inflammation of obese adults.

Trial registration

ClinicalTrials.gov, number NCT04315376. Registered 20 March 2020—retrospectively registered

Increased atherogenic index in the general hearing loss population

Purpose

The purpose of this study was to evaluate the association of hearing loss with atherogenic index (AI) in the general population.

Methods

A multistage study using cluster random sampling method was conducted in the Zhejiang province from 2016 to 2018. Pure-tone air-conduction hearing thresholds were measured at frequencies of 0.125-8 kHz for each subject. After obtaining their consent, all participants were asked to provide their own plasma lipid data.

Results

A total of 3,414 eligible participants were included, 1,765 (51.7%) were men and 1,649 (48.3%) were women and 1,113 (32.6%) had hearing loss. Ridge regression showed increased AI in subjects with hearing loss. The subgroup with the highest quartile of AI, presenting the highest risk of hearing loss as compared to the lowest quartile, comprised young and middle-aged women. Further analysis revealed that the AI in people with different categories of hearing loss was higher than that in the normal population, except for those with (extremely) severe hearing loss. Moreover, the young and middle-aged women exhibited the most significant correlations between AI and hearing loss.

Conclusion

AI was positively associated with hearing loss in the general population, especially the young and middle-aged women.

A comparison of acute glycaemic responses to accumulated or single bout walking exercise in apparently healthy, insufficiently active adults

OBJECTIVES

To investigate the acute glyacaemic response to accumulated or single bout walking exercise in apparently healthy adults.

DESIGN

Three arm, randomised crossover control study.

METHODS

Ten adults (age: 50±12.6 y; BMI 29.0±5.4kgm^-2) completed three separate trials comprising three 10-min walking bouts after breakfast, lunch, and dinner (APPW), a single 30-min walking bout after dinner only (CPPW), or a no-exercise control (NOEX). Participants walked on a treadmill at a moderate intensity of 55%-70% heart rate reserve. Two-hour postprandial glucose response was assessed using a continuous glucose monitor.

RESULTS

There was a difference in the pattern of the glucose response between the trials during the two hours following dinner (p<0.001). Postprandial dinner glucose concentrations were not different between APPW and CPPW but were up to 1.01mmolL^-1 lower than NOEX (partial eta²=0.21, p=0.041).

CONCLUSIONS

Ten minutes of moderate intensity walking completed 30min after each meal lowers postprandial dinner glucose concentrations in comparison to no-exercise, and reduces glucose by a similar magnitude as a single 30-min bout after the evening meal. Short bouts of exercise after each meal may be recommended to minimise glucose elevations after dinner that might increase risk of cardiometabolic disease.

Association between Bout Duration of Physical Activity and Health: Systematic Review

PURPOSE

This study aimed to conduct a systematic literature review to determine whether physical activity episodes of <10 min in duration have health-related benefits or, alternatively, if the benefits are only realized when the duration of physical activity episodes is ≥10 min.

METHODS

The primary literature search was conducted for the 2018 Physical Activity Guidelines Advisory Committee Report and encompassed literature through June 2017, with an additional literature search conducted to include literature published through March 2018 for inclusion in this systematic review.

RESULTS

The literature review identified 29 articles that were pertinent to the research question that used either cross-sectional, prospective cohort, or randomized designs. One prospective cohort study (N = 4840) reported similar associations between moderate to vigorous physical activity (MVPA) and all-cause mortality when examined as total MVPA, MVPA in bouts ≥5 min in duration, or MVPA in bouts ≥10 min in duration. Additional evidence was identified from cross-sectional and prospective studies to support that bouts of physical activity <10 min in duration are associated with a variety of health outcomes. Randomized studies only examined bouts of physical activity ≥10 min in duration.

CONCLUSIONS

The current evidence, from cross-sectional and prospective cohort studies, supports that physical activity of any bout duration is associated with improved health outcomes, which includes all-cause mortality. This may suggest the need for a contemporary paradigm shift in public health recommendations for physical activity, which supports total MVPA as an important lifestyle behavior regardless of the bout duration.

The Effects of Continuous Compared to Accumulated Exercise on Health: A Meta-Analytic Review

BACKGROUND

Public health guidelines suggest that physical activity can be accumulated in multiple short bouts dispersed through the day. A synthesis of the evidence for this approach is lacking.

OBJECTIVE

Our objective was to undertake a systematic review and meta-analysis to examine if exercise interventions consisting of a single bout of exercise compared with interventions comprising the same total duration, mode, and intensity of exercise accumulated over the course of the day have different effects on health outcomes in adults.

METHODS

Six electronic databases were searched (Jan 1970-29 August 2018). Two authors identified studies that evaluated the effects of a single bout of exercise compared with the same intensity, total duration, and mode of exercise accumulated in multiple bouts over the course of a day, in community-dwelling adults. Risk of bias was assessed using the Cochrane Collaboration tool. Pooled effects were reported as standardised mean differences (MDs) and 95% confidence intervals (CIs) using a random effects model.

RESULTS

A total of 19 studies involving 1080 participants met the inclusion criteria. There were no differences between accumulated and continuous groups for any cardiorespiratory fitness or blood pressure outcomes. A difference was found in body mass changes from baseline to post-intervention in favour of accumulated exercise compared with continuous (MD - 0.92 kg, 95% CI - 1.59 to - 0.25, I2 = 0%; five studies, 211 participants). In subgroup analyses, accumulating > 150 min of weekly exercise in multiple bouts per day resulted in small effects on body fat percentage (combined post-intervention and change from baseline values: MD - 0.87%, 95% CI - 1.71 to - 0.04, I2 = 0%; three studies, 166 participants) compared with 150 min of exercise amassed via single continuous bouts per day. There was a decrease in low-density lipoprotein (LDL) cholesterol with accumulated versus continuous exercise (MD - 0.39 mmol/l, 95% CI - 0.73 to - 0.06, I2 = 23%; two studies, 41 participants). No differences were observed for any other blood biomarker (total cholesterol, high-density lipoprotein cholesterol, triglycerides, fasting blood glucose, and fasting insulin).

CONCLUSIONS

There is no difference between continuous and accumulated patterns of exercise in terms of effects on fitness, blood pressure, lipids, insulin and glucose. There is some evidence from a small number of studies that changes in body mass and LDL cholesterol are more favourable following the accumulated condition. Collectively our findings suggest that adults are likely to accrue similar health benefits from exercising in a single bout or accumulating activity from shorter bouts throughout the day. This review will inform public health guidelines for physical activity at the global and national levels (PROSPERO 2016 CRD42016044122).

Effects of HIIT and MICT on cardiovascular risk factors in adults with overweight and/or obesity: A meta-analysis

Objective

The purpose of this study was to evaluate the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on cardiovascular disease (CVD) risk factors in adults with overweight and obesity.

Methods

Twenty-two articles were included by searching six databases, the total number of subjects was 620 in these articles. Outcomes were synthesised using a random-effects meta-analysis of the Standardized mean difference (SMD) in CVD risk factors.

Results

HIIT and MICT resulted in statistically significant reductions in Weight, BMI, fat%, total cholesterol(TC), and improvement in VO_2max. Compared with MICT, subgroup of durations of HIIT training interval ≥2 min can significantly increase VO_2max (SMD = 0.444, 95% CI:0.037~0.851,P = 0.032), subgroup of energy expenditure of HIIT equal to MICT can significantly increase VO_2max (SMD = 0.399, 95% CI:0.106~0.692,P = 0.008).

Conclusions

HIIT appears to provide similar benefits to MICT for improving body composition, VO_2maxand TC, but HIIT spent less time than MICT by 9.7 min on one session. HIIT is superior to MICT in improving cardiopulmonary fitness when durations of HIIT training interval ≥2 min or energy expenditure of HIIT same as MICT. PROSPERO ID: CRD42016045835.

Atherogenic Index in Type 2 Diabetes and Its Relationship with Chronic Microvascular Complications

OBJECTIVE

This study was designed to investigate risk factors related to atherogenic index of plasma (AIP), as well as the relationship between AIP and chronic microvascular complications in patients with type 2 diabetes (T2DM).

METHODS

This study included 2523 patients with T2DM who had not been treated with lipid-lowering drugs and were admitted to the Department of Endocrinology at Zhongnan Hospital, Wuhan University, during the period from January 2015 to February 2018. Anthropometric indicators were measured after overnight fasting. Low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglyceride (TG) were detected by enzymatic analysis. Standard 75 g oral glucose tolerance testing was performed to measure 0 and 2 hr plasma levels of glucose and insulin. Insulin sensitivity was assessed with HOMA-IR.

RESULTS

Increase in AIP was associated with an increased risk for hypertension (P < 0.05), HbA_1c (P < 0.05), HOMA-IR (P < 0.05), UA (P < 0.05), and decreased eGFR levels (P < 0.05). Furthermore, AIP values directly correlated with BMI (r = 0.182, P < 0.001), waist circumference (r = 0.129, P < 0.001), blood glucose index (FBG (r = 0.153, P < 0.001), PPBG (r = 0.117, P < 0.001), and HbA_1c (r = 0.074, P < 0.001)), insulin resistance (HOMA-IR; r = 0.112, P < 0.001), and uric acid (UA, r = 0.177, P < 0.001). Multiple logistic regression analysis showed that waist circumference, HOMA-IR, FBG, systolic blood pressure, and UA were independent risk factors for AIP (all P < 0.05). The prevalence of diabetic neuropathy and metabolic syndrome was significantly higher among patients with higher AIP.

CONCLUSION

AIP represents a clinically convenient indicator for the detection of T2DM with high risk of complications and associated diseases and thus is a good predictor and indicator for follow-up monitoring in the treatment of patients with high-risk type 2 diabetes.