Body Composition by DEXA and Its Association With Physical Fitness in 140 Conscripts

Exercise-induced extracellular vesicles mediate apoptosis in human colon cancer cells in an exercise intensity-dependent manner

Regular exercise reduces the incidence and improves the prognosis of many cancer types, but the underlying mechanisms remain elusive. Evidence suggests that exercise exerts its therapeutic effects through extracellular vesicles (EVs), which are essential for cellular communication. Here, we hypothesized that exercise-induced EVs from serum of healthy individuals would exert anti-tumorigenic effects on human colon cancer HT-29 cells, in an exercise intensity-dependent manner. Ten healthy young active males participated in a randomized crossover trial, completing two workload-matched acute exercise bouts, moderate-intensity continuous exercise (MICE) and high-intensity interval exercise (HIIE), on a cycle ergometer. A control session of rest (PRE) was included. EVs were isolated from serum samples collected during PRE and immediately after each exercise session. EVs were co-incubated with HT-29 colon cancer cells, and the effects on cell viability, migration, and apoptosis were measured. EV treatment reduced cell viability in all groups (PRE, MICE, and HIIE) by 35%, 43% and 47%, respectively, vs. PBS. HIIE-EVs showed a significantly greater reduction in cell viability vs. PRE; therefore, only these groups were used for further analysis. PRE EVs reduced migration by 27%, and HIIE-EVs by 39%. HIIE-EVs increased expression of pro-apoptotic markers: Bax/Bcl-2 ratio by 56% and Caspase 3 by 30% vs. PBS, with no change observed in the PRE group. Further, 16% of cells in PRE and 28% of cells in HIIE were TUNEL-positive, indicating DNA fragmentation. To our knowledge, this is the first human study that illustrates the therapeutic potential of exercise-induced EVs in cancer treatment.

Predicting special forces dropout via explainable machine learning

Selecting the right individuals for a sports team, organization, or military unit has a large influence on the achievements of the organization. However, the approaches commonly used for selection are either not reporting predictive performance or not explainable (i.e., black box models). In the present study, we introduce a novel approach to selection research, using various machine learning models. We examined 274 special forces recruits, of whom 196 dropped out, who performed a set of physical and psychological tests. On this data, we compared four machine learning models on their predictive performance, explainability, and stability. We found that a stable rule-based (SIRUS) model was most suitable for classifying dropouts from the special forces selection program. With an averaged area under the curve score of 0.70, this model had good predictive performance, while remaining explainable and stable. Furthermore, we found that both physical and psychological variables were related to dropout. More specifically, a higher score on the 2800 m time, need for connectedness, and skin folds was most strongly associated with dropping out. We discuss how researchers and practitioners can benefit from these insights in sport and performance contexts.

Muscle strength deficits are associated with low bone mineral density in young pediatric cancer survivors: The iBoneFIT project

BACKGROUND

Pediatric cancer survivors are at increased risk of muscle weakness and low areal bone mineral density (aBMD). However, the prevalence of muscle strength deficits is not well documented, and the associations of muscle strength with aBMD are unknown in this population. Therefore, this study aimed to investigate the prevalence of upper- and lower-body muscle strength deficits and to examine the associations of upper- and lower-body muscle strength with age-, sex, and race-specific aBMD Z-scores at the total body, total hip, femoral neck, and lumbar spine.

METHODS

This cross-sectional study included 116 pediatric cancer survivors (12.1 ± 3.3 years old, mean ± SD; 42.2% female). Upper- and lower-body muscle strength were assessed by handgrip and standing long jump test, respectively. Dual‑energy X‑ray absorptiometry was used to measure aBMD (g/cm2). Associations between muscle strength and aBMD were evaluated in multivariable linear regression models. Logistic regression was used to evaluate the contribution of muscle strength (1-decile lower) to the odds of having low aBMD (Z-score ≤ 1.0). All analyses were adjusted for time from treatment completion, radiotherapy exposure, and body mass index.

RESULTS

More than one-half of survivors were within the 2 lowest deciles for upper- (56.9%) and lower- body muscle strength (60.0%) in comparison to age- and sex-specific reference values. Muscle strength deficits were associated with lower aBMD Z-scores at all sites (B = 0.133-0.258, p = 0.001-0.032). Each 1-decile lower in upper-body muscle strength was associated with 30%-95% higher odds of having low aBMD Z-scores at all sites. Each 1-decile lower in lower-body muscle strength was associated with 35%-70% higher odds of having low aBMD Z-scores at total body, total hip, and femoral neck.

CONCLUSION

Muscle strength deficits are prevalent in young pediatric cancer survivors, and such deficits are associated with lower aBMD Z-scores at all sites. These results suggest that interventions designed to improve muscle strength in this vulnerable population may have the added benefit of improving aBMD.

The Impact of Gender-Affirming Hormone Therapy on Physical Performance

CONTEXT

The inclusion of transgender people in elite sport has been a topic of debate. This narrative review examines the impact of gender-affirming hormone therapy (GAHT) on physical performance, muscle strength, and markers of endurance.

EVIDENCE ACQUISITION

MEDLINE and Embase were searched using terms to define the population (transgender), intervention (GAHT), and physical performance outcomes.

EVIDENCE SYNTHESIS

Existing literature comprises cross-sectional or small uncontrolled longitudinal studies of short duration. In nonathletic trans men starting testosterone therapy, within 1 year, muscle mass and strength increased and, by 3 years, physical performance (push-ups, sit-ups, run time) improved to the level of cisgender men. In nonathletic trans women, feminizing hormone therapy increased fat mass by approximately 30% and decreased muscle mass by approximately 5% after 12 months, and steadily declined beyond 3 years. While absolute lean mass remains higher in trans women, relative percentage lean mass and fat mass (and muscle strength corrected for lean mass), hemoglobin, and VO2 peak corrected for weight was no different to cisgender women. After 2 years of GAHT, no advantage was observed for physical performance measured by running time or in trans women. By 4 years, there was no advantage in sit-ups. While push-up performance declined in trans women, a statistical advantage remained relative to cisgender women.

CONCLUSION

Limited evidence suggests that physical performance of nonathletic trans people who have undergone GAHT for at least 2 years approaches that of cisgender controls. Further controlled longitudinal research is needed in trans athletes and nonathletes.

High-Intensity Functional Training Induces Superior Training Adaptations Compared With Traditional Military Physical Training

ABSTRACT

Helén, J, Kyröläinen, H, Ojanen, T, Pihlainen, K, Santtila, M, Heikkinen, R, and Vaara, JP. High-intensity functional training induces superior training adaptations compared with traditional military physical training. J Strength Cond Res 37(12): 2477-2483, 2023-This study examined the effectiveness of concurrent strength and endurance training with an emphasis on high-intensity functional training (HIFT) during military service. Voluntary male conscripts (aged 18-28 years) were placed in either an experimental (EXP: n = 50-66) or a control (CON: n = 50-67) group. The training for the EXP group included HIFT using body mass, sandbags, and kettlebells. The CON group trained according to the current practice. Physical performance and body composition were assessed at baseline (PRE), at week 10 (MID), and after (POST) the 19-week training period. Significance was set at p < 0.05. The total distance covered in a 12-minute running test increased in both groups, but the change in EXP was superior to the change in CON (11.6%, ES: 0.79 vs. 5.7%, ES: 0.33; p = 0.027). Maximal strength and power characteristics increased in EXP (3.1-5.0%), whereas no improvements were observed in CON. Conscripts with the highest initial fitness showed no improvements in physical performance in either group. Body mass and waist circumference decreased in EXP, whereas CON showed an increase in muscle mass. These findings suggest that HIFT is an effective and time-efficient approach to improve soldiers' aerobic fitness during military service. For the optimal development of strength, the training equipment used may not have provided sufficient and progressive loading to yield considerable strength adaptations. More focus should be placed on sufficient intensity and volume in both strength and endurance training, especially for the most fit soldiers.

Assessment of physical activity among adolescents: a guide to the literature

Purpose

The aim of this article is to systematically review articles and annual reports concerning young peoples' physical activity (PA) and linking this to considerations of the state and national defense.

Method

A systematic search of the literature included an analysis of publications accessible in global databases and other available books, student papers, and projects. The articles and reports were categorized based on year of publication, methods used, age of respondents, sample size, country, and digital object identifier (DOI).

Results

The result of this search is an overview of the extent and manner in which the worldwide scientific community is addressing the current situation and the long-term development of the physical fitness of adolescents. This publication also maps to what extent professional publications and articles are addressing PA from the perspective of the needs of armies and armed forces of various countries around the world.

Conclusions

The article provides a systematic overview of methods used to measure PA, and an overview of articles dealing with assessing PA. The examined articles indicate that from the perspective of not only national defense, but also health and overall quality of life, in particular, we need initiatives to encourage and motivate young people to increase their everyday PA. The research therefore also includes an overview of factors that may considerably influence PA. The results ascertained in this publication will be used, i.a. for investigating a longitudinal defense research project of the Ministry of Defense of the Czech Republic in which the authors are participating.

Decreased Percent Body Fat but Not Body Mass is Associated with Better Performance on Combat Fitness Test in Male and Female Marines

ABSTRACT

Pletcher, ER, Lovalekar, M, Coleman, LC, Beals, K, Nindl, BC, and Allison, KF. Decreased percent body fat but not body mass is associated with better performance on the Marine Corps Combat Fitness Test. J Strength Cond Res 37(4): 887-893, 2023-The military uses a variety of physical fitness tests to assess physical readiness. The Marine Corps designed the Combat Fitness Test (CFT) to emphasize functional fitness related to operational demands. The purpose of this study was to investigate the association between body mass (BM), fat free mass (FFM), and percent body fat (BF%) measured via air displacement plethysmography with CFT performance in male and female marines. Two-hundred 10 male (22.4 ± 2.6 years) and 84 female (22.6 ± 2.8 years) marines were grouped into quintiles according to BM (in kilograms), FFM (in kilograms), and BF%. Kruskal-Wallis test or 1-way analysis of variance were used to determine if significant differences in CFT total and component scores existed between the groups of subjects classified into quintiles of BM, FFM, and BF%. No significant differences in CFT scores were observed between BM quintile in either men or women. No significant differences in CFT scores were observed between FFM quintiles in men. Total CFT score ( p = 0.002), movement to contact (MTC; p = 0.014), maneuver under fire (MANUF; p = 0.008), and ammunition lift (AL; p = 0.014) were all significantly different among FFM quintiles in women. Total CFT score ( p = 0.007), MTC ( p = 0.001), and MANUF ( p = 0.022) were significantly different among BF% quintiles in men. Total CFT score ( p = 0.008), MTC ( p = 0.033), and AL ( p = 0.016) were significantly different among BF% quintiles in women. Male and female marines in the quintile with lowest BF% had better CFT scores than those in higher quintiles. Targeted physical training and nutrition considerations to optimize BF% may help improve military task performance.

Associations of serum 25(OH)D levels with physical performance and anabolic hormones in young men

Purpose: The present study examined the association of vitamin D measured by serum 25(OH)D with physical performance outcomes and serum levels of anabolic hormones in young men. Methods: 412 young men (age 19 ± 1 year) entering their compulsory military service volunteered to participate in the study. The study consisted of two groups from two different military bases: Group A was studied in January and group B in July. The groups were first compared with each other and due to statistically significant (p < 0.001 analyzed with independent samples t-test) differences in physical condition (sit-up, push-up, and standing long jump-tests and testosterone levels) between the groups, groups were analyzed separately. The serum levels of 25(OH)D, testosterone (TES), sex hormone binding globulin (SHBG), and insulin-like growth factor-1 (IGF-1) were analyzed by electrochemiluminescence immunoassay. Physical performance tests consisted of muscular fitness (sit-ups, push-ups, standing long jump) and aerobic fitness (12-minute-running) tests. The association of serum 25(OH)D with physical performance tests and anabolic hormones was analyzed using linear regression. Results: After controlling for the group, body mass index, and leisure-time physical activity, serum 25(OH)D level was positively associated with aerobic and muscular fitness (β = 0.15-0.20, all p < 0.05). Also, the participants with sufficient serum 25(OH)D levels (≥75 nmol/L) had better aerobic and muscular fitness and higher TES in group B, and better upper extremity muscular fitness in group A (all p < 0.05). In group A, there were 166 participants with serum levels of 25(OH) D < 75 nmol/L and 18 ≥ 75 nmol/L. In group B, the amounts were 92 (<75 nmol/L) and 136 (≥75 nmol/L), respectively. Conclusion: Serum 25(OH)D was positively associated with both aerobic and muscular fitness and those with sufficient vitamin D levels, had higher levels of TES. Thus, maintaining a sufficient serum 25(OH)D level may be beneficial for physical performance and anabolic state in young men.

Validity and reliability of the measurement instrument of the nursing outcome health-related Physical Fitness (2004), proposed and transculturally adapted to the Spanish context

BACKGROUND

Presently, physical inactivity is the main public health problem in many countries worldwide. Physical activity promotes the maintenance or improvement of one's physical condition. Physical fitness has been established as the main biological marker of the state of health of an individual, and therefore, there is a clear need to measure health-related physical fitness through the use of a reliable and valid instrument. This study is a continuation of the transcultural adaptation process and a new proposal of the nursing outcome Physical Fitness (2004), found in the 5^th Edition of the Nursing Outcomes Classification. The objective of this study was to examine the validity and reliability of the nursing outcome Health-Related Physical Fitness survey, proposed and transculturally adapted to the Spanish context.

METHODS

An instrumental study to validate the nursing outcome Physical Fitness (2004), from the 5^th Edition of the Nursing Outcome Classification was carried out. It took place between the months of May, 2016 to May, 2017. On the first stage, the instrument proposed Health-Related Physical Fitness survey was administered to 160 adults who used the Health Services of Murcia, Spain by three independent evaluators. After 4 weeks, it was administered again to 33 participants to calculate the intra-rater reliability. Lastly, the SF-12v2 Health Survey was administered to obtain external evidence of validity.

RESULTS

The inter-rater reliability of the nursing outcome proposed obtained high values (between 0.91-0.99) in the evaluations performed by the three evaluators. As for the intra-rater reliability, high values were obtained (0.94-1), except for the item "balance", which was moderate (0.56). Lastly, a positive and statistically significant correlation (p < 0.05) was obtained between the Physical Component Summary, and the dimensions Physical Functioning and General Health from the SF-12v2 Health Survey, and the global score of the Health-Related Physical Fitness proposed instrument.

CONCLUSIONS

The validity and reliability results of the nursing outcome Health-Related Physical Fitness survey, proposed and transculturally adapted to the Spanish context, were adequate for its use by nurses with adults who use the Health Services of Murcia. However, this instrument must be analyzed with more diverse samples of health services users.

Military Body Composition Standards and Physical Performance: Historical Perspectives and Future Directions

ABSTRACT

Harty, PS, Friedl, KE, Nindl, BC, Harry, JR, Vellers, HL, and Tinsley, GM. Military body composition standards and physical performance: historical perspectives and future directions. J Strength Cond Res 36(12): 3551-3561, 2022-US military physique and body composition standards have been formally used for more than 100 years. These metrics promote appropriate physical fitness, trim appearance, and long-term health habits in soldiers, although many specific aspects of these standards have evolved as evidence-based changes have emerged. Body composition variables have been shown to be related to many physical performance outcomes including aerobic capacity, muscular endurance, strength and power production, and specialized occupational tasks involving heavy lifting and load carriage. Although all these attributes are relevant, individuals seeking to improve military performance should consider emphasizing strength, hypertrophy, and power production as primary training goals, as these traits appear vital to success in the new Army Combat Fitness Test introduced in 2020. This fundamental change in physical training may require an adjustment in body composition standards and methods of measurement as physique changes in modern male and female soldiers. Current research in the field of digital anthropometry (i.e., 3-D body scanning) has the potential to dramatically improve performance prediction algorithms and potentially could be used to inform training interventions. Similarly, height-adjusted body composition metrics such as fat-free mass index might serve to identify normal weight personnel with inadequate muscle mass, allowing for effective targeted nutritional and training interventions. This review provides an overview of the origin and evolution of current US military body composition standards in relation to military physical readiness, summarizes current evidence relating body composition parameters to aspects of physical performance, and discusses issues relevant to the emerging modern male and female warrior.

Countermovement Jump and Drop Jump Performances Are Related to Grand Jeté Leap Performance in Dancers With Different Skill Levels

ABSTRACT

Blanco, P, Nimphius, S, Seitz, LB, Spiteri, T, and Haff, GG. Countermovement jump and drop jump performances are related to grand jeté leap performance in dancers with different skill levels. J Strength Cond Res 35(12): 3386-3393, 2021-Thirty-five classical ballet dancers were chosen to investigate relationships between the grand jeté leap, countermovement jump (CMJ), and drop jump (DJ) and establish whether the magnitude of the relationship between these tests differed across 3 skill levels. Subjects (male: n = 11 and female: n = 24) were divided into 3 groups: novice (n = 12; age: 16.6 ± 1.5 years; height: 1.7 ± 0.1 m; body mass: 58.0 ± 13.0 kg), semiprofessional (n = 13; age: 20.0 ± 1.6 years; height: 1.7 ± 0.1 m; body mass: 64.1 ± 10.5 kg), and professional (n = 10; age: 23.8 ± 3.5 years; height: 1.8 ± 1.2 m; body mass: 63.3 ± 14.7 kg). Grand jeté leap height, followed by CMJ and DJ vertical displacement, was assessed. Significant relationships were found between the grand jeté, CMJ (r = 0.77, p = 0.001) and DJ (r = 0.76, p = 0.001). After a Fisher's r-z transformation, professional dancers and novice dancers showed greater r-value differences in CMJ (r2 - r1 = 0.27) compared with novice (r2 - r1 = 0.17) and semiprofessional dancers (r2 - r1 = 0.11), indicating larger strength of CMJ to grand jeté relationship in professionals. The grand jeté leap showed large to very large correlations with CMJ and DJ within groups. These common performance tests were determined to be practical and efficient methods for assessing the jumping ability of dancers. As dance skill increased, larger correlations were observed, suggesting that dancers with superior ballet skills may be more likely to use their underpinning physical capacities to jump higher within the context of ballet-specific jumping.

Cardiorespiratory Fitness of Firefighters: Initial Results of a Multi-Phased Study

OBJECTIVE

To address which body composition (BC) measures best correlate with cardiorespiratory fitness (CRF) in firefighters and develop a model for accurate CRF estimation compared with traditional methods.

METHODS

Career firefighters had body mass index (BMI) and waist circumference (WC) measured in addition to body fat percentage (FM%) by dual-energy x-ray absorptiometry (DXA). CRF as maximum oxygen uptake (VO2max) was estimated by rowing machine and measured by indirect calorimetry in a treadmill exercise test.

RESULTS

Fifty two firefighters participated (92.3% men). Univariate correlations with BMI were best with WC. Univariate correlations with VO2max were best with FM%. Obesity classifications by BC measures agreed weakly at best. Multivariate analysis of several variables yielded an improved VO2max estimate (R2 = 0.70).

CONCLUSIONS

Fire departments may benefit from more sophisticated measures of BC and CRF to evaluate firefighter fitness.

Prevalence of Normal Weight Obesity and Health Risk Factors for the Female Collegiate Dancer

ABSTRACT

Brown, AF, Alfiero, CJ, Brooks, SJ, Kviatkovsky, SA, Smith-Ryan, AE, and Ormsbee, MJ. Prevalence of normal weight obesity and health risk factors for the female collegiate dancer. J Strength Cond Res 35(8): 2321-2326, 2021-The purpose of this study was to investigate the prevalence of normal weight obesity (NWO) and evaluate the relationship between NWO and health risk factors in a collegiate dancer population. Reanalysis of data of female dancers (N = 42) from 2 larger studies was used to assess prevalence and health risk factors of NWO. Dancers completed a dual-energy x-ray absorptiometry scan to assess fat mass (FM), lean mass (LM), and visceral adipose tissue (VAT) and a 3-day food record. Normal weight obesity was defined as a body mass index (BMI) of 18.5-24.9 kg·m-2 and body fat (BF) ≥30%. Twenty-five (60%) dancers were classified as normal weight lean (NWL), and 17 dancers (40%) were classified as NWO. Significant differences were observed for BMI (NWL: 21.1 ± 1.7, NWO: 23.1 ± 1.6, p < 0.001), LM (NWL: 71.0 ± 2.9%, NWO: 62.5 ± 2.7%, p < 0.001), %BF (NWL: 24.8 ± 3.1%, NWO: 33.9 ± 2.6%, p < 0.001), and VAT (NWL: 130.6 ± 43.0 g, NWO: 232.3 ± 70.8 g, p < 0.001) between NWL and NWO. A significant difference was observed for carbohydrate intake (NWL: 4.7 ± 1.8 g·kg-1, NWO: 3.7 ± 1.0 g·kg-1, p = 0.020) between groups. Significant positive correlations with FM were observed between carbohydrate (kcal, p = 0.048), fat (kcal, p = 0.018; g·kg-1, p = 0.040), and total calories (p = 0.019) in NWO. Normal weight obesity in collegiate dancers may be more prevalent than previously perceived and may be significantly related to important health risk factors. The current study demonstrates the need for body composition assessments and emphasizing on promoting overall health in collegiate dancers.

The Effects of Exercise During a 10-Week Basic Military Training Program on the Physical Fitness and the Body Composition of the Greek Naval Cadets

INTRODUCTION

The period of basic military training (BMT) is a sudden change in the individual habits of the trainees and is characterized by significant improvements in body composition such as the percentage of body fat (%BF) and lean body mass (BM). Research has shown that physical activity during the period of BMT lasting 7-10 weeks has positive effects on the physical condition and BM of cadets. The purpose of this study was to examine the effects of training combining cardiovascular conditioning, circuit strength training, swimming, team sports, and obstacle course on physical fitness and body composition during a 10-week BMT period over 4 years in the Hellenic Naval Academy (HNA).

MATERIALS AND METHODS

The sample consisted of 185 Greek cadets of the HNA (age: 18.4 ± 0.7 years, height: 1.77 ± 6.7 m, BM: 72.6 ± 9.1 kg), of which 153 was male (age: 18.3 ± 0.6 years, height: 1.79 ± 5.8 cm, BM: 75.3 ± 7.6 kg) and 32 was female (age: 18.6 ± 0.9 years, height: 1.68 ± 2.8 cm, BM: 59.9 ± 3.1 kg).The cadets participated each year for 4 years in the BMT, performing 94 training sessions, five times a week. The weekly training program included cardiovascular conditioning, circuit strength training, swimming, team sports, and obstacle course. The measurements of the participants before and after BMT were on BM, %BF, and body mass index (BMI); on the number of sit-ups (SU1), push-ups (PU1), and pull-ups (PullU1) in 1 minute; and on the 12-minute aerobic Cooper test (12-min run).

RESULTS

The results of the study showed that the BM of the cadets decreased significantly by 2.5%, (t184 = 17.591, P < .01), in men by 2.7% (t152 = 16.243, P < .01) and in women by 2.2% (t31 = 9.280, P < .01). Body mass index (BMI) decreased significantly by 2.6% (t184 = 17.681, P < .01), in men by 3.0% (t152 = 16.046, P < .01) and in women by 2.3% (t31 = 9.224, P < 0.01). Reduction in %BF in all cadets reached 11.3% (t184 = 8.134, P < .01), for men -14.8% (t152 = 8.918, P < .01) and women -2.1% (t31 = 0.860, P > .05) without significant differences between the measurements.The number of push-ups in 1 minute (PU1) significantly increased by 27.6% (t184 = -27.813, P < .01), in women by +35.6% (t31 = 13,864, P < .01). The number of sit-ups in 1 minute (SU1) significantly increased by 27.3% (t184 = -30.501, P < .01), for men +28.8% (t152 = -29.862, P < .01). The number of pull-ups in 1 minute (PullU1) reached 20.8% (t184 = -13.426, P < .01) in total, at similar levels in men (t152 = -13.918, p < .01) and women (t31 = -2.820, P < .01).On the 12-min run, the significant improvement exceeded 10.8% (t184 = -45.289, P < .01), in men by 11.1% (t152 = -45.222, P < .01) while in women by 9.0% (t31 = 15.709, P < .01).

CONCLUSIONS

The results of this study showed that 10 weeks of BMT, which combined cardiovascular conditioning, circuit strength training, swimming, team sports, and obstacle course improved the body composition, cardiorespiratory endurance, and the strength of the Greek HNA cadets.

Association of mitochondrial DNA haplogroups J and K with low response in exercise training among Finnish military conscripts

Background

We have previously suggested that some of the mutations defining mitochondrial DNA (mtDNA) haplogroups J and K produce an uncoupling effect on oxidative phosphorylation and thus are detrimental for elite endurance performance. Here, the association between haplogroups J and K and physical performance was determined in a population-based cohort of 1036 Finnish military conscripts.

Results

Following a standard-dose training period, excellence in endurance performance was less frequent among subjects with haplogroups J or K than among subjects with non-JK haplogroups (p = 0.041), and this finding was more apparent among the best-performing subjects (p < 0.001).

Conclusions

These results suggest that mtDNA haplogroups are one of the genetic determinants explaining individual variability in the adaptive response to endurance training, and mtDNA haplogroups J and K are markers of low-responders in exercise training.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12864-021-07383-x.

Effects of an Experimental vs. Traditional Military Training Program on 2-Mile Run Performance During the Army Physical Fitness Test

Stone, BL, Heishman, AD, and Campbell, JA. The effects of an experimental vs. traditional military training program on 2-mile run performance during the army physical fitness test. J Strength Cond Res 34(12): 3431-3438, 2020-The purpose of this study was to compare the effects of an experimental vs. traditional military run training on 2-mile run ability in the Army Reserve Officers' Training Corps cadets. Fifty college-aged cadets were randomly placed into 2 groups and trained for 4 weeks with either an experimental running program (EXP, n = 22) comprised rating of perceived exertion (RPE) intensity-specific, energy system-based intervals or with traditional military running program (TRA, n = 28) using a crossover study design. A 2-mile run assessment was performed just before the start, at the end of the first 4 weeks, and again after the second 4 weeks of training after crossover. The EXP program significantly decreased 2-mile run times (961.3 ± 155.8 seconds to 943.4 ± 140.2 seconds, p = 0.012, baseline to post 1), whereas the TRA group experienced a significant increase in run times (901.0 ± 79.2 vs. 913.9 ± 82.9 seconds) over the same training period. There was a moderate effect size (d = 0.61, p = 0.07) for the experimental run program to "reverse" the adverse effects of the traditional program within the 4-week training period (post 1 to post 2) after treatment crossover. Thus, for short-term training of military personnel, RPE intensity-specific running program comprising aerobic and anaerobic system development can enhance 2-mile run performance superior to a traditional program while reducing training volume (60 minutes per session vs. 43.2 minutes per session, respectively). Future research should extend the training period to determine efficacy of this training approach for long-term improvement of aerobic capacity and possible reduction of musculoskeletal injury.

DEXA overestimates bone mineral density in adults with knee replacements

We examined bone mineral density (BMD) measurements made by dual-energy-xray-absorptiometry (DEXA) taken from 100 patients (♂46/♀54, 66±6yr) who previously underwent single total-knee arthroplasty (TKA) to determine if automated software-based artifact detection (ASAD) adequately removes implant artifact from the DXA image before analysis and if potential inaccuracies could be overcome through manual artifact correction (MAC). We also sought to determine if software-based inaccuracies would result in fracture risk misclassification (Low-BMD/Osteopenia = Young-Adult T-Score < −1). Select Results: When using ASAD, limbs with implants had higher BMD (+12.0 ​± ​1.7%, p ​< ​0.001) compared to control limbs resulting in a 2.5 ​± ​0.2% overestimation of total-body BMD (single implant). Consequently, the prevalence of osteopenia in 95% of patients who would have been observed to have low leg BMD (18/19 patients) and 80% of those found to have low total-body BMD (4/5 patients) would have gone un-diagnosed. This overestimation was eliminated when using MAC. These results reveal a potential issue with ASAD for total-body DEXA scans in TKA patients and highlight the importance of careful review and MAC in those with joint replacements before making diagnostic decisions.

Characteristics of Physical Fitness and Cardiometabolic Risk in Chinese University Students with Normal-Weight Obesity: A Cross-Sectional Study

PURPOSE

To (i) describe the characteristics of physical fitness and cardiometabolic risk in Chinese university students with normal-weight obesity (NWO); (ii) assess the association between NWO with physical fitness and cardiometabolic risk.

METHODS

A total of 249 participants from the 2018 Shanghai University of Sport Alumni Health Cohort Study in China formed the study cohort. NWO was defined as normal body mass index (17.9-23.9 kg/m2 for males; 17.2-23.9 kg/m2 for females) but with excess body-fat percentage (≥20% for males; ≥30% for females). Body composition was assessed by dual-energy X-ray absorptiometry. Physical-fitness scores were calculated from a battery of sex-specific tests. Cardiometabolic risk was calculated using a continuous clustered risk (MetS) score.

RESULTS

We found that 16.7% of male and 45.3% of female university students were classified as having NWO. Participants with NWO showed worse cardiorespiratory fitness than those with normal weight (NW) (male NWO (37±8) vs male NW (41±6) mL/kg/min, p<0.01; female NWO (31±4) vs female NW (33±6) mL/kg/min, p<0.01). NWO was associated negatively with the fitness score (OR = 0.853; 95% CI = 0.793-0.917) and was associated positively with the MetS score (1.280; 1.162-1.410).

CONCLUSION

University students with NWO were characterized by higher cardiometabolic risk and lower levels of physical fitness. Our findings implied that university students with NWO should be mindful of the potential hidden health risks of excess body fat and participate in exercise to enhance physical fitness.

VISCERAL FAT, PHYSICAL FITNESS AND BIOCHEMICAL MARKERS OF BRAZILIAN MILITARY PERSONNEL

ABSTRACT Introduction: Adipocyte volume (fat accumulation) in different parts of the body may play different roles in the metabolism and in the appearance of cardiovascular risk factors. Most studies indicate that the regional distribution of body fat seems to be more important than excess adiposity per se. High levels of physical activity are associated with lower total and visceral body fat levels. Military physical training is of paramount importance for the health and performance of soldiers in the Brazilian Army. In this context, physical evaluation will provide data on the main physical benefits involved in military tasks. Objective: Verify the relationship between visceral fat (VF), physical performance and biochemical markers of soldiers in the Brazilian Army. Methods: The sample consisted of 41 (38.9 ± 2.2 years) Brazilian male military personnel. VF was obtained with a Dual Energy X-Ray Absorptiometry densitometry device. The biochemical analysis included fasting glycemia, triglycerides (TG) and HDL-C levels. Physical performance was evaluated through two tests (12-min run and pull-ups). The Shapiro-Wilk test confirmed the normality of the variables. Pearson's correlation test was then applied, with a p-value of <0.05. Results: Significant negative correlations of VF were found with the results of both physical tests (Pull-ups r = −0.59; 12-min r = −0.61). The only biochemical variable that had a significant positive correlation with VF was TG (r = 0.44). Conclusion: The results of this study showed a significant negative association between VF and physical tests. A significant positive association between VF and TG was also found. Level of Evidence I; Diagnostic studies - Investigation of a diagnostic test.

Effect of 7 Months of Physical Training and Military Routine on the Bone Mass of Young Adults

INTRODUCTION

Physical activity (PA) has a great influence on bone mineral density (BMD) and bone mineral content (BMC), however longitudinal studies that seek to relate bone mass to physical activity are scarce and have a small sample size. The aim of this study was to evaluate and compare the effect of 7 months of military physical training (MPT), impact sports (IS), and swimming in the bone mass of young military adults.

MATERIALS AND METHODS

A prospective study was conducted with 213 military school students (male and aged 19.2 ± 1.2 years) divided into three groups: MPT (n = 144), IS (n = 56), and Swimming (n = 13). Dual-energy X-ray absorptiometry was used to determine body composition (percentage of fat, fat mass, and fat-free mass) and bone mass (BMD, BMD Z-Score, total BMC, arm BMC, leg BMC, and trunk BMC), at the beginning of the military service and after 7 months of training.

RESULTS

It was observed a significant increase in BMD, BMD Z-Score, total BMC and BMC of all segments analyzed for all groups (p < 0.01). There was a significantly greater variation in BMD of the IS group in relation to the MPT group (p < 0.01), and in the arm BMC of the MPT group in relation to the IS group (p < 0.05).

CONCLUSION

After 7 months of training, there were significant increases in BMC and BMD of all the groups evaluated. The bone response was associated with the muscular group used in the physical exercise and the IS group showed greater gain in BMD.

Influence of Vitamin D Supplementation by Sunlight or Oral D3 on Exercise Performance

Purpose

To determine the relationship between vitamin D status and exercise performance in a large, prospective cohort study of young men and women across seasons (study 1). Then, in a randomized, placebo-controlled trial, to investigate the effects on exercise performance of achieving vitamin D sufficiency (serum 25(OH)D ≥ 50 nmol·L⁻¹) by a unique comparison of safe, simulated-sunlight and oral vitamin D₃ supplementation in wintertime (study 2).

Methods

In study 1, we determined 25(OH)D relationship with exercise performance in 967 military recruits. In study 2, 137 men received either placebo, simulated sunlight (1.3× standard erythemal dose in T-shirt and shorts, three times per week for 4 wk and then once per week for 8 wk) or oral vitamin D₃ (1000 IU·d⁻¹ for 4 wk and then 400 IU·d⁻¹ for 8 wk). We measured serum 25(OH)D by high-pressure liquid chromatography tandem mass spectrometry and endurance, strength and power by 1.5-mile run, maximum dynamic lift and vertical jump, respectively.

Results

In study 1, only 9% of men and 36% of women were vitamin D sufficient during wintertime. After controlling for body composition, smoking, and season, 25(OH)D was positively associated with endurance performance (P ≤ 0.01, ΔR² = 0.03–0.06, small f² effect sizes): 1.5-mile run time was ~half a second faster for every 1 nmol·L⁻¹ increase in 25(OH)D. No significant effects on strength or power emerged (P > 0.05). In study 2, safe simulated sunlight and oral vitamin D₃ supplementation were similarly effective in achieving vitamin D sufficiency in almost all (97%); however, this did not improve exercise performance (P > 0.05).

Conclusions

Vitamin D status was associated with endurance performance but not strength or power in a prospective cohort study. Achieving vitamin D sufficiency via safe, simulated summer sunlight, or oral vitamin D₃ supplementation did not improve exercise performance in a randomized-controlled trial.

An Increase in Fat Mass Index Predicts a Deterioration of Running Speed

A low fat mass is associated with a good running performance. This study explores whether modifications in body composition predicted changes in running speed. We included people who underwent several measurements of body composition by bioelectrical impedance analysis between 1999 and 2016, at the “Course de l’Escalade”, taking place yearly in Geneva. Body composition was reported as a fat-free mass index (FFMI) and fat mass index (FMI). Running distances (men: 7.2 km; women: 4.8 km) and running times were used to calculate speed in km/h. We performed multivariate linear mixed regression models to determine whether modifications of body mass index, FFMI, FMI or the combination of FFMI and FMI predicted changes in running speed. The study population included 377 women (1419 observations) and 509 men (2161 observations). Changes in running speed were best predicted by the combination of FFMI and FMI. Running speed improved with a reduction of FMI in both sexes (women: ß −0.31; 95% CI −0.35 to −0.27, p < 0.001. men: ß −0.43; 95% CI −0.48 to −0.39, p < 0.001) and a reduction of FFMI in men (ß −0.20; 95% CI −0.26 to −0.15, p < 0.001). Adjusted for body composition, the decline in running performance occurred from 50 years onward, but appeared earlier with a body mass, FFMI or FMI above the median value at baseline. Changes of running speed are determined mostly by changes in FMI. The decline in running performance occurs from 50 years onward but appears earlier in people with a high body mass index, FFMI or FMI at baseline.

Running performance in a timed city run and body composition: A cross-sectional study in more than 3000 runners

OBJECTIVE

The importance of body composition for running performance is unclear in the general population. The aim of this study was to evaluate whether body composition influences running speed and whether it is a better predictor of running speed than body mass index (BMI).

METHODS

The study included 1353 women (38.2 ± 12.1 y of age) and 1771 men (39.6 ± 12.1 y of age) who underwent, for the first time, a measurement of body composition by bioelectrical impedance analysis between 1999 and 2016, before a timed run occurring annually in Geneva. The running distances and times were converted to average speed (km/h). Body composition was expressed as sex-specific quartiles, where quartile 1 (lowest values) was the reference quartile. The relationships between speed and BMI or body composition were analyzed by multivariate linear regressions.

RESULTS

Multivariate regressions showed that the higher the fat mass index (FMI) quartile, the lower the running speed in women and men (all P < 0.001). In men, a fat-free mass index (FFMI) in quartile 4 (>20 kg/m²) was associated with a poor running performance (r = -0.50, P < 0.001), whereas in women, an FFMI in quartile 2 or 3 (15-16.4 kg/m²) was associated with a higher running speed (r = 0.23, P = 0.04; r = 0.28, P = 0.01, respectively). Body composition predicted speed better than BMI in women (R² = 26.8% versus 14.4%) and men (R² = 29.8% versus 25.4%).

CONCLUSIONS

Running speed is negatively associated with BMI and FMI in both sexes. Body composition is a better predictor of running performance than BMI.

High Body Mass Index Masks Body Composition Differences in Physically Active Versus Sedentary Participants

BACKGROUND

Despite the benefits of aerobic exercise on body composition, runners with high body mass index (BMI) remain understudied. We examined body composition differences between sedentary insulin-resistant [obese insulin-resistant sedentary (OS-IR)], sedentary insulin-sensitive [obese insulin-sensitive sedentary (OS-IS)], and trained [obese trained (OT)] individuals with high BMI (≥25 kg/m²). We hypothesized that after matching for high BMI, OT individuals would have less fat mass (absolute and relative) and greater lean mass than OS-IR or OS-IS individuals.

METHODS

This is a retrospective analysis of OS-IR, OS-IS, and OT participants selected for similar age, sex, and BMI. Activity was self-reported. OT participants exercised at least 30 min/day (predominantly running) for 3-5 days/week. OS-IS and OS-IR participants actively exercised <0.5 hr/week. Body composition was measured by dual X-ray absorptiometry.

RESULTS

Thirty-three participants were recruited [n = 11/group, mean age 31.7 years (standard error): (0.9)], 7 females/group, overall BMI [31.6 kg/m² (0.7)]. Insulin resistance, quantified by the homeostatic model assessment for insulin resistance, was higher in the OS-IR [3.3 (0.2)] than the OS-IS [0.9 (0.2): P < 0.0001] or OT [1.6 (0.2): P < 0.0001] groups. We found the following: (i) Compared to the OS-IR group, the OT group had lower region-specific fat mass as measured by percent fat (trunk) or absolute fat mass (trunk, android region, and abdominal visceral region). (ii) OT and OS-IS groups had similar body composition. (iii) Total fat mass and percent body fat correlated with BMI, (iv) Visceral fat correlated with BMI (r = 0.80, P = 0.003) only in the OS-IR (P = 0.03 for BMI × group interaction).

CONCLUSIONS

Using BMI to classify obesity masks body composition differences in high BMI individuals discrepant for insulin resistance and physical activity status.

Physical Fitness, Adiposity, and Diets as Surrogate Measures of Bone Health in Schoolchildren: A Biochemical and Cross-Sectional Survey Analysis

This study aimed to investigate the associations between adiposity, muscular fitness (MF), diet, sun exposure, and physical activity profiles as surrogate measures with bone health status in a sample of schoolchildren aged 8-18 yr old. A total of 250 Egyptian schoolchildren aged 8-18 yr were randomly invited to participate in these cross-sectional survey analyses. Calcaneal broadband ultrasound attenuation (c-BUA), bone mineral density (BMD), and bone formation markers (total calcium, serum bone alkaline phosphatase, and osteocalcin) were measured as markers of bone health. Adiposity profile, MF, physical activity (PA), sun exposure, Ca, and vitamin D dietary intake as related cofactors of bone health were measured by using prevalidated questionnaires and standard analytical techniques. A total of 85% (n = 213) of the study population showed normal bone health and 14.8% (n = 37) had abnormal bone health; most of them are girls (67.6%) classified according to BMD and c-BUA Z-scores into osteopenia (9.6%) and osteoporosis (5.2%). Compared with boys, higher correlations between c-BUA, bone mineral content, and BMD measures in the femoral neck, lumbar spine, whole body, and bone markers were reported in girls with lower bone mass. There was a positive significant correlation between body mass index, adiposity, sun exposure, MF, PA status, Ca and vitamin D intake, and c-BUA and BMD score analyses. These parameters were shown to be associated with about ~57.3%-88.4% of bone health characteristics of children and adolescents with osteopenia and osteoporosis. In children and adolescents, sun exposure, Ca and vitamin D diets, adiposity, PA, and changes in the levels of Ca, osteocalcin, and serum bone alkaline phosphatase were shown to be associated with bone health. Also, a significant correlation was reported between c-BUA score, dual-energy X-ray absorptiometry-BMD measures, and bone markers at clinically important bone sites of girls and boys. However, further clinical trials should be studied to consider c-BUA and bone markers as the benchmark estimates of bone mass for diagnostic purposes in young ages.

Body Composition, Nutritional Profile and Muscular Fitness Affect Bone Health in a Sample of Schoolchildren from Colombia: The Fuprecol Study

The objective of the present study is to investigate the relationships between body composition, nutritional profile, muscular fitness (MF) and bone health in a sample of children and adolescents from Colombia. Participants included 1118 children and adolescents (54.6% girls). Calcaneal broadband ultrasound attenuation (c-BUA) was obtained as a marker of bone health. Body composition (fat mass and lean mass) was assessed using bioelectrical impedance analysis. Furthermore height, weight, waist circumference and Tanner stage were measured and body mass index (BMI) was calculated. Standing long-jump (SLJ) and isometric handgrip dynamometry were used respectively as indicators of lower and upper body muscular fitness. A muscular index score was also computed by summing up the standardised values of both SLJ and handgrip strength. Dietary intake and degree of adherence to the Mediterranean diet were assessed by a 7-day recall questionnaire for food frequency and the Kidmed questionnaire. Poor bone health was considered using a z-score cut off of ≤-1.5 standard deviation. Once the results were adjusted for age and Tanner stage, the predisposing factors of having a c-BUA z-score ≤-1.5 standard deviation included being underweight or obese, having an unhealthy lean mass, having an unhealthy fat mass, SLJ performance, handgrip performance, and unhealthy muscular index score. In conclusion, body composition (fat mass and lean body mass) and MF both influenced bone health in a sample of children and adolescents from Colombia. Thus promoting strength adaptation and preservation in Colombian youth will help to improve bone health, an important protective factor against osteoporosis in later life.

Validity of Bioelectrical Impedance Analysis to Estimation Fat-Free Mass in the Army Cadets

Background: Bioelectrical Impedance Analysis (BIA) is a fast, practical, non-invasive, and frequently used method for fat-free mass (FFM) estimation. The aims of this study were to validate predictive equations of BIA to FFM estimation in Army cadets and to develop and validate a specific BIA equation for this population. Methods: A total of 396 males, Brazilian Army cadets, aged 17–24 years were included. The study used eight published predictive BIA equations, a specific equation in FFM estimation, and dual-energy X-ray absorptiometry (DXA) as a reference method. Student’s t-test (for paired sample), linear regression analysis, and Bland–Altman method were used to test the validity of the BIA equations. Results: Predictive BIA equations showed significant differences in FFM compared to DXA (p < 0.05) and large limits of agreement by Bland–Altman. Predictive BIA equations explained 68% to 88% of FFM variance. Specific BIA equations showed no significant differences in FFM, compared to DXA values. Conclusion: Published BIA predictive equations showed poor accuracy in this sample. The specific BIA equations, developed in this study, demonstrated validity for this sample, although should be used with caution in samples with a large range of FFM.

Block-Periodized Training Improves Physiological and Tactically Relevant Performance in Naval Special Warfare Operators

Human performance training and prevention strategies are necessary to promote physical readiness and mitigate musculoskeletal injuries of the Naval Special Warfare (NSW) Operator. The purpose of this study was to measure the effectiveness of 2 training programs when performed during a training evolution of Operators. A total of 85 Operators (experimental: n = 46, age: 29.4 ± 5.5 years, height: 176.7 ± 6.4 cm, mass: 86.7 ± 11.6 kg; control: n = 39, age: 29.0 ± 6.0 years, height: 177.1 ± 6.3 cm, mass: 85.7 ± 12.5 kg) participated in a trial to measure the effectiveness of these programs to improve physical, physiological, and performance characteristics. Operators in the experimental group performed a 12-week block-periodized program, whereas those in the control group performed a nonlinear periodized program. Pretesting/posttesting was performed to assess body composition, aerobic capacity/lactate threshold, muscular strength, flexibility, landing biomechanics, postural stability, and tactically relevant performance. The experimental group demonstrated a significant loss in body fat, fat mass, and body mass compared with the control group, whereas aerobic capacity increased for the both groups. The experimental group demonstrated a significant increase in posterior shoulder flexibility and ankle dorsiflexion, whereas the control group had a significant reduction in shoulder, knee, and ankle flexibility. The experimental group also improved landing strategies and balance. Both groups improved upper and lower muscular power and upper-body muscular endurance, whereas only the experimental group demonstrated significant improvements in agility and total body muscular strength. Implementation of a population-specific training program provides structured and progressive training effectively and promotes physical readiness concurrently with tactical training without overload.

Risk factors of acute and overuse musculoskeletal injuries among young conscripts: a population-based cohort study

BACKGROUND

Military service in Finland is compulsory for all male citizens and annually about 80% of 19-year-old men enter into the service. The elevated risk for many chronic diseases and loss of function among those who are inactive and unfit can be often detected already in youth. On the other hand, activity-induced injuries among young are true public health issue. The purpose of the present prospective cohort follow-up study was to evaluate predictive associations between acute or overuse injuries and their various intrinsic risk factors.

METHODS

Four successive cohorts of conscripts who formed a representative sample of Finnish young men were followed for 6 months. At the beginning of the service, the risk factors of injuries were measured and recorded and then the acute and overuse injuries treated at the garrison clinic were identified. Predictive associations between injuries and their risk factors were examined by multivariate Cox's proportional hazard models.

RESULTS

Of the 1411 participants, 27% sustained an acute injury and 51% suffered from overuse injury. Concerning acute injuries, highest risk for severe injuries were detected among conscripts with low fitness level in both the standing long-jump and push-up tests (hazard rate, HR=5.9; 95% CI: 1.6‒21.3). A history of good degree in school sports was not a protective factor against acute injuries. High waist circumference and, on the other hand, being underweight according to BMI increased the HR for overuse injuries. Brisk leisure time physical activity before military entry was a protective factor against overuse injuries. Poor result in Cooper's test was a warning signal of elevated risk of overuse injuries.

CONCLUSION

We confirmed previous findings that low level of physical fitness is predictor for musculoskeletal injuries during intensive physical training. The U-shaped relationship between body composition and overuse injuries was noticed indicating that both obesity and underweight are risk factors for overuse injuries. Persons with excellent sports skills according to their earlier degrees in school sports had similar HR for acute injuries than those with poorer degrees. This indicates that school-age sports skills and fitness do not carry far and therefore preventive programmes are needed to prevent activity-induced injuries.

Circuit resistance training attenuates acute exertion-induced reductions in arterial function but not inflammation in obese women

BACKGROUND

Cardiovascular disease (CVD) is a leading cause of preventable death among young women in the United States. Habitual resistance exercise training is known to have beneficial effects on endothelial function and CVD risk factors, including obesity; however, previous studies show that acute resistance exercise impairs endothelial function in obese adults who are sedentary, a response that may be linked to inflammation. We sought to determine if circuit-based resistance training (CRT) attenuates acute resistance exercise-induced reductions in endothelial function in a population of young, obese, sedentary women and whether or not inflammation plays a role in this response.

METHODS

Eighteen obese [body mass index (BMI) 30.0-40.0 kg · m(-2)] young premenopausal women were randomly assigned to either a CRT group or a no-exercise control group (CON). Conduit artery endothelial function was assessed using brachial artery flow-mediated dilation (FMD) determined by ultrasound before and after a single bout of strenuous weightlifting (SWL). In addition, circulating inflammatory mediators (tumor necrosis factor-α and C-reactive protein), blood pressure, fasting blood lipids, glucose, waist circumference, body composition, and aerobic capacity were assessed.

RESULTS

Among participants randomized to the CRT group, 8 weeks of training led to considerable increases in FMD after SWL (P=0.001) compared to the CON group. However, no significant differences between the groups were observed in circulating inflammatory mediators, blood pressure, fasting blood lipids, or other physical and physiological characteristics.

CONCLUSIONS

This study shows that CRT alleviates acute exertion-induced reductions in endothelial function among obese sedentary women in the absence of changes in inflammation.

Reduced vasodilator function following acute resistance exercise in obese women

Obesity contributes to stress induced impairments in endothelium-dependent vasodilation (EDV), a precursor to atherosclerosis. Since obesity is associated with inflammation and oxidative stress, we sought to determine if a single bout of strenuous weight lifting (SWL) reduces EDV among sedentary obese adults. Participants included 9 obese (OB) (BMI 30.0–40.0 kg/m²) and 8 lean (LN) (BMI 18.5–24.9 kg/m²) sedentary young women. All participants underwent a single bout of SWL using a progressive leg-press protocol. Brachial artery flow-mediated dilation (FMD) (an index of EDV) was determined using ultrasonography before and after SWL. Sublingual nitroglycerin (NTG) was used to determine brachial artery endothelium-independent vasodilation following SWL. Brachial artery FMD was significantly reduced in OB and LN women (LN: 6.4 ± 1.6%, p = 0.22) after SWL. There was no difference in the magnitude of change pre- and post-SWL between groups (OB: −2.4 ± 0.6% and LN: −2.2 ± 1.6%, p = 0.84). Dilation to NTG was lower in OB (21.6 ± 1.3%) compared to LN women (27.6 ± 2.1%, p = 0.02) and associated with body weight (r = −0.70, p = 0.01). These data suggest that EDV is reduced in woman after acute resistance exercise. Dilations to NTG were lower in obese compared to lean woman and associated with body weight suggesting that changes in sensitivity of blood vessels to NO occurs during obesity. These findings may be important for understanding vascular risk following acute exercise in obesity.

Associations of cardiorespiratory fitness with cardiovascular disease risk factors in middle-aged Chinese women: a cross-sectional study

Background

High levels of physical activity (PA) and cardiorespiratory fitness (CRF) are each associated with a favorable cardiovascular disease (CVD) risk profile. However, the relationship between CRF and obesity is still inconsistent across studies, and there has been no thorough exploration of the independent contribution of CRF to different CVD risk factors in Chinese women. This study investigated the relationship between CRF and CVD risk factors in 40–49 year old women in Beijing.

Methods

The study included 231 urban-dwelling asymptomatic 40–49 year old women. Body mass index (BMI), body fat percentage (BF%), blood glucose, blood lipids, blood pressure, and pulse wave velocity (PWV) were measured at rest. Cycle ergometer exercise tests were conducted to assess CRF as indicated by maximal oxygen uptake (VO_2max). Participants were categorized into three CRF levels (low, moderate and high).

Results

High CRF level was associated with significantly less BF%, lower PWV, and higher weekly physical activity compared with low and moderate CRF (P < 0.05). Compared to high CRF, the odds ratios for having ≥3 main CVD risk factors (overweight, hypertension, and dyslipidemia) in low and moderate CRF were 2.09 (95% CI: 1.48-2.94) and 1.84 (95% CI: 1.29-2.62), respectively. The proportion of participants with clinical ST segment depression and prolonged QTC interval during cycle ergometer testing was significantly higher in women with low CRF.

Conclusions

Overall, Chinese middle-aged women demonstrated a moderate level of CRF. CRF was independently associated with CVD risk factors, including overweight, hypertension, dyslipidemia, arterial stiffness, and abnormal ECG during exercise, with the least fit women exhibiting the highest number of CVD risk factors.

Measurement of cardiorespiratory fitness in children from two commonly used field tests after accounting for body fatness and maturity

Body fat and maturation both influence cardiorespiratory fitness, however few studies have taken these variables into account when using field tests to predict children's fitness levels. The purpose of this study was to determine the relationship between two field tests of cardiorespiratory fitness (20 m Maximal Multistage Shuttle Run [20-MST], 550 m distance run [550-m]) and direct measurement of VO2max after adjustment for body fatness and maturity levels. Fifty-three participants (25 boys, 28 girls, age 10.6 ± 1.2 y, mean ± SD) had their body fat levels estimated using bioelectrical impedance (16.6% ± 6.0% and 20.0% ± 5.8% for boys and girls, respectively). Participants performed in random order, the 20-MST and 550-m run followed by a progressive treadmill test to exhaustion during which gas exchange measures were taken. Pearson correlation coefficient analysis revealed that the participants' performance in the 20-MST and 550-m run were highly correlated to VO2max obtained during the treadmill test to exhaustion (r = 0.70 and 0.59 for 20-MST and 550-m run, respectively). Adjusting for body fatness and maturity levels in a multivariate regression analysis increased the associations between the field tests and VO2max (r = 0.73 for 20-MST and 0.65 for 550-m). We may conclude that both the 20-MST and the 550-m distance run are valid field tests of cardiorespiratory fitness in New Zealand 8-13 year old children and incorporating body fatness and maturity levels explains an additional 5-7% of the variance.

Toward identifying a broader range of social cognitive determinants of dietary intentions and behaviors

BACKGROUND

Measurement of social cognitive variables is often restricted to long-term and health-related outcomes. A more comprehensive measurement of cognitive determinants would enable evidence-based design of health behavior interventions with a focus on the most relevant targets. The purpose of this study was to examine the relative impact of different social cognitive determinants on fruit and vegetable (FV) and fast food consumption.

METHODS

Finnish male conscripts (N = 855, age M = 20) filled in questionnaires on social cognitive factors when entering the military service, and on food consumption frequency after two months. The data were analysed using structural equation modeling.

RESULTS

Physical well-being expectation and bad taste expectation were most strongly related to both FV and fat avoidance intentions. Perceived weight gain risk predicted fat avoidance intention, whereas perceived risk for other health problems predicted FV intention. Social self-efficacy was associated with FV intention only. Consumption of both FV and fast food was predicted by action planning and intention.

CONCLUSIONS

A more careful evaluation of subtypes of social cognitions sheds light on the specific content behind motivation. Such understanding might help in designing more effective intervention messages.

Predictors of low back pain in physically active conscripts with special emphasis on muscular fitness

BACKGROUND CONTEXT

Association between low physical fitness and low back pain (LBP) is contradictory in previous studies.

PURPOSE

The objective of the present prospective cohort study was to investigate the predictive associations of various intrinsic risk factors in young conscripts for LBP, with special attention to physical fitness.

STUDY DESIGN

A prospective cohort study.

PATIENT SAMPLE

A representative sample of Finnish male conscripts. In Finland, military service is compulsory for male citizens and 90% of young men enter into the service.

OUTCOME MEASURES

Incidence of LBP and recurrent LBP prompting a visit at the garrison health clinic during 6-month military training.

METHODS

Four successive cohorts of 18- to 28-year-old male conscripts (N=982) were followed for 6 months. Conscripts with incidence of LBP were identified and treated at the garrison clinic. Predictive associations between intrinsic risk factors and LBP were examined using multivariate Cox proportional hazard models.

RESULTS

The cumulative incidence of LBP was 16%, the incidence rate being 1.2 (95% confidence interval [CI], 1.0-1.4) per 1,000 person-days. Conscripts with low educational level had increased risk for incidence of LBP (hazard ratio [HR], 1.6; 95% CI, 1.1-2.3). Conscripts with low dynamic trunk muscle endurance and low aerobic endurance simultaneously (ie, having coimpairment) at baseline also had an increased risk for incidence of LBP. The strongest risk factor was coimpairment of trunk muscular endurance in tests of back lift and push-up (HR, 2.8; 95% CI, 1.4-5.9).

CONCLUSIONS

The increased risk for LBP was observed among young men who had a low educational level and poor fitness level in both muscular and aerobic performance.

Clinical observations in total body DXA: technical aspects of positioning and analysis

Total body (TB) dual-energy X-ray absorptiometry (DXA) can assess regional body composition, which may necessitate greater attention to patient positioning and analysis than required for whole body assessment. This report describes technical challenges experienced in performing TB DXA, explores the frequency with which autoanalysis inaccuracies occur, assesses their effect on regional body composition results, and describes a uniform clinical approach for TB DXA positioning and analysis. Patient positioning followed manufacturer recommendations with additional facility-imposed procedures. On visual inspection, it was apparent that automated analysis often did not meet manufacturer guidelines, thus requiring manual alteration. To explore the frequency with which manual adjustments were needed, and the impact on results, TB scans were obtained in 20 men and 20 women aged 18-93 yr. The head line was altered in 98%, one or both shoulder lines in 93%, and the lateral hip boundary in 40%. Manual and automated TB analyses were highly correlated (r(2)=0.98-1.00). However, regional result correlation was less robust, that is, automated and manual appendicular lean mass differed by more than our least significant change in 33%. In conclusion, manual correction of automated TB DXA scan analysis is often needed. Such alterations do not affect TB measures but may affect regional body composition results.

Factors of trainability and predictability associated with military physical fitness test success

Cuddy, JS, Slivka, DR, Hailes, WS, and Ruby, BC. Factors of trainability and predictability associated with military physical fitness test success. J Strength Cond Res 25(12): 3486-3494, 2011-The purpose of this study was to determine the trainability of college-aged men using varied training programs and to assess factors associated with successfully passing a Special Operations Forces (SOF) physical fitness test (PFT). One hundred thirty-five male subjects were stratified into 3 training groups (run focused, calisthenic focused, or combined run and calisthenic) and were trained 3 times·per week for 12 weeks. Body composition and accelerometer activity patterns were measured pretraining and posttraining. The PFT performance (pull-ups, sit-ups, push-ups, and 1.5-mile run time) was measured weekly throughout the study period. The subjects exhibited reduced body fat (18.4 ± 7.7 to 16.9 ± 7.3), increased fat-free mass (66.1 ± 8.2 to 67.4 ± 7.9), reduced fat mass (15.8 ± 9.2 to 14.6 ± 8.9) from pretraining to posttraining, respectively (p < 0.05). All groups improved in each component of PFT performance with training (p < 0.05). There was a significant 20 ± 35% increase in 6-day average daily activity for the run-focused training group from pretraining and posttraining. The key indicators of a candidate's potential to successfully reach SOF PFT standards (in 12 weeks) were determined to be as follows: enter the pipeline being able to run 2.4 km in ≤10:41 minutes, have a body fat percentage of ≤12.9%, and participate in a minimum of 30 min·d of vigorous physical activity. Training an individual's relative run or calisthenic deficiency did not prove to be a better training approach compared with a program that emphasizes training both running and calisthenic activities.

Low physical fitness is a strong predictor of health problems among young men: a follow-up study of 1411 male conscripts

BACKGROUND

Military service in Finland is compulsory for male citizens and annually about 90% of 19-year-old men enter into the service. Approximately 15% of them are discharged due to medical reasons constituting a group of young men who are at risk of being marginalised in society. The purpose of the study was to evaluate predictive associations between medical discharge from the compulsory military service and various intrinsic risk factors, including socio-economic, health, health behavior, and physical fitness outcomes.

METHODS

We followed four successive cohorts of conscripts who formed a representative sample of Finnish young men (18-28 years old, median age 19 yrs) for 6 months. To exclude injuries and illnesses originating before the onset of service, conscripts discharged from the service at the medical screenings during the 2-week run-in period were excluded from the analyses. Data regarding medical discharge were charted from computerised patient records. Predictive associations between medical discharge and intrinsic risk factors were examined using multivariate Cox's proportional hazard models.

RESULTS

Of 1411 participants, 9.4% (n = 133) were discharged prematurely for medical reasons, mainly musculoskeletal (44%, n = 59) and mental and behavioral (29%, n = 39) disorders. Low levels of physical fitness assessed with a 12-min running test (hazard ratio [HR] 3.3; 95% confidence interval [CI]: 1.7-6.4), poor school success (HR 4.6; 95% CI: 2.0-11.0), poor self-assessed health (HR 2.8; 95% CI: 1.6-5.2), and not belonging to a sports club (HR 4.9; 95% CI: 1.2-11.6) were most strongly associated with medical discharge in a graded manner. The present results highlight the need for an improved pre-enlistment examination and provide a new means of identifying young persons with a high risk for discharge.

CONCLUSIONS

The majority of the observed risk factors are modifiable. Thus preventive measures and programs could be implemented. The findings suggest that increasing both aerobic and muscular fitness is a desirable goal in a pre-training program before entering military service. Attention to appropriate waist circumference and strategies addressing psychological well-being may strengthen the preventive program. Optimally the effectiveness of these programs should be tested in randomized controlled intervention studies.

Leg skinfold thicknesses and race performance in male 24-hour ultra-marathoners

The association of skinfold thicknesses with race performance has been investigated in runners competing over distances of ≤50 km. This study investigated a potential relation between skinfold thicknesses and race performance in male ultra-marathoners completing >50 km in 24 hours. Variables of anthropometry, training, and previous performance were related to race performance in 63 male ultra-marathoners aged 46.9 (standard deviation [SD] 10.3) years, standing 1.78 (SD 0.07) m in height, and weighing 73.3 (SD 7.6) kg. The runners clocked 146.1 (SD 43.1) km during the 24 hours. In the bivariate analysis, several variables were associated with race performance: body mass (r = -0.25); skinfold thickness at axilla (r = -0.37), subscapula (r = -0.28), abdomen (r = -0.31), and suprailiaca (r = -0.30); the sum of skinfold thicknesses (r = -0.32); percentage body fat (r = -0.32); weekly kilometers run (r = 0.31); personal best time in a marathon (r = -0.58); personal best time in a 100-km ultra-run (r = -0.31); and personal best performance in a 24-hour run (r = 0.46). In the multivariate analysis, no anthropometric or training variable was related to race performance. In conclusion, in contrast to runners up to distances of 50 km, skinfold thicknesses of the lower limbs were not related to race performance in 24-hour ultra-marathoners.

Accuracy of direct segmental multi-frequency bioimpedance analysis in the assessment of total body and segmental body composition in middle-aged adult population

BACKGROUND & AIMS

Body composition measurement is a valuable tool for assessing nutritional status and physical fitness in a variety of clinical settings. Although bioimpedance analysis (BIA) can easily assess body composition, its accuracy remains unclear. We examined the accuracy of direct segmental multi-frequency BIA technique (DSM-BIA) in assessing different body composition parameters, using dual energy X-ray absorptiometry (DEXA) as a reference standard.

METHODS

A total of 484 middle-aged participants from the Leiden Longevity Study were recruited. Agreements between DSM-BIA and DEXA for total and segmental body composition quantification were assessed using intraclass correlation coefficients and Bland-Altman plots.

RESULTS

Excellent agreements were observed between both techniques in whole body lean mass (ICC female = 0.95, ICC men = 0.96), fat mass (ICC female = 0.97, ICC male = 0.93) and percentage body fat (ICC female = 0.93, ICC male = 0.88) measurements. Similarly, Bland-Altman plots revealed narrow limits of agreements with small biases noted for the whole body lean mass quantification but relatively wider limits for fat mass and percentage body fat quantifications. In segmental lean muscle mass quantification, excellent agreements between methods were demonstrated for the upper limbs (ICC female≥0.91, ICC men≥0.87) and lower limbs (ICC female≥0.83, ICC male≥0.85), with good agreements shown for the trunk measurements (ICC female = 0.73, ICC male = 0.70).

CONCLUSIONS

DSM-BIA is a valid tool for the assessments of total body and segmental body composition in the general middle-aged population, particularly for the quantification of body lean mass.

Differential correlations between anthropometry, training volume, and performance in male and female Ironman triathletes

We investigated in 27 male Ironman triathletes aged 30.3 (9.1) years, with 77.7- (9.8) kg body mass, 1.78- (0.06) m body height, 24.3- (2.2) kg·m⁻² body mass index (BMI), and 14.4 (4.8) % body fat and in 16 female Ironman triathletes aged 36.6 (7.0) years, with 59.7- (6.1) kg body mass, 1.66- (0.06) m body height, 21.5 (1.0) kg·m⁻² BMI, and 22.8 (4.8) % body fat to ascertain whether anthropometric or training variables were related to total race time. The male athletes were training 14.8 (3.2) h·wk⁻¹ with a speed of 2.7 (0.6) km·h⁻¹ in swimming, 27.3 (3.0) in cycling, and 10.6 (1.4) in running. The female athletes trained for 13.9 (3.4) h·wk⁻¹ at 2.1 (0.8) km·h⁻¹h in swimming, 23.7 (7.6) km·h⁻¹ in cycling, and 9.0 (3.7) km·h⁻¹ in running, respectively. For male athletes, percent body fat was highly significantly (r² = 0.583; p < 0.001) associated with total race time. In female triathletes, training volume showed a relationship to total race time (r² = 0.466; p < 0.01). Percent body fat was unrelated to training volume for both men (r² = 0.001; p > 0.05) and women (r² = 0.007; p > 0.05). We conclude that percent body fat showed a relationship to total race time in male triathletes, and training volume showed an association with total race time in female triathletes. Presumably, the relationship between percent body fat, training volume, and race performance is genetically determined.

Surgical versus functional treatment for acute ruptures of the lateral ligament complex of the ankle in young men: a randomized controlled trial

BACKGROUND

Some have recommended surgical treatment of Grade-III lateral ligament injuries in very active individuals with high functional demands on the ankle. The purpose of this study was to establish whether surgery provides better long-term results than functional treatment for acute ruptures of the lateral ligaments of the ankle.

METHODS

Physically active Finnish men (mean age, 20.4 years) with an acute Grade-III lateral ligament rupture of the ankle were randomly allocated to surgical (n = 25) or functional (n = 26) treatment. Ligament injury was confirmed with stress radiographs. Surgical treatment comprised suture repair of the injured ligament(s) within the first week after injury. A below-the-knee plaster cast was worn for six weeks with full weight-bearing. Functional treatment consisted of the use of an Aircast ankle brace for three weeks. The main outcome measures included final follow-up examinations, calculation of an ankle score, stress radiographs, and magnetic resonance imaging scans.

RESULTS

Fifteen (60%) of twenty-five surgically treated patients and eighteen (69%) of twenty-six functionally treated patients returned for long-term follow-up (mean duration, fourteen years). All patients in both groups had recovered their preinjury activity level and reported that they could walk and run normally. The prevalence of reinjury was one of fifteen in the surgical group and seven of eighteen in the functional treatment group (risk difference: 32%; 95% confidence interval: 6% to 58%). The mean ankle score did not differ significantly between the groups (mean difference: 8.3 points; 95% confidence interval: -0.03 to 16.6 points). Stress radiographs revealed no difference between groups with regard to the mean anterior drawer (-1 mm in the surgical group and 0 mm in the functional treatment group; mean difference: 0.7 mm; 95% confidence interval: -1.4 to 2.7 mm) or mean tilt angle (0° in both groups; mean difference: 0.1°; 95% confidence interval: -3.2° to 3.5°). Grade-II osteoarthritis was observed on magnetic resonance images of four of the fifteen surgically treated patients and in none of the eighteen functionally treated patients (risk difference: 27%; 95% confidence interval: 4% to 49%).

CONCLUSIONS

These findings indicate that, in terms of recovery of the preinjury activity level, the long-term results of surgical treatment of acute lateral ligament rupture of the ankle correspond with those of functional treatment. Although surgery appeared to decrease the prevalence of reinjury of the lateral ligaments, there may be an increased risk for the subsequent development of osteoarthritis.

Race performance in male mountain ultra-marathoners: anthropometry or training?

The association of anthropometric variables, training volume, and prerace experience with race time was investigated in 25 male mountain ultra-marathoners (M age = 44.5 yr., SD = 7.0; M body mass = 73.0 kg, SD = 7.8; M body height = 1.78 m, SD = 0.07; M Body Mass Index = 22.9 kg/m2, SD = 1.8) in a 7-day mountain ultra-marathon over 350 km with a total 11,000 m of altitude gained and lost. The relationship of anthropometry (body mass, body height, Body Mass Index, percent body fat, circumferences of limbs, and thicknesses of skin-folds), training, and prerace experience (years as active runner, average training volume in hours and kilometres per week, average running speed in training, and personal best time in marathon running) with total race time was investigated using bivariate correlation analysis. None of the variables of anthropometry were related to total race time. Average speed in running during training and personal best time in marathon running were associated with total race time. Speed in running during training was correlated with personal best time in marathon running. The finding that average speed in running during training and personal best marathon time were related to race performance suggests that training and especially intensity might be of increased importance in these ultra-runners compared to anthropometry.

The relationship between selected body composition variables and muscular endurance in women

The primary purpose of this study was to determine if muscular endurance is affected by referenced waist circumference groupings, independent of body mass and subcutaneous abdominal fat, in women. This study also explored whether selected body composition measures were associated with muscular endurance. Eighty-four women were measured for height, weight, body mass index (BMI), waist circumference (WC), and abdominal skinfold thickness (SFAB) and performed 60-s sit-ups (SU) and maximal push-ups (PU) tests. Mean differences in SU and PU scores were tested across three groups based on WC as follows: WCG1 < 70 cm; WCG2 between 70 and 89 cm; WCG3 > or = 90 cm. There were no significant differences in SU and PU scores between WCG1 and WCG2. WCG3 had significantly lower SU and PU scores compared to the other groups. After adjusting for the influence of SFAB, BMI, and weight, the differences disappeared. The regression analysis revealed a two-variable (BMI and SFAB) model that accounted for the variation in SU performance. For PU, only BMI loaded into the regression model. The results of this study suggest that women with a WC > or = 90 cm have decreased muscular endurance compared to their lower WC counterparts. This difference is related to higher body masses.