Influence of exercise type and duration on cardiorespiratory fitness and muscular strength in post-menopausal women: a systematic review and meta-analysis

Effects of jazz dance and concurrent training on physical variables in postmenopausal women

OBJECTIVE

This study aimed to analyze the effects of jazz dance or concurrent training on the cardiorespiratory fitness (CRF), muscle strength and sleep quality of postmenopausal women.

METHOD

A randomized clinical trial with 6-month and 12-month follow-up was conducted including 70 postmenopausal women (mean age 53.19 ± 3.39 years). Participants were randomized into the jazz dance intervention (JD) group, concurrent training intervention (CT) group and control group (CG). CRF was assessed using the 6-min walk test, muscle strength using the isokinetic dynamometer and sleep quality using the Pittsburgh Sleep Quality Index questionnaire. Generalized estimating equations with post-hoc minimum significant difference were used, and intention-to-treat and protocol adherence analyses were performed.

RESULTS

CRF showed changes between groups, times and interactions, but the CT group achieved greater gains compared to the JD group. Isokinetic strength showed long-term intragroup improvement for both intervention groups, at peak extension and flexion. Intergroup differences were observed, with the JD group presenting higher means in peak extension at all times compared to the CG post intervention; however, the CT group achieved higher means compared to the JD group; and at peak flexion, the JD group presented with higher averages compared to the CG post intervention. The JD group showed an improvement in sleep duration in the short term, while the CT group did so at the 6-month follow-up. There were intergroup changes in the reduction in sleep medication in both intervention groups compared to the CG.

CONCLUSION

Both modalities are effective for improving CRF, muscle strength and sleep quality.

Association of cardiorespiratory fitness with dementia risk across different levels of genetic predisposition: a large community-based longitudinal study

OBJECTIVE

We aimed to investigate the association of cardiorespiratory fitness (CRF) with cognitive function and dementia risk, taking genetic predisposition for dementia into account.

METHODS

Within the UK Biobank, 61 214 dementia-free participants aged 39-70 years were followed for up to 12 years. CRF score was estimated using a 6 min submaximal exercise test on a stationary bike and divided into tertiles (ie, low, moderate, and high; standardised by age and sex). Global cognitive function was evaluated at baseline. Dementia was identified based on medical history and medical records. Genetic predisposition for dementia was estimated using the polygenic risk score for Alzheimer's disease (PRSAD), tertiled as low, moderate, or high. Data were analysed using linear regression, Poisson regression, and Laplace regression.

RESULTS

Compared with low CRF, high CRF was related to better global cognitive function (β=0.05, 95% CI 0.04 to 0.07). Over the follow-up period, 553 individuals developed dementia. Compared with low CRF, the incidence rate ratio (IRR) of all dementia was 0.60 (95% CI 0.48 to 0.76) for high CRF, and the onset of all dementia was delayed by 1.48 (95% CI 0.58 to 2.39) years among people with high versus low CRF. Among people with a moderate/high polygenic risk score, high CRF attenuated all dementia risk by 35% (IRR 0.65, 95% CI 0.52 to 0.83).

CONCLUSION

High CRF is associated with better cognitive performance at baseline, and lower dementia risk long-term. High CRF could mitigate the impact of genetic predisposition on the development of dementia by 35%.

Jazz dancing for improving cardiorespiratory fitness, body composition, muscle strength, and sleep quality in postmenopausal women: a randomized clinical trial with 6- and 12-month follow-ups

OBJECTIVE

The aim of the study was to analyze the effects of 16 weeks of Jazz Dance training compared to a control group in postmenopausal women, postintervention, and at the 6- and 12-month follow-ups, on cardiorespiratory fitness, body composition, muscle strength, and sleep quality.

METHODS

Two-arm randomized clinical trial with a total of 47 women (jazz dance intervention group [JDIG] [n = 23] and control group (CG) [n = 24]) with a mean age of 53.41 ± 2.8 y. Data collection was carried out at four times, baseline, postintervention, and 6- and 12-month follow-ups using the 6-minute walk test (cardiorespiratory fitness); bioimpedance (body composition); isokinetic dynamometry (muscle strength); and the Pittsburgh Sleep Quality Index (sleep quality).

RESULTS

In the intention-to-treat analysis, the results showed positive differences for the JDIG in cardiorespiratory fitness at all time points (P = 0.034) and in the group x time interaction (P = <0.001). Lower limb muscle strength showed differences from baseline to postintervention and from baseline to the 12-month follow-up for the concentric force ratio (P = 0.021; P = 0.009). However, for peak extension and flexion, the results were not positive for the JDIG. There was a short-term improvement in sleep duration for the JDIG (P = 0.001) and significant intergroup differences in subjective sleep quality, where the JDIG showed better results compared to the CG (P = 0.041).

CONCLUSIONS

Jazz Dance is effective for improving cardiorespiratory fitness (in the short, medium, and long term) and sleep quality (in the short and medium term); however, it does not seem to have presented sufficient intensity and duration for facilitating changes in body composition or increasing lower limb muscle strength in postmenopausal women.

Unpicking Causal Relationships Between Grip Strength and Cardiorespiratory Fitness: A Bidirectional Mendelian Randomization Study

Understanding the dominant direction of association between cardiorespiratory fitness (CRF) and grip strength could help refine physical activity recommendations. We performed a Mendelian Randomization (MR) analysis to elucidate the bidirectional relationship between CRF and grip strength (GS). Using an inverse-variance weighted (IVW) MR framework, we estimated the strength of the GS (exposure)-CRF (outcome) association using genome-wide association summary data. When examining the CRF (exposure)-GS (outcome) association, the CRF genetic instrument was related to individual-level GS phenotypic data in 367 693 UK Biobank participants. Several sensitivity analyses were performed (e.g., MR-Egger, MR-weighted median estimator and MR-PRESSO) and both measures were scaled by body weight (w). In the direction GS-to-CRF, a 1-unit increase in GSw (i.e., GS/weight) was associated with 1.70 mL/kg/min (95% confidence interval (CI): 1.14,2.27) higher CRFw (IVW model). This finding persisted across most sensitivity analyses. In the reverse direction, there was no evidence supporting an effect of CRFw on GSw, e.g., a 1-unit increase in CRFw led to a 0.00 kg/kg (95% CI: -0.01,0.02) higher GSw (IVW model). Our finding of a dominant direction of association from greater GS to higher CRF is relevant when considering how to promote physical activity guidelines. For example, placing too much emphasis on improving/maintaining CRF is unlikely to result in maximum benefits for other fundamental components of physical fitness, particularly muscle strength.

Exercise for peri- and postmenopausal women: Recommendations from synergistic alliances of women's medicine and health psychology for the promotion of an active lifestyle

Adopting healthy behaviors is a multifaceted and complex process that poses significant challenges for individuals. Despite awareness of the detrimental effects of certain behaviors on health, many individuals continue to engage in risky practices. Traditional medical advice and prescriptions, while well intentioned, often fall short in fostering lasting lifestyle changes. Although individuals may also have good intentions, solely relying on doctor's counsel does not ensure successful lifestyle adjustments. One primary reason for this limitation is the lack of specialized expertise in behavioral modification among gynecologists and healthcare providers. Health psychologists are specialized professionals capable of effectively guiding and assisting individuals in modifying health-related behaviors. Their expertise in behavior change strategies and psychological interventions proves invaluable in empowering individuals to embrace healthier lifestyles and contributes to people's well-being. This paper emphasizes the importance of collaborative efforts between medical professionals, such as gynecologists, and health psychologists to promote healthy behaviors among peri- and postmenopausal women and enhance women's health. By forging integrative alliances, they can develop comprehensive and tailored interventions. By bridging the gap between medical advice and behavior modification, this collaborative effort has the potential to ensure a more effective intervention process. This holistic approach not only addresses women's specific health needs but also fosters sustainable behavior change when promoting healthy behaviors among middle-aged women. The ultimate goal of such a synergy is to improve women's health outcomes and contribute to a healthier society overall.

Combined versus independent effects of exercise training and intermittent fasting on body composition and cardiometabolic health in adults: a systematic review and meta-analysis

INTRODUCTION AND AIM

Exercise training (Ex) and intermittent fasting (IF) are effective for improving body composition and cardiometabolic health overweight and obese adults, but whether combining Ex and IF induces additive or synergistic effects is less well established. We therefore, performed a systematic review and meta-analysis to compare the combined versus independent effects of Ex and IF on body composition and cardiometabolic health in adults.

METHOD

An electronic search was conducted in three main online databases including PubMed, Web of Science, and Scopus, from inception to March 9, 2023 for studies involving Ex plus IF trials versus standalone Ex and/or IF interventions in adults. Interventions had a duration of ≥ 2 weeks. Standardized (SMD) or weighted mean differences (WMD) and 95% confidence intervals were calculated in order to compare effects on body weight, body mass index (BMI), body fat lean body mass (LBM), visceral fat, and waist circumference. For cardiometabolic health, outcomes included fasting glucose, insulin, total cholesterol (TC), low-density lipoprotein cholesterol (LDL), triglycerides (TG), high-density lipoprotein cholesterol (HDL), systolic (SBP) and diastolic (DBP) blood pressure, and VO2max/peak.

RESULTS

Ex plus IF decreased body weight [WMD: -3.03 kg (95% CI: -3.44 to -2.61), p = 0.001], BMI [WMD: -1.12 kg.m2 (95% CI: -1.28 to -0.95), p = 0.001], body fat [SMD: -0.72 (95% CI: -1.23 to -0.21), p = 0.005], visceral fat [SMD: -0.34 (95% CI: -0.63 to -0.05), p = 0.01], and waist circumference [WMD: -2.63 cm (95% CI: -4.16 to -1.11), p = 0.001] more than Ex alone. However, changes in body composition and cardiometabolic health markers were not significantly different for Ex plus IF when compared with IF alone, with the exception of VO2max/peak [SMD: 0.55 (95% CI: 0.14 to 0.97), p = 0.009].

CONCLUSION

We demonstrate that a combination of Ex and IF produces superior changes in body composition, but not in markers of cardiometabolic health when compared with Ex or IF alone. Ex plus IF could therefore be effective for weight and fat loss but has no additive or synergistic effects for other cardiometabolic health markers.

The Impact of Physical Activity and Inactivity on Cardiovascular Risk across Women's Lifespan: An Updated Review

Physical inactivity (PI) represents a significant, modifiable risk factor that is more frequent and severe in the female population worldwide for all age groups. The physical activity (PA) gender gap begins early in life and leads to considerable short-term and long-term adverse effects on health outcomes, especially cardiovascular (CV) health. Our review aims to highlight the prevalence and mechanisms of PI across women's lifespan, describing the beneficial effects of PA in many physiological and pathological clinical scenarios and underlining the need for more awareness and global commitment to promote strategies to bridge the PA gender gap and limit PI in current and future female generations.

The effects of exercise training on body composition in postmenopausal women: a systematic review and meta-analysis

INTRODUCTION

We conducted a systematic review and meta-analysis to investigate the effect of exercise training on body composition outcomes in postmenopausal women.

METHODS

PubMed, Web of Science, CINAHL, and Medline were searched to identify the randomized controlled trials which evaluated effect of exercise training versus control in postmenopausal women. Standardized mean differences (SMD), weighted mean differences (WMD) and 95% confidence intervals (95% CIs) were calculated using random effects model.

RESULTS

One hundred and one studies involving 5,697 postmenopausal women were included in the meta-analysis. Results indicated that exercise training effectively increased muscle mass/ volume, muscle and fiber cross-sectional area and fat-free mass, and decreased fat mass, body fat percentage, waist circumference and visceral fat. Furthermore, subgroup analyses results revealed that aerobic and combined training had greater beneficial effects on fat mass outcomes, whereas resistance and combined training had greater beneficial effects on muscle mass outcomes.

DISCUSSION

Overall, our results revealed that exercise training is effective for improving body composition in postmenopausal women. To be specific, aerobic training is effective on fat loss, whereas resistance training is effective on muscle gain. However, combination of aerobic and resistance trainings may be considered a viable strategy to improve body composition in postmenopausal women.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/, identifier CRD42021283425.