Dose-dependent associations of joint aerobic and muscle-strengthening exercise with obesity:A cross-sectional study of 280,605 adults

Background:Emerging epidemiological evidence suggests that compared to engaging in 1 activity mode alone,a combination of moderate-tovigorous physical activity(MVPA:brisk walking/jogging,cycling)and muscle-strengthening exercise(MSE:push-ups/sit-ups,using weight machines)has more favorable associations with optimal weight status.However,few studies have examined the dose-dependent and joint associations of MVPA and MSE with obesity.Methods:Based on cross-sectional analyses of the European Health Interview Survey Wave 2(2013-2014),we examined prevalence ratios(PRs)of joint and stratified associations between MVPA(4 categories:(ⅰ)0 min/week,(ⅱ)1-149 min/week,(ⅲ)150-299 min/week,and(ⅳ)≥300 min/week)and MSE(3 categories:(ⅰ)0 day/week,(ⅱ)1 day/week,and(ⅲ)>2 days/week)with body mass index-defined obesity(body mass index of>30.0 kg/m2)using Poisson regression with robust error variance.PRs were examined unadjusted and adjusted for sociodemographic and lifestyle characteristics(e.g.,sex,age,education,income,and smoking status).Results:Data were available for 280,456 adults(≥18 years),of which 46,166(15.5%)were obese.The interaction MVPA x MSE guideline adherence was statistically significant for obesity(p≤0.05).The joint MVPA-MSE analysis showed that compared to the reference group(i.e.,no MVPA and no MSE),the PRs followed a dose-dependent pattern,with the lowest observed among those reporting≥150 MVPA min/week and≥1 MSE days/week(PR:0.43;95%confidence interval:0.41-0.46).When stratified across each MVPA strata,the PRs were mostly lower among those engaging in MSE 1 day/week,as compared to those doing MSE≥2 days/week.Conclusion:"There was evidence for a dose-dependent association between joint MVPA-MSE with a reduced prevalence of obesity.Public health strategies for the prevention and management of obesity should recommend both MVPA and MSE.

Exercise therapy for sarcopenia and diabetes

Aging is characterized by the gradual deterioration of function at the molecular,cellular,tissue,and organism levels in humans.The typical diseases caused by changes in body composition,as well as functional decline in the human body’s organs due to aging include sarcopenia and metabolic disorders.The accumulation of dysfunctional agingβcells with age can cause decreased glucose tolerance and diabetes.Muscle decline has a multifactorial origin,involving lifestyle habits,disease triggers,and age-dependent biological changes.The reduced function ofβcells in elderly people lowers insulin sensitivity,which affects protein synthesis and interferes with muscle synthesis.The functional decrease and aggravation of disease in elderly people with less regular exercise or physical activity causes imbalances in food intake and a continuous,vicious cycle.In contrast,resistance exercise increases the function ofβcells and protein synthesis in elderly people.In this review,we discuss regular physical activities or exercises to prevent and improve health,which is sarcopenia as decreased muscle mass and metabolic disorders as diabetes in the elderly.

Physical exercise in the prevention and treatment of Alzheimer’s disease

Dementia is one of the greatest global challenges for health and social care in the 21st century.Alzheimer’s disease(AD),the most common type of dementia,is by no means an inevitable consequence of growing old.Several lifestyle factors may increase,or reduce,an individual’s risk of developing AD.Much has been written over the ages about the benefits of exercise and physical activity.Among the risk factors associated with AD is a low level of physical activity.The relationship between physical and mental health was established several years ago.In this review,we discuss the role of exercise(aerobic and resistance)training as a therapeutic strategy for the treatment and prevention of AD.Older adults who exercise are more likely to maintain cognition.We address the main protective mechanism on brain function modulated by physical exercise by examining both human and animal studies.We will pay especial attention to the potential role of exercise in the modulation of amyloid b turnover,inflammation,synthesis and release of neurotrophins,and improvements in cerebral blood flow.Promoting changes in lifestyle in presymptomatic and predementia disease stages may have the potential for delaying one-third of dementias worldwide.Multimodal interventions that include the adoption of an active lifestyle should be recommended for older populations.

Dynamic resistance exercise increases skeletal muscle-derived FSTL1 inducing cardiac angiogenesis via DIP2A-Smad2/3 in rats following myocardial infarction

Purpose:The aim of this study was to investigate the potential of dynamic resistance exercise to generate skeletal muscle-derived follistatin like-1(FSTL1),which may induce cardioprotection in rats following myocardial infarction(MI)by inducing angiogenesis.Methods:Male,adult Sprague-Dawley rats were randomly divided into 5 groups(n=12 in each group):sham group(S),sedentary MI group(MI),MI+resistance exercise group(MR),MI+adeno-associated virus(AAV)-FSTL1 injection group(MA),and MI+AAV-FSTL1 injection+resistance exercise group(MAR).The AAV-FSTL1 vector was prepared by molecular biology methods and injected into the anterior tibialis muscle.The MI model was established by ligation of the left anterior descending coronary artery.Rats in the MR and MAR groups underwent 4 weeks of dynamic resistance exercise training using a weighted climbing-up ladder.Heart function was evaluated by hemodynamic measures.Collagen volume fraction of myocardium was observed and analyzed by Masson’s staining.Human umbilical vein vessel endothelial cells culture and recombinant human FSTL1 protein or transforming growth factor-b receptor 1(TGFbR1)inhibitor treatment were used to elucidate the molecular signaling mechanism of FSTL1.Angiogenesis,cell proliferation,and disco interacting protein 2 homolog A(DIP2A)location were observed by immunofluorescence staining.The expression of FSTL1,DIP2A,and the activation of signaling pathways were detected by Western blotting.Angiogenesis of endothelial cells was observed by tubule experiment.One-way analysis of variance and Student’s t test were used for statistical analysis.Results:Resistance exercise stimulated the secretion of skeletal muscle FSTL1,which promoted myocardial angiogenesis,inhibited pathological remodeling,and protected cardiac function in MI rats.Exercise facilitated skeletal muscle FSTL1 to play a role in protecting the heart.Exogenous FSTL1 promoted the human umbilical vein vessel endothelial cells proliferation and up-regulated the expression of DIP2A,while TGFbR1 inhibitor intervention down-regulated the phosphorylation level of Smad2/3 and the expression of vascular endothelial growth factor-A,which was not conducive to angiogenesis.FSTL1 bound to the receptor,DIP2A,to regulate angiogenesis mainly through the Smad2/3 signaling pathway.FSTL1-DIP2A directly activated Smad2/3 and was not affected by TGFbR1.Conclusion:Dynamic resistance exercise stimulates the expression of skeletal muscle-derived FSTL1,which could supplement the insufficiency of cardiac FSTL1 and promote cardiac rehabilitation through the DIP2A-Smad2/3 signaling pathway in MI rats.

The etiology and exercise implications of sarcopenia in the elderly

An increasing aging population greatly impacts health care services worldwide.A large percentage of healthcare expenditures for seniors arise from the negative outcomes of muscle loss,also known as sarcopenia.Aging-related losses of muscle strength and quality impair balance,walking ability and endurance and cause negative events such as falls,incident disability and frailty.This review systemically explores the significance of sarcopenia in the elderly and addresses several important physiological mechanisms of sarcopenia.The implications of crucial exercise regimens that improve muscle strength and delay the onset of sarcopenia are also discussed.

Effect of resistance exercise on insulin sensitivity of skeletal muscle

Insulin resistance(IR)is the common pathophysiological basis of many metabolic diseases.IR is characterized by decreased glucose uptake in skeletal muscle and adipose tissue,especially in skeletal muscle.Skeletal muscle is the main target tissue of glucose uptake under insulin stimulation.Glucose uptake by skeletal muscle is complex,and it is controlled by many pathways.The PI3K/AKt/GSK-1 signaling pathway is not only the main pathway for insulin signal transduction but also an important mechanism for regulating blood glucose.From the binding of insulin to its receptors on the surface of target cells to the transportation of glucose from extracellular fluid to skeletal muscle,a series of signal transduction processes is completed,any of which potentially affects the physiological effects of insulin and leads to IR.Resistance exercise(RT)can reduce skeletal muscle IR and effectively improve blood glucose control and glycosylated hemoglobin level in patients with type 2 diabetes mellitus(T2DM).However,the exact mechanism by which RT improves skeletal muscle IR remains unclear.Therefore,this paper discusses the above problems by tracking the progress of the literature to deepen the correlation between RT and skeletal muscle insulin sensitivity and provide further evidence for the application of exercise therapy in IR.In conclusion,RT mainly improves insulin sensitivity of skeletal muscle by increasing muscle mass,microvascular blood flow,and glucose transporter-4 expression in skeletal muscle,as well as by reducing lipid accumulation and inflammation in skeletal muscle.Thus,it is potentially useful in the prevention and treatment of T2DM.

Impact of resistance exercise training on physical performance of patients undergoing hemodialysis

Background:Hemodialysis is the major treatment option for patients with chronic kidney disease.With the increase in the number of maintenance hemodialysis patients,debilitating conditions of muscle willing and atrophy and numerous health problems associated with chronic kidney disease and hemodialysis have become the most significant concerns.Methods:This randomized controlled trial study design will be conducted at Al-Najaf city in the southern region of Iraq and carried out on 68 patients with chronic kidney disease undergoing hemodialysis for at least six months and who had a medically stable condition,which will be randomly divided into training group;exercise therapy and control,groups.The training group participated in 8-week(3 sessions per week)resistance exercise therapy in three sets of 10 repetitions of knee extension,hip flexion,and hip abduction with the use of an elastic band under the supervision of a training physiotherapist and researcher during the first hour of the three routine hemodialysis treatment session per week.But the control group did not experience any intervention.To analyze the data,two-way analysis of variance and Bonferroni statistical tests will be used at the significant level of(P=0.05).Discussion:Important features of this study include the randomization procedures,double-blind,large sample size,and a standardized protocol for resistance exercise training on the physical performance of hemodialysis patients.This study aims to determine the effectiveness of resistance exercise for the patient with chronic kidney disease and undergoing hemodialysis.Therefore,our results will be useful for patients with chronic kidney diseases,medical staff,and healthcare decision-makers.

Overview of Exercise Prescription for Diabetes Patients and Its Application in Japan

In recent years,the Westernization of dietary habits and increasingly sedentary lifestyle have contributed to a marked increase in the number of type 2 diabetes patients.Sedentary behavior may play a significant role in the development and aggravation of type 2 diabetes.The results of various follow-up studies have demonstrated that proper diet combined with physical exer-cise is useful in the prevention and treatment of type 2 diabetes.A nationwide survey regarding exercise therapy for diabetes patients in Japan revealed that relatively few physicians provide patients with exercise guidance because of time constraints,that the physicians do not receive additional consultation fee,and that there is a lack of specialized physical exercise educa-tors.Physical exercise promotes the utilization of glucose and free fatty acids in the muscles,and thus lowers blood glucose(BG)levels.Dietary restriction and physical exercise are effective in the prevention and treatment of type 2 diabetes by improving the in vivo sensitivity to insulin.Most adults with diabetes should engage in 150 min or more of moderate-to-vigorous intensity aerobic activity per week,spread out over at least 3 days/week,with no more than two consecutive days without activity.Mild-intensity resistance training such as half squat and calf raise is recommended for elderly individuals who have decreased muscle strength and mass(sarcopenia).Prolonged sitting should be interrupted every 30 min for BG benefits,particularly in adults with type 2 diabetes.Individuals with type 2 diabetes are also encouraged to increase their total daily unstructured physical activity(daily movement).

Resistance Exercise Increases the Regulation of Skeletal Muscle FSTL1 Consequently Improving Cardiac Angiogenesis in Rats with Myocardial Infarctions

Purpose The aim of this study was to investigate whether skeletal muscle-derived follistatin-like 1(FSTL1)reaches the heart and exerts the angiogenetic function in rats suffering myocardial infarctions(MI)after exercise intervention.Methods Forty-eight male adult Sprague-Dawley rats were randomly divided into four groups.MI was provoked by ligation of left anterior descending coronary artery.MI rats underwent adeno-associated virus injection of FST1 in tibialis anterior muscle and 4 weeks of resistance exercise via a tail-suspended incremental weight-climbing method(0-75%body weight,daily load increased by 10%;1 h/day,5 day/w).Heart function was evaluated by hemodynamics including LVSP,LVEDP and±dP/dt max;the cross-sectional area of muscle cells and myocardium fibrosis were analyzed by DiI and Masson’s stain-ing,respectively;the FSTL1 expression,endothelial cell proliferation and angiogenesis were visualized by immunofluores-cence staining;and protein expression was quantified by Western blotting.Results Resistance exercise reverted MI-induced skeletal muscle atrophy,increased muscle FSTL1 expression and stimulated skeletal muscle derived FSTL1 entering into the MI heart via blood circulation.The overexpression of skeletal muscle FSTL1 improved myocardial endothelial cell proliferation,increased small vessel density in the fibrotic border,inhibited myocardial fibrosis and improved heart function in the MI rats after the exercise intervention.Meanwhile,DIP2A-PI3K-Akt-mTOR,Erk1/2 and TGFβ-Smad2/3 pathways were activated in the myocardium.Conclusion Resistance exercise stimulates skeletal muscle derived FSTL1 to reach the myocardium which makes a positive contribution to cardioprotection in MI rat.

Effect of the Resistance Exercise on Elementary School Students’Physical Fitness

Background Physical activity programs using components of resistance have the potential to improve health in school chil-dren.The purpose of this study was to examine the effect of a school-based resistance exercise program on physical fitness in elementary school students.Methods The sample was 256 children(mean age=8.3±2.5 years;119 girls)from kindergarten to 5th grade.Participants performed a 10-min resistance exercise 2-3 times in each school day.Physical fitness outcomes were assessed using President’s Physical Fitness Challenge test.Measures were collected at baseline and at a 6-month post-test time point.A 2×2 doubly MANOVA was employed to examine the effect of sex and time.Results The multivariate model was statistically significant with a main time effect(Wilks’λ=0.19,F=290.9,P<0.001).Follow-univariate tests found significant differences between time-points on flex arm hang(P=0.033),shuttle run(P<0.001),and 1-mile run/walk times(P<0.001).Conclusions A 6-month resistance exercise program improved upper body strength and cardiorespiratory endurance in elementary school aged children.The use of resistance exercise intervention during school day can be effectively used to promote physical fitness and ultimately improve the health of children.

Myocardial Oxygenation Response to Stress Performing a Single-set Compared to Volume-Matched Multiple-Set of Leg Press in Untrained Young Adults

Background Debates exist about the preference for single-or multiple-set resistance exercise(RE)on achieving similar training outcome,however,no study examined their effects on the heart,thus,this study was to examine the effect of volume-matched single-and multiple-set RE on the myocardial response through examining rate pressure product(RPP).Methods Fourteen healthy untrained college students performed two leg press exercises(4×10 and 1×40 at 150%body mass)on different days,and each was performed twice in a counterbalanced crossover order.Pre-and post-exercise SBP and HR were measured by auscultatory method,RPP was calculated as SBP×HR×10^(-3),RPP difference(RPPdiff)was calcu-lated by post-exercise RPP subtracting pre-exercise RPP.Results Single-set post-exercise RPP(17.48±3.16 mmHg·beats/min),HR(123.86±20.25 beats/min)was significantly greater than multiple-set post-exercise RPP(13.66±3.04 mmHg·beats/min),HR(101.61±19.14 beats/min),respec-tively.There was no significant difference of SBP(141.07±9.37 vs.134.29±15.16 mmHg)between exercise protocols(P=0.13).The RPPdiff of single-set(6.74±2.86 mmHg·beats/min)was significantly greater than that of multiple-set(3.62±2.90 mmHg·beats/min)(P<0.001).Conclusions Single-set RE exerts a greater myocardial oxygenation response as compared to multiple-set,HR contributed more than SBP to the increase of RPP in RE.The results indicate that single-set RE can be warranted when wanting to train the heart,while multiple-set RE would appear best for those who should avoid heart stress.

Creatine Supplementation Improves Physical Performance,Without Negative Effects on Health Markers,in Young Weightlifters

Purpose The safety of creatine supplementation has been investigated,however,the safety of a high-dose/short-term or low-dose/long-term supplementation dosing scheme,combined with a resistance training program,a commonly used dosing scheme,has not yet studied.The aim of this study was to evaluate physical performance and the safety of the cited creatine supplementation dosing scheme in a double-blind placebo-controlled study by assessing blood and urine health indicators in subjects undertaking resistance training.Method Thirty-four healthy male subjects were randomly assigned to creatine supplement(CREA/7 days,0.3 g/kg body mass+21 days,0.03 g/kg)or placebo(PLA)group and both groups participated in a resistance training intervention(6 exercises,3 sets of 8-12 repetitions per exercise at 85%of 1RM,3 d/week).Blood and urine samples were collected pre-,7 and 30 days post-supplementation.For blood(26 parameters)and urine markers(15),between-group differences were calculated by using 2 groups(CREA and PLA)×2 measures(“POST7 minus PRE”and“POST30 minus PRE”)terms.Results The CREA group exhibited significant body weight and 1RM increase(POST30 minus PRE)of all evaluated exercises,when compared to PLA group.Regarding the blood and urine health markers,only hematocrit,LDL,Uric Acid,Phosphatase Alkaline and Creatinine exhibited between-group differences,but with small magnitude of differences and maintained into the range of clinical reference values.Conclusion Our data suggest that creatine supplementation the used dosing scheme,concomitantly with resistance training,improves physical performance with no evident risk or protection to health for young weightlifters.

The Effect of Familiarization on the Reliability of Isokinetic Assessment in Breast Cancer Survivors

Purpose To determine the amount of familiarization sessions required by breast cancer survivors to achieve a reliable meas-urement of muscle function assessed using isokinetic dynamometry.Methods Twenty-six breast cancer survivors performed three isokinetic knee extension tests separated by,at least,48 h.The isokinetic testing protocol included one warm-up set of 10 submaximal knee extensions at 120°/s,followed by two sets of four maximal knee extensions at 60°/s,with 2-min rest interval between sets.Peak torque(PT),time to peak torque(TPT),angle of peak torque(APT),and average power(AP)of each trial was used for the assessment of testing reliability.Percentage change in the mean,typical error,coefficient of variation and intraclass correlation coefficients(ICC2.1)were calculated to determine test-retest reliability.Results For PT,change in mean was lower between trials 2 and 3 than between trials 1 and 2(4.18% and 13.18%,respec-tively),and ICC was greater between trials 2 and 3 than between trials 1 and 2(0.962 and 0.818,respectively).For TPT and APT,ICC was clinically acceptable only between trials 2 and 3(0.757 and 0.803,respectively).For AP,change in mean was clinically acceptable between trials 2 and 3(9.84%),while ICC met acceptable reliability between both,trials 1 and 2 and,trials 2 and 3(0.756 and 0.891,respectively).Conclusion At least one familiarization session is adequate to achieve reliable measurements of muscle function using isokinetic dynamometry,while avoiding the impact of learning effect of the measurements in breast cancer survivors.