Statin Use Improves Cardiometabolic Protection Promoted By Physical Training in an Aquatic Environment: A Randomized Clinical Trial. / Uso de Estatinas Melhora a Proteção Cardiometabólica Promovida pelo Treinamento Físico em Ambiente Aquático: Um Ensaio Clínico Randomizado.

BACKGROUND: Statin use is highlighted as the most commonly utilized therapy for the treatment of dyslipidemias and can be considered as the most efficient pharmacological intervention for low-density lipoprotein (LDL) reduction. On the other hand, physical training can be considered an efficient and safe non-pharmacological strategy to promote improvements in lipid profile. However, the influence of statins on lipid adaptations arising from water-based training in populations with dyslipidemia is not known. OBJECTIVES: To analyze the influence of simvastatin use on lipid adaptations arising from water-based aerobics and resistance training in elderly women with dyslipidemia. METHODS: Sixty-nine elderly (66.13 ± 5.13 years), sedentary, and dyslipidemic women, both non-users and users of simvastatin (20 mg and 40 mg), were randomized into the following 3 groups: water-based aerobic training (WA), water-based resistance training (WR), and control group (CG). Total duration of interventions, for all experimental groups consisted of 10 weeks, with 2 weekly sessions. Biochemical analyses were performed before the beginning of the interventions and repeated after the end of the trial. Generalized estimating equations were used to compare these data, setting α = 0.05. RESULTS: In intention-to-treat analysis, the medicated participants obtained a greater magnitude of decrease in total cholesterol (TC) (-3.41 to -25.89 mg.dl-1; p = 0.038), LDL (-5.58 to -25.18 mg.dl-1; p = 0.007) and TC/HDL ratio (-0.37 to -0.61; p = 0.022) when compared to the non-medicated participants, and this decrease was statistically significant only in the WR group. CONCLUSIONS: Statin use enhances the adaptations promoted by water-based physical training in CT, LDL levels, and CT/HDL ratio, and it is more pronounced after WR.

FUNDAMENTO: O uso de estatinas destaca-se como a terapia mais frequentemente utilizada para o tratamento de dislipidemias e pode ser considerado a intervenção farmacológica mais eficiente para a redução da lipoproteína de baixa densidade (LDL). Por outro lado, o treinamento físico pode ser considerado uma estratégia não farmacológica eficiente e segura para promover melhorias no perfil lipídico. No entanto, não se sabe qual seria a influência das estatinas nas adaptações lipídicas decorrentes do treinamento aquático em populações com dislipidemia. OBJETIVOS: Analisar a influência do uso de sinvastatina nas adaptações lipídicas decorrentes do treinamento aeróbico em meio aquático e de resistência em mulheres idosas com dislipidemia. MÉTODOS: Sessenta e nove mulheres idosas (66,13 ± 5,13 anos), sedentárias e dislipidêmicas, tanto não usuárias quanto usuárias de sinvastatina (20 mg e 40 mg), foram randomizadas nos 3 grupos seguintes: treinamento aeróbico em meio aquático (WA), treinamento de força em meio aquático (WR) e grupo controle (GC). A duração total das intervenções, para todos os grupos experimentais, foi de 10 semanas, com 2 sessões semanais. As análises bioquímicas foram realizadas antes do início das intervenções e repetidas após o final do ensaio. Foram utilizadas equações de estimativa generalizada para comparar esses dados, estabelecendo α = 0,05. RESULTADOS: Na análise por intenção de tratar, as participantes medicadas demonstraram uma redução de magnitude maior do colesterol total (CT) (−3,41 a −25,89 mg.dl−1; p = 0,038), LDL (−5,58 a −25,18 mg.dl−1; p = 0,007) e da relação CT/HDL (−0,37 a −0,61; p = 0,022) quando comparadas às participantes não medicadas, essa redução sendo estatisticamente significativa apenas no grupo WR. CONCLUSÕES: O uso de estatina incrementa as adaptações promovidas pelo treinamento físico aquático no CT, nos níveis de LDL e na relação CT/HDL, sendo mais pronunciado após WR.

Uso de estatinas melhora a proteção cardiometabólica promovida pelo treinamento físico em ambiente aquático: Um ensaio clínico randomizado / Statin use improves cardiometabolic protection promoted by physical training in an aquatic environment: A Randomized Clinical Trial

Resumo Fundamento: O uso de estatinas destaca-se como a terapia mais frequentemente utilizada para o tratamento de dislipidemias e pode ser considerado a intervenção farmacológica mais eficiente para a redução da lipoproteína de baixa densidade (LDL). Por outro lado, o treinamento físico pode ser considerado uma estratégia não farmacológica eficiente e segura para promover melhorias no perfil lipídico. No entanto, não se sabe qual seria a influência das estatinas nas adaptações lipídicas decorrentes do treinamento aquático em populações com dislipidemia. Objetivos: Analisar a influência do uso de sinvastatina nas adaptações lipídicas decorrentes do treinamento aeróbico em meio aquático e de resistência em mulheres idosas com dislipidemia. Métodos: Sessenta e nove mulheres idosas (66,13 ± 5,13 anos), sedentárias e dislipidêmicas, tanto não usuárias quanto usuárias de sinvastatina (20 mg e 40 mg), foram randomizadas nos 3 grupos seguintes: treinamento aeróbico em meio aquático (WA), treinamento de força em meio aquático (WR) e grupo controle (GC). A duração total das intervenções, para todos os grupos experimentais, foi de 10 semanas, com 2 sessões semanais. As análises bioquímicas foram realizadas antes do início das intervenções e repetidas após o final do ensaio. Foram utilizadas equações de estimativa generalizada para comparar esses dados, estabelecendo α = 0,05. Resultados: Na análise por intenção de tratar, as participantes medicadas demonstraram uma redução de magnitude maior do colesterol total (CT) (−3,41 a −25,89 mg.dl−1; p = 0,038), LDL (−5,58 a −25,18 mg.dl−1; p = 0,007) e da relação CT/HDL (−0,37 a −0,61; p = 0,022) quando comparadas às participantes não medicadas, essa redução sendo estatisticamente significativa apenas no grupo WR. Conclusões: O uso de estatina incrementa as adaptações promovidas pelo treinamento físico aquático no CT, nos níveis de LDL e na relação CT/HDL, sendo mais pronunciado após WR.

Abstract Background: Statin use is highlighted as the most commonly utilized therapy for the treatment of dyslipidemias and can be considered as the most efficient pharmacological intervention for low-density lipoprotein (LDL) reduction. On the other hand, physical training can be considered an efficient and safe non-pharmacological strategy to promote improvements in lipid profile. However, the influence of statins on lipid adaptations arising from water-based training in populations with dyslipidemia is not known. Objectives: To analyze the influence of simvastatin use on lipid adaptations arising from water-based aerobics and resistance training in elderly women with dyslipidemia. Methods: Sixty-nine elderly (66.13 ± 5.13 years), sedentary, and dyslipidemic women, both non-users and users of simvastatin (20 mg and 40 mg), were randomized into the following 3 groups: water-based aerobic training (WA), water-based resistance training (WR), and control group (CG). Total duration of interventions, for all experimental groups consisted of 10 weeks, with 2 weekly sessions. Biochemical analyses were performed before the beginning of the interventions and repeated after the end of the trial. Generalized estimating equations were used to compare these data, setting α = 0.05. Results: In intention-to-treat analysis, the medicated participants obtained a greater magnitude of decrease in total cholesterol (TC) (−3.41 to −25.89 mg.dl−1; p = 0.038), LDL (−5.58 to −25.18 mg.dl−1; p = 0.007) and TC/HDL ratio (−0.37 to −0.61; p = 0.022) when compared to the non-medicated participants, and this decrease was statistically significant only in the WR group. Conclusions: Statin use enhances the adaptations promoted by water-based physical training in CT, LDL levels, and CT/HDL ratio, and it is more pronounced after WR.

Pilates training improves aerobic capacity, but not lipid or lipoprotein levels in elderly women with dyslipidemia: A controlled trial.

INTRODUCTION: The aim of the present study was to verify the effects of a Pilates training on total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), glucose and C-reactive protein (CRP) levels, as well as on functionality of postmenopausal women with dyslipidemia. METHOD: This randomized study involved 35 sedentary women with dyslipidemia, aged between 60 and 75 years. One group participated in a Pilates exercises training with two to four weekly sessions during 10 weeks (Pilates group, n = 20) and the other group did not perform any intervention (control group, n = 6). Biochemical analyses and functionality parameters were measured before and after the 10 weeks. RESULTS: No significant differences were observed in TC, TG, LDL and HDL for both groups. Regarding glucose and CRP levels, significant reductions were observed in both groups after the intervention period. In functional parameters, both groups significantly increased their 30-s chair stand test values. On the other hand, only the Pilates group presented significant increments in the 6-min walk test (p < 0.05). CONCLUSION: Pilates training did not change lipid or lipoprotein levels, but improved cardiorespiratory fitness of elderly women with dyslipidemia.

Effect of Strength Training on Lipid and Inflammatory Outcomes: Systematic Review With Meta-Analysis and Meta-Regression.

Background: The aim of this study was to perform a systematic review with meta-analysis and meta-regressions evaluating the effects of isolated strength training (ST), compared with a control group, on total cholesterol (TC), triglycerides (TG), low-density (LDL), high-density lipoprotein (HDL), C-reactive protein (CRP), and adiponectin of adults. Methods: Embase, PubMed, Cochrane, and Scopus data sources were searched up to May 2017. Clinical trials that compared ST with a control group of adults older than 18 years, which evaluated blood TC, TG, LDL, HDL, CRP, or adiponectin as an outcome were included. Random effect was used and the effect size (ES) was calculated by using the standardized mean difference with a 95% confidence interval. Results: ST promotes a reduction in TC (ES: -0.399; P < .001), TG (ES: -0.204; P = .002), LDL (ES: -0.451; P < .001), and CRP (ES: -0.542; P = .01) levels. In addition, ST is associated to an increase in HDL (ES: 0.363; P < .001) and adiponectin concentrations (ES: 1.105; P = .01). Conclusion: ST promotes decreases in TC, TG, LDL, and CRP levels and increases HDL and adiponectin concentrations. Thus, progressive ST could be a potential therapeutic option for improving abnormalities in lipid and inflammatory outcomes in adults.

Water-Based Aerobic and Resistance Training as a Treatment to Improve the Lipid Profile of Women With Dyslipidemia: A Randomized Controlled Trial.

Background: Regular exercise is recommended for the treatment of dyslipidemia. The aquatic environment presents some beneficial characteristics for patients suffering from dyslipidemia. However, it is unknown which modality promotes better results. This study aims to compare the effects of water-based aerobic training (WA) and water-based resistance training (WR) on lipid profile of dyslipidemic elderly women. Methods: Sixty-nine dyslipidemic elderly women participated in this 3-arm randomized controlled clinical trial with groups in parallel. The interventions were WA, WR, and control group, with 2 weekly sessions for 10 weeks. Total cholesterol (TC), triglycerides, low-density lipoprotein, high-density lipoprotein (HDL) levels, and TC/HDL ratio, were determined before and after interventions. Results: Intention-to-treat analysis showed that WA and WR participants obtained similar decreases in TC (-10.0% and -9.6%, respectively), triglycerides (-13.4% and -15.7%, respectively), low-density lipoprotein (-16.1% and -16.9%, respectively), TC/HDL (-16.9% and -23.4%, respectively) and increases in HDL (7.6% and 16.9%, respectively). The control group maintained their TC and low-density lipoprotein levels unchanged, whereas triglycerides and TC/HDL were increased (3.6% and 11.3%, respectively), and HDL decreases 4.8%. Conclusions: WA and WR improve similarly the lipid profile of dyslipidemic elderly women, representing interesting nonpharmacological tools in the treatment of dyslipidemia.

Water-based aerobic training improves strength parameters and cardiorespiratory outcomes in elderly women.

The aim of the present study was to compare the effects of water-based aerobic training and water-based resistance training on muscular strength and cardiorespiratory fitness in older women. Sixty-nine individuals were randomized into the following three groups: the water-based aerobic training (WA, n = 23) group, the water-based resistance training (WR, n = 23) group, and the control group (CG, n = 23). Participants were trained two times per week for 10 weeks. The trainings presented a linear periodization with an increase in the volume-intensity relation. Maximal dynamic muscular strength and the cardiorespiratory fitness were evaluated before the start of training and after 10 weeks of training. Only the WA group showed an increase in maximal oxygen consumption (13.8%) and oxygen consumption at the second ventilatory threshold (16.4%). Maximal dynamic strength of knee extensors improved in 10.6% of WA, 8.0% of WR, and 4.7% of CG participants, without any difference between the groups. Maximal dynamic strength of knee flexors was increased in 14.1% of WA and in 17.7% of WR participants; however, it remains unchanged in CG participants. No differences were observed in resting heart rate, peak heart rate, heart rate at the second ventilatory threshold and maximal dynamic strength of shoulder horizontal flexors. It was concluded that WA seems to be more efficient for improvement in cardiorespiratory responses, and both WA and WR were efficient for development of maximal dynamic strength of knee flexion and extension.

Short-term water-based aerobic training promotes improvements in aerobic conditioning parameters of mature women.

Aging is accompanied by a decrease in aerobic capacity. Therefore, physical training has been recommended to soften the effects of advancement age. The aim of this study was to assess the effects of a short-term water-based aerobic training on resting heart rate (HRrest), heart rate corresponding to anaerobic threshold (HRAT), peak heart rate (HRpeak), percentage value of HRAT in relation to HRpeak and test duration (TD) of mature women. Twenty-two women (65.91 ± 4.83 years) were submitted to a five-week water-based interval aerobic training. Aerobic capacity parameters were evaluated through an aquatic incremental test. After training, there was an increase in TD (16%) and HRAT percentage in relation to HRpeak (4.68%), and a reduction of HRrest (9%). It is concluded that a water-based aerobic interval training prescribed through HRAT of only five weeks is able to promote improvements in aerobic capacity of mature women.

Effects of aerobic exercise performed in fasted v. fed state on fat and carbohydrate metabolism in adults: a systematic review and meta-analysis.

This study aimed to verify the effect of aerobic exercise performed in the fasted v. fed states on fat and carbohydrate metabolism in adults. Searches were conducted in March 2015, and updated in July 2016, using PubMed®, Scopus and Cochrane databases (terms: 'fasting', 'exercise', 'aerobic exercise', 'substrate', 'energy metabolism', 'fat', 'glucose', 'insulin' and 'adult') and references from selected studies. Trials that compared the metabolic effects of aerobic exercise (duration ≤120 min) performed in the fasted v. fed states in adults were accepted. The outcomes evaluated were fat oxidation during exercise and the plasma concentrations of insulin, glucose and NEFA before and immediately after exercise; two independent reviewers extracted the data (A. F. V. and L. C.). The results were presented as weighted mean differences between treatments, with 95 % CI. Of 10 405 articles identified, twenty-seven studies - with a total of 273 participants - were included. There was a significant increase in fat oxidation during exercise performed in the fasted, compared with fed, state (-3·08 g; 95 % CI -5·38, -0·79; I 2 39·1 %). The weighted mean difference of NEFA concentrations was not significantly different between states (0·00 mmol/l; 95 % CI -0·07, 0·08; I 2 72·7 %). However, the weighted mean differences of glucose (0·78 mmol/l; 95 % CI 0·43, 1·14; I 2 90·8 %) and insulin concentrations (104·5 pmol/l; 95 % CI 70·8, 138·2; I 2 94·5 %) were significantly higher for exercise performed in the fed state. We conclude that aerobic exercise performed in the fasted state induces higher fat oxidation than exercise performed in the fed state.