Aquatic Aerobic and Combined Training in Management of Type 2 Diabetes: The Diabetes and Aquatic Training Study (DATS): A Randomized Clinical Trial.

BACKGROUND: To compare the effects of aquatic aerobic and combined (aerobic more resistance) training on glycemic control and other cardiometabolic outcomes in patients with type 2 diabetes. METHODS: Patients were randomized to an aquatic aerobic training (AERO, n = 19; 57.5 [7.4] y; 9 [47%] women), or an aquatic combined training (COMBI, n = 19; 60.9 [7.4] y; 10 [53%] women), or an aquatic active procedure control (n = 19; 58.6 [9.7] y; 10 [53%] women) in 3 weekly sessions (50 min each), during 15 weeks. Glycated hemoglobin was the primary outcome, whereas insulin resistance markers, lipid profile, systemic inflammation, renin concentration, blood pressure, physical activity levels, and sitting time were secondary outcomes. RESULTS: Glycated hemoglobin was reduced in all groups (P = .021), although changes were more marked in AERO (-0.36%) and COMBI (-0.44%) than in active control (-0.26%) group. Lipid profile was similarly modified in all groups. Diastolic blood pressure and renin concentration were also reduced in all groups; however, renin showed more marked reductions in AERO (-17.7 uIU/mL) and COMBI (-15.1 uIU/mL) than in active control (0.2 uIU/mL) group. Fasting insulin, triglycerides, C-reactive protein, systolic blood pressure, walking time, and sitting time on weekends were not modified. CONCLUSION: AERO and COMBI presented similar effect to improve glycemic control and some cardiometabolic risk factors in patients with type 2 diabetes.

Cardiometabolic health profile of young girls with aesthetic professions.

BACKGROUND: In the literature, professions that impose body standards for daily performance are designated as non-conventional professions (i.e. models, athletes, ballet dancers), with great emphasis on the female population. More than a job, it becomes a lifestyle to those inserted in this environment, thus, thousands of children and adolescents seek inclusion and success in these professions due to financial and media gains. Such professions are associated with several health-related risk factors. The purpose of this study was to identify and compare among physical fitness levels, cardiometabolic health markers, mental health and dietary habits in non-conventional professions. METHODS: The sample consisted of 41 female individuals aged between 14 and 24 years, allocated into four groups, control group composed by university students (UG = 11), models (MG = 11), ballet dancers (BG = 11), and athletes' group (AG = 8). Physical fitness outcomes (cardiorespiratory fitness, flexibility, maximal dynamic strength, muscular endurance and body composition); biochemical outcomes (high-density lipoprotein [HDL], low-density lipoprotein [LDL], total cholesterol [TC], fasting glucose [FG], fasting insulin [FI], C-reactive protein [CRP]), diet quality and mental health were evaluated. RESULTS: No impairments were observed in the health markers evaluated among groups, both for health-related physical fitness and biochemical outcomes. However, low levels of bone mineral density (BMD) were observed. Even with statistically significant differences between the groups for chronological age (p = 0.002), menarche (p = 0.004), career length (p = 0.001), height (p = 0.001), body mass index (p = 0.018), waist-to-height ratio (p < 0.001), %Fat (p = 0.020), VO2peak (p = 0.020), maximal dynamic strength of knee extensors (p = 0.031) and elbow flexors (p = 0,001) and flexibility (p < 0.001), all these values are within the normal range for health. CONCLUSION: The professions analyzed do not seem to interfere in the physical fitness and cardiometabolic health of the girls assessed. However, we identified that exposure to these profession can impair mental health (depressive symptoms in 100% of participants) and body composition (BMD 63% of participants).

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.

Short and long-term effects of water-based aerobic and concurrent training on cardiorespiratory capacity and strength of older women.

Studies show that, in the short term, water-based aerobic training (WAT) promotes the same strength gains as water-based concurrent training (WCT). In addition, it is known that some training progression strategy must be employed after the first weeks of training in order to continue stimulating neuromuscular gains. The aim of this paper was to compare the effects of three water-based training on cardiorespiratory capacity and strength of older women in short and long-terms. Fifty-seven participants were randomized into the groups: 1) aerobic training (AT); 2) concurrent training whose resistance training progressed to the use of resistive equipment (CTRE); and 3) concurrent training whose resistance training progressed to multiple sets (CTMS). Participants trained twice a week for 16 weeks. An incremental treadmill test and the one-repetition maximal test of knee extensors were performed before and after 8 and 16 weeks. Peak oxygen consumption showed similar increases from pre to post-16 weeks (AT: 9%, CTRE: 11%, CTMS: 5%). Oxygen consumption at the second ventilatory threshold and strength were increased from pre to post-8 weeks (AT: 15%, CTRE: 16%, CTMS: 3% and AT: 9%, CTRE: 5%, CTMS: 9%, respectively) and from post-8 to post-16 weeks (AT: 6%, CTRE: 3%, CTMS: 12% and AT: 4%, CTRE: 8%, CTMS: 4%, respectively). In conclusion, the three training programs promoted similar increases in the cardiorespiratory capacity and WAT promoted similar strength gains as WCT in short and long terms. Moreover, the use of resistive equipment and the increase in the number of sets are effective progression strategies.

Effects of 2 Models of Aquatic Exercise Training on Cardiorespiratory Responses of Patients With Type 2 Diabetes: The Diabetes and Aquatic Training Study-A Randomized Controlled Trial.

BACKGROUND: There are a lack of clinical trials with suitable methodological quality that compare aquatic exercise training types in type 2 diabetes (T2D) treatment. This study aimed to compare the effects of aerobic and combined aquatic training on cardiorespiratory outcomes in patients with T2D. METHODS: Untrained patients with T2D were randomized to receive an aerobic aquatic training, a combined aquatic training, or a procedure control in 3 weekly sessions for 15 weeks. The sessions were 50 minutes long. The intensities were from 85% to 100% of heart rate of anaerobic threshold and at maximal velocity for aerobic and resistance parts, respectively. Resting heart rate, peak oxygen uptake (VO2peak), and oxygen uptake corresponding to second ventilatory threshold and its relation with VO2peak were evaluated. RESULTS: Participants were 59.0 (8.2) years old and 51% women. Intervention groups increased in VO2peak (aerobic aquatic training group: 4.48 mL·kg-1·min-1, P = .004; combined aquatic training group: 5.27 mL·kg-1·min-1; P = .006) and oxygen uptake corresponding to second ventilatory threshold, whereas the control group presented an increase in oxygen uptake corresponding to second ventilatory threshold and minimal change in VO2peak. CONCLUSIONS: Aerobic and combined aquatic exercise interventions improve the cardiorespiratory fitness of patients with T2D.

Continuous and interval aerobic sessions: effects on triglyceride concentrations / Sessões aeróbicas intervaladas e contínuas: efeitos sobre as concentrações de triglicerídeos

The regular practice of physical exercise, primarily aerobic, has been recommended as a component of the non-pharmacological treatment for dyslipidemias. However, there is a lack of studies in the literature comparing the acute effects of different aerobic exercise models (continuous and interval) on triglycerides concentrations.The purpose of the present study was to analyze the magnitude of change on triglycerides concentrations after a single session of interval and continuous exercise in persons with dyslipidemia. This study was a randomized crossover clinical trial. Fifteen volunteers performed two different aerobic sessions, a continuous and an interval session. The intensity of the continuous session was maintained between 85-90% of the heart rate at anaerobic threshold (HRAT). The interval session consisted of 9 sets of 4 minutes at 85-90%HRAT followed by one minute below 85%HRAT. Triglycerides concentrations were assessed before, immediately after and at the end of 30 minutes after all sessions. Both sessions models resulted in alterations in triglycerides concentrations immediately after exercise (p = 0.005), without difference between them (p = 0.446). Continuous session increased triglycerides concentrations by 34.9% from pre-exercise to immediately post-exercise and the interval session, by 7.9%. Thirty minutes after exercise, triglyceride concentrations showed no significant difference in relation to the pre-exercise and immediately after exercise moments in both session models. Therefore,it is concluded that aerobic exercise promotes responses in triglycerides concentrations of dyslipidemic patients, independently of the exercise method, either continuous or interval

A prática regular de exercício físico, principalmente aeróbico, tem sido recomendado como componente de tratamento não farmacológico contra as dislipidemias. No entanto, a literatura carece de estudos comparando os efeitos agudos de diferentes modelos de exercício aeróbico (contínuo e intervalado) sobre as concentrações de triglicerídeos. O objetivo do presente estudo foi analisar a magnitude de mudança sobre as concentrações de triglicerídeos após uma sessão de exercício intervalado e contínuo em pessoas com dislipidemia. Além disto, este estudo se caracteriza por ser um ensaio clínico randomizado cruzado. Nele, quinze voluntários realizaram duas sessões aeróbicas diferentes, uma sessão contínua e outra intervalada. A intensidade da sessão contínua se manteve entre 85-90% da frequência cardíaca referente ao limiar anaeróbico (HRAT). A sessão intervalada consistiu de 9 séries de quatro minutos entre 85-90% da HRAT seguidas de um minuto abaixo de 85% da HRAT. As concentrações de triglicerídeos eram verificadas antes, imediatamente após e passados 30 minutos do término de todas as sessões. Ambos os modelos de sessões resultaram em alterações das concentrações de triglicerídeos imediatamente após exercício (p = 0,005), sem diferença entre elas (p = 0,446). A sessão contínua aumentou as concentrações de triglicerídeos em 43,9% do pré-exercício para imediatamente após o exercício e a sessão intervalada aumentou em 7,93% no mesmo período. Trinta minutos após o exercício, as concentrações de triglicerídeos não apresentaram diferença significativa em relação aos momentos pré-exercício e imediatamente após o exercício em ambos os modelos de sessão. Assim, conclui-se que o exercício aeróbico promove alterações nas concentrações de triglicerídeos de pacientes dislipidêmicos, independentemente do método de exercício, se contínuo ou intervalado

Long-Term Effects of Three Water-Based Training Programs on Resting Blood Pressure in Older Women.

The aim of the study was to compare the effects of three water-based training on blood pressure (BP) in older women. A total of 57 participants were randomized into the following groups: (a) aerobic training (AT), (b) concurrent training in which resistance training progresses to the use of resistive equipment (CTRE), and (c) concurrent training in which resistance training progresses to multiple sets (CTMS). The participants trained twice a week for 16 weeks. Systolic BP decreased from pretraining to after 8 weeks of training and, subsequently, to after 16 weeks of training (AT: -6.53 mmHg, CTRE: -10.45 mmHg, and CTMS: -10.73 mmHg). Diastolic BP decreased from pretraining to after 8 and 16 weeks of training (AT: -6.23 mmHg, CTRE: -4.61 mmHg, and CTMS: -6.19 mmHg). Furthermore, 16% of the AT participants, 23% of the CTRE participants, and 28.5% of the CTMS participants were no longer classified as hypertensive. Water-based aerobic and concurrent training are efficient nonpharmacological measures to reduce BP in older women.

The Role of Aerobic Training Variables Progression on Glycemic Control of Patients with Type 2 Diabetes: a Systematic Review with Meta-analysis.

BACKGROUND: Aerobic training (AT) improves glycemic control in patients with type 2 diabetes. However, the role of the progression of training variables remains unclear. The objective of this review was to analyze the effects of progressive AT (PAT) and non-progressive AT (NPAT) on glycated hemoglobin (HbA1c) in patients with type 2 diabetes. METHODS: Data sources used were PubMed, Cochrane Central, Embase, SPORTDiscus, and LILACS. Studies that evaluated the effect of at least 12 weeks of PAT and NPAT compared to a control condition on HbA1c levels in type 2 diabetes patients were eligible for analysis. Two independent reviewers screened the search results, extracted the data, and assessed the risk of bias. Effect sizes (ESs) were calculated using the standardized mean difference in HbA1c levels between the intervention and control groups using a random-effect model. RESULTS: Of 5848 articles retrieved, 24 randomized clinical trials (825 participants) were included. Among the included studies, 92% reported to have performed a randomization process, 8% presented allocation concealment, 21% reported blinding of outcome assessment, and 38% reported complete outcome data. AT reduced HbA1c levels by 0.65% (ES: - 1.037; 95% confidence interval [CI]: - 1.386, - 0.688; p < 0.001). The reduction in HbA1c induced by PAT was 0.84% (ES: - 1.478; 95% CI - 2.197, - 0.759; p < 0.001), and NPAT was 0.45% (ES: - 0.920; 95% CI - 1.329, - 0.512; p < 0.001). Subgroup analysis of the different forms of progression showed a reduction in HbA1c levels of 0.94% (ES: - 1.967; 95% CI - 3.783, - 0.151; p = 0.034) with progression in volume, 0.41% (ES: - 1.277; 95% CI - 2.499, - 0.056; p = 0.040) with progression in intensity, and 1.27% (ES: - 1.422; 95% CI - 2.544, - 0.300; p = 0.013) with progression in both volume and intensity. Subgroup analysis of the different modalities of AT showed a reduction of 0.69% (ES: - 1.078; 95% CI - 1.817, - 0.340; p = 0.004) with walking and/or running and of 1.12% (ES: - 2.614; 95% CI - 4.206, - 1.022; p = 0.001) with mixed protocols while progressive training was adopted. In non-progressive protocols, a significant HbA1c reduction was only found with walking and/or running (- 0.43%; ES: - 1.292; 95% CI - 1.856, - 0.72; p < 0.001). CONCLUSION: The effect of PAT on glycemic control was greater than that of NPAT, especially when volume and intensity were progressively incremented throughout the interventions.

Acute and chronic glycemic effects of aerobic training in patients with type 2 diabetes / Efeitos glicêmicos agudos e crônicos do treinamento aeróbio em pacientes com diabetes tipo 2

The aim of the present study was to analyze acute glycemic effects in different moments of an aerobic training, as well as to analyze the chronic effect of training, in patients with type 2 diabetes mellitus (T2D). The participants performed 16 weeks of interval aerobic training with three weekly sessions. The main part of each session consisted of nine blocks of five minutes, in which four minutes consist-ed of stimulus between 85% and 95% of the anaerobic threshold heart rate (ATHR) and one minute consisted of recovery below 85% of the ATHR, totalizing 45 minutes. Capillary glucose was assessed before, immediately after and 30 minutes after the first and the last training sessions. Glycated hemoglobin (HbA1c) was assessed before and after the intervention. Paired t-test and Generalized Estimating Equations were performed for the analyses; α = 5%. The participants were seven individ-uals (four women) aged 59.60 ± 6.69 years. In the first session, glucose values immediately after and 30 minutes after exercise were lower than pre-exercise values. On the other hand, in the last training session, only the glucose values immediately after exercise were lower than pre-exercise values. Ana-lyzing the glycemic reductions, the first session presented a greater reduction immediately after (p = 0.042) and 30 minutes after exercise (p = 0.010). Regarding chronic glycemic effects, an increase (p = 0.010) in HbA1c levels was observed after training. It is concluded that, after 16 weeks of training without progression of duration and intensity, the exercise loses its acute glycemic effect, and may be even insufficient to reduce HbA1c levels

O objetivo do estudo foi analisar os efeitos glicêmicos agudos em diferentes momentos de um treinamento aeróbio, bem como o efeito glicêmico crônico deste treinamento, em pacientes com diabetes tipo 2 (DM2). Os participantes realizaram16 semanas de treinamento aeróbio intervalado, com três sessões semanais, sendo a parte principal de cada sessão composta de nove blocos de cinco minutos, tendo cada bloco quatro minutos de estímulo a 85% a 90% da frequência cardíaca referente ao limiar anaeróbio (FCLAN) e um minuto de recu-peração abaixo de 85% da FCLAN, totalizando 45 minutos. A glicemia capilar foi avaliada antes, imediata-mente e 30 minutos após a primeira e a última sessão de treinamento. A hemoglobina glicada (HbA1c) foi avaliada antes e após a intervenção. Teste t pareado e Equações de Estimativas Generalizadas foram usados para as análises; α = 5%. Participaram sete indivíduos (59,60 ± 6,69 anos; quatro mulheres). Na primeira sessão, os valores glicêmicos imediatamente e 30 minutos após o exercício foram menores que os valores pré--exercício. Já na última sessão de treinamento, somente os valores glicêmicos imediatamente após o exercício foram menores que os valores pré-exercício. Analisando as reduções glicêmicas, a primeira sessão apresentou maior redução tanto imediatamente após (p = 0,042) como 30 minutos após o exercício (p = 0,027). Em relação ao efeito glicêmico crônico, observou-se aumento (p = 0,010) dos níveis de HbA1c após o treinamento. Conclui-se que após 16 semanas de treinamento sem progressão de duração e intensidade, o exercício perde efeito glicêmico agudo, podendo inclusive ser ineficiente na redução dos níveis de HbA1c

Water-Based Aerobic Training Successfully Improves Lipid Profile of Dyslipidemic Women: A Randomized Controlled Trial.

PURPOSE: This study aimed to investigate the effects of water-based aerobic training on the lipid profile and lipoprotein lipase (LPL) levels in premenopausal women with dyslipidemia. METHOD: Forty women were randomly assigned to: aquatic training (WA; n = 20) or a control group (CG; n = 20). The WA group underwent 12 weeks of water-based interval aerobic training twice a week at intensities ranging from 9 to 15 on the Borg Scale of Perceived Exertion. Total cholesterol (TC), triglycerides (TG), high- (HDL) and low- (LDL) density lipoprotein, TC/HDL ratio, LPL levels, and peak oxygen consumption (VO2peak) were evaluated before and after 12 weeks in both groups. RESULTS: The WA group elicited decreases in TC (9%; effect size [ES] = 0.69; 95% CI [0.05, 1.33]), LDL (16%; ES = 0.78; 95% CI [0.13, 1.42]), and the TC/HDL ratio (17%; ES = 1.13; 95% CI [0.46, 1.79]), as well as increases in VO2peak (10%; ES = 0.64; 95% CI [0.002, 1.27]) and HDL (10%; ES = 0.28; 95% CI [-0.35. 0.90]), without significant changes in TG (ES = 0.16; 95% CI [-0.46, 1.79]) and LPL (ES = 0.36; 95% CI [-0.27, 0.98]) levels. In the CG, no statistically significant changes in any of these variables were found (TC, ES = 0.19, 95% CI [-0.43, 0.82]; LDL, ES = 0.22, 95% CI [-0.40, 0.85]; HDL, ES = 0.05, 95% CI [-0.57, 0.67]; TG, ES = 0.09, 95% CI [-0.53, 0.71]; TC/HDL ratio, ES = 0.20, 95% CI [-0.42, 0.82]; LPL, ES = 0.02, 95% CI [-0.60, 0.64]; VO2peak, ES = 0.20, 95% CI [-0.42, 0.82]). CONCLUSION: Water-based interval aerobic training positively affected the lipid profile in premenopausal dyslipidemic women.

Acute glycemic and pressure responses of continuous and interval aerobic exercise in patients with type 2 diabetes.

BACKGROUND: Aerobic training has been widely indicated to patients with type 2 diabetes. However, there are still few studies comparing acute glycemic and blood pressure effects of different methods of aerobic training. The aim is to compare glycemic and pressure acute responses of continuous aerobic exercise to interval aerobic exercise in patients with type 2 diabetes. MATERIALS AND METHODS: This study is a randomized, crossover clinical trial. Fourteen patients with type 2 diabetes performed two sessions of aerobic training with different methods (continuous and interval). Continuous session had duration of 35 minutes with intensity of 85-90% of heart rate corresponding to anaerobic threshold (HRAT), while interval session had 45 minutes, with stimulus in intensity of 85-90% of HRAT with recovery in intensity under 85% of HRAT. Capillary glycemia, systolic and diastolic blood pressure were analyzed before and after the sessions. RESULTS: Patients were 63.5 ± 9.8 years old. Glycemia was reduced in both sessions (p < 0.001). Only glycemia measured at 25 minutes after continuous session was not lower than pre-session values. Systolic blood pressure was also reduced in both sessions (p = 0.010) with similar behavior between them. In the diastolic blood pressure, there were differences only between the values measured immediately after exercise and the values measured 20 minutes (p = 0.002) and 30 minutes after exercise (p = 0.008). CONCLUSION: Both continuous and interval aerobic exercise, in a same intensity, are effective for glycemic and pressure acute reductions in individuals with type 2 diabetes. For patients with greater risk of hypertension, we believe that the interval method is safer.

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.