Exercise and Protein Supplementation Recommendations for Older Adults With Sarcopenic Obesity: A Meta-Review.

This systematic meta-review evaluated the effects of exercise with and without protein interventions on muscle strength and function in older adults with sarcopenic obesity. PubMed, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, Scopus, and SPORTDiscus databases were searched through February 2021 for relevant systematic reviews and meta-analyses with aerobic, resistance, and/or combined training interventions with and without protein supplementation in older adults ≥ 65 years with sarcopenic obesity. This meta-review showed that exercise with and without protein supplementation improved body composition (i.e., decreased percentage body fat) and functional outcomes (i.e., gait speed and grip strength). Because the current literature is limited, determining the effects of exercise and combined protein supplementation in this population requires further investigation. In the meantime, protein recommendations should align with general sarcopenia recommendations. Based upon available findings, tentative exercise recommendations to optimize health outcomes in this population are proposed.

Effects of Manual Therapies and Resistance Exercise on Postexercise Hypotension in Women With Normal Blood Pressure.

ABSTRACT: Monteiro, ER, Pescatello, LS, Winchester, JB, Corrêa Neto, VG, Brown, AF, Budde, H, Marchetti, PH, Silva, JG, Vianna, JM, and Novaes, JdS. Effects of manual therapies and resistance exercise on postexercise hypotension in women with normal blood pressure. J Strength Cond Res 36(4): 948-954, 2022-The purpose of this investigation was to examine the acute effects of resistance exercise (RE) and different manual therapies (static stretching and manual massage [MM]) performed separately or combined on blood pressure (BP) responses during recovery in women with normal BP. Sixteen recreationally strength-trained women (age: 25.1 ± 2.9 years; height: 158.9 ± 4.1 cm; body mass: 59.5 ± 4.9 kg; body mass index: 23.5 ± 1.9 kg·m-2; baseline systolic BP median: 128 mm Hg; and baseline diastolic BP median: 78 mm Hg) were recruited. All subjects performed 6 experiments in a randomized order: (a) rest control (CON), (b) RE only (RE), (c) static-stretching exercise only (SS), (d) MM only, (e) RE immediately followed by SS (RE + SS), and (f) RE immediately followed by MM (RE + MM). RE consisted of 3 sets of bilateral bench press, back squat, front pull-down, and leg press exercises at 80% of 10RM. Static stretching and MM were applied unilaterally in 2 sets of 120 seconds to each of the quadriceps, hamstring, and calf regions. Systolic (SBP) and diastolic BP were measured before (rest) and every 10 minutes for 60 minutes following (Post 10-60) each intervention. There were significant intragroup differences for RE in Post-50 (p = 0.038; d = -2.24; ∆ = -4.0 mm Hg). Similarly, SBP intragroup differences were found for the SS protocol in Post-50 (p = 0.021; d = -2.67; ∆ = -5.0 mm Hg) and Post-60 (p = 0.008; d = -2.88; ∆ = -5.0 mm Hg). Still, SBP intragroup differences were found for the MM protocol in Post-50 (p = 0.011; d = -2.61; ∆ = -4.0 mm Hg) and Post-60 (p = 0.011; d = -2.74; ∆ = -4.0 mm Hg). Finally, a single SBP intragroup difference was found for the RE + SS protocol in Post-60 (p = 0.024; d = -3.12; ∆ = -5.0 mm Hg). Practitioners should be aware that SS and MM have the potential to influence BP responses in addition to RE or by themselves and therefore should be taken into consideration for persons who are hypertensive or hypotensive.

Exercise to Treat Hypertension: Late Breaking News on Exercise Prescriptions That FITT.

ABSTRACT: Hypertension is the leading risk factor for cardiovascular disease and an independent predictor of mortality. The prevalence of hypertension has doubled in the last two decades and evidence suggests that almost half the individuals are unaware of their condition. The antihypertensive effects of exercise are now undisputable, and exercise training is recommended by the major professional and scientific societies, including the American College of Sports Medicine (ACSM), as first-line treatment to prevent, treat, and control hypertension. This review aims to overview the evidence supporting the current ACSM Frequency, Intensity, Time, and Type exercise recommendations for hypertension, discuss new and emerging evidence on exercise in the treatment of hypertension from our laboratories; and propose future directions of research integrating this new and emerging evidence.

How trauma influences cardiovascular responses to stress: contributions of posttraumatic stress and cognitive appraisals.

Mechanisms for the association between posttraumatic stress disorder (PTSD) symptoms and cardiovascular diseases remain poorly understood. The present study examined associations among PTSD symptoms, appraisals of a current stressor, baseline cardiovascular indices, and cardiovascular responses to the stressor, including appraisals as a potential mediator of PTSD symptoms and cardiovascular responses. A sample of 125 undergraduates provided information about demographics, physical health, trauma history, and PTSD symptoms. Weight, height, blood pressure (BP), and heart rate (HR) measurements were obtained. During a modified Trier Social Stress Task, appraisals of the stressor were assessed and BP and HR were measured again. Findings suggest that PTSD symptoms are associated with current physical health (resting BP and HR) and more negative appraisals of the stressor; in turn, more negative appraisals were associated with increases in cardiovascular response. In particular, threat appraisal mediated the relationship between PTSD symptoms and increases in systolic BP response.

Acute Effect of a Single Session of Pilates on Blood Pressure and Cardiac Autonomic Control in Middle-Aged Adults With Hypertension.

Rocha, J, Cunha, FA, Cordeiro, R, Monteiro, W, Pescatello, LS, and Farinatti, P. Acute effect of a single session of Pilates on blood pressure and cardiac autonomic control in middle-aged adults with hypertension. J Strength Cond Res 34(1): 114-123, 2020-We investigated the blood pressure (BP) and heart rate variability (HRV) responses to a single session of Pilates among adults with hypertension. Thirteen participants (7 women), aged 44-66 years, underwent Pilates and nonexercise control sessions separated by 48-72 hours in a randomized counterbalanced order. Blood pressure and HRV indices were simultaneously assessed 10 minutes before and 60 minutes after all sessions in the supine position: root mean square of successive differences (rMSSD), percentage of successive normal sinus RR intervals >50 ms (pNN50), SD of all normal sinus RR intervals over 24 hours (SDNN), and low-frequency (LF) and high-frequency (HF) bands. After an acute session of Pilates, the mean values for area under the curve for systolic BP (p = 0.004, corresponding to -7.4 ± 8.2 mm Hg) and mean arterial pressure (p = 0.023, corresponding to -5.3 ± 5.4 mm Hg) were significantly lower compared to the control session. No significant difference was detected for diastolic BP (-4.2 ± 4.7 mm Hg, p = 0.106). Concomitant to BP reduction, significant lowering of parasympathetic HRV indices occurred: RR intervals (-64.1 ± 69.9 ms·min, p = 0.043), rMSSD (-8.3 ± 15.4 ms·min, p = 0.013), pNN50 (-3.6 ± 13%·min, p = 0.028), and total power (-3,089.4 ± 5,938 m·min, p = 0.037). No difference was found for sympathetic markers: SDNN (-17.7 ± 34.6 ms·min, p = 0.100), LF (-5.2 ± 21,6 n.u.·min, p = 0.417), and LF:HF ratio (-0.3 ± 5.2 ratio·min, p = 0.422). In conclusion, a single session of Pilates reduced BP by ∼5-8 mm Hg in adults with hypertension during the first 60 minutes of post-exercise recovery. Acute BP reduction was concomitant to lowered cardiac parasympathetic activity. Our findings are promising for the use of Pilates as an alternative exercise modality to lower BP.

Venous thromboemboli associated with acute aerobic exercise: A review of case report commonalities.

Venous thromboembolic (VTE) events such as deep vein thrombosis (DVT) and pulmonary embolism (PE) have been reported in otherwise low-risk healthy athletes following acute bouts of aerobic exercise. PURPOSE: To review case reports and assess the commonalities of athletic individuals with VTE, as well as return-to-play (RTP) recommendations. METHODS: We reviewed 47 reports (20 DVTs, 15 PEs, and 12 DVTs/PEs, 19 women) of trained individuals who were diagnosed with DVT and/or PE following aerobic exercise. We assessed frequency of VTE risk factors, presenting symptoms, and RTP recommendations. RESULTS: The age of women (24.6 ± 7.0 years) was lower (P < .01) than of men (40.6 ± 13.6 years). Of the 19 women, 14 (73.7%) used oral contraceptives. Thirteen cases (27.7%) reported a recent period of prolonged inactivity (>1 hour), and another 12 cases were found to have an antithrombin disorder following testing after diagnosis. The most frequently reported symptoms were muscle pain in 26 of 32 (81.3%) DVT or DVT/PE cases, and dyspnea in 21 of 27 (77.8%) PE or DVT/PE cases. Despite these common symptoms, the estimated time from first report of symptoms to confirmed diagnosis was 56.3 ± 118.7 days and 25 cases (53.2%) were initially misdiagnosed. Twenty-three cases (48.9%) did not report RTP recommendations, and those which did varied widely. CONCLUSIONS: Thirty-two cases (~70%) had at least one of three major risk factors, suggesting that many cases of VTE in athletes may be preventable with better education and awareness. The wide variety of RTP recommendations highlights the need for standardized guidelines in this population.

The "Hypertension Approaches in the Elderly: a Lifestyle study" multicenter, randomized trial (HAEL Study): rationale and methodological protocol.

BACKGROUND: Hypertension is a clinical condition highly prevalent in the elderly, imposing great risks to cardiovascular diseases and loss of quality of life. Current guidelines emphasize the importance of nonpharmacological strategies as a first-line approach to lower blood pressure. Exercise is an efficient lifestyle tool that can benefit a myriad of health-related outcomes, including blood pressure control, in older adults. We herein report the protocol of the HAEL Study, which aims to evaluate the efficacy of a pragmatic combined exercise training compared with a health education program on ambulatory blood pressure and other health-related outcomes in older individuals. METHODS: Randomized, single-blinded, multicenter, two-arm, parallel, superiority trial. A total of 184 subjects (92/center), ≥60 years of age, with no recent history of cardiovascular events, will be randomized on a 1:1 ratio to 12-week interventions consisting either of a combined exercise (aerobic and strength) training, three times per week, or an active-control group receiving health education intervention, once a week. Ambulatory (primary outcome) and office blood pressures, cardiorespiratory fitness and endothelial function, together with quality of life, functional fitness and autonomic control will be measured in before and after intervention. DISCUSSION: Our conceptual hypothesis is that combined training intervention will reduce ambulatory blood pressure in comparison with health education group. Using a superiority framework, analysis plan prespecifies an intention-to-treat approach, per protocol criteria, subgroups analysis, and handling of missing data. The trial is recruiting since September 2017. Finally, this study was designed to adhere to data sharing practices. TRIAL REGISTRATION: NCT03264443 . Registered on 29 August, 2017.

Associations of 25-Hydroxyvitamin D With the Blood Pressure Response to Maximal Exercise Among Healthy Adults.

Insufficient 25-hydroxyvitamin D [25(OH)D] levels are associated with high resting blood pressure (BP). However, the relationship between 25(OH)D and the peak systolic BP (SBP) response to exercise, a predictor of future hypertension, has yet to be investigated. We sought to examine the relationship among serum 25(OH)D and the peak SBP response to a graded exercise stress test (GEST) among a large sample (n = 417) of healthy men (49%) and women (51%) over a broad age range (20-76 years; mean age: 44.1 ± 0.8 years). We hypothesized that individuals with clinically insufficient 25(OH)D would have a greater peak SBP response to a GEST compared to individuals with sufficient 25(OH)D levels. Fasting serum 25(OH)D, anthropometrics, resting BP, and peak exercise SBP were obtained at the baseline visit of a larger clinical trial (STOMP; NCT01140308). Mean 25(OH)D levels were 36.1 ± 0.7 ng/ml, with ∼35% of individuals classified as insufficient (<30 ng/ml). Average resting BP was 119 ± 13 mmHg/75 ± 10 mmHg, with 52.3% considered to have normal BP, while 25.2% had elevated BP and 22.5% had established hypertension. The peak SBP response to a GEST was similar between individuals with sufficient (48 ± 19 mmHg) versus insufficient (48 ± 18 mmHg) 25(OH)D (p = 1.000). One unexpected finding emerged such that individuals with sufficient 25(OH)D had higher resting SBP (120 ± 14 mmHg vs. 117 ± 13 mmHg; p = .020) than individuals with insufficient 25(OH)D. In contrast to our hypothesis, 25(OH)D levels were not associated with the peak SBP response to a GEST. Baseline 25(OH)D levels were positively correlated with resting SBP; however, the magnitude of this effect is likely not clinically meaningful.

The Influence of Compression Socks During a Marathon on Exercise-Associated Muscle Damage.

CONTEXT: Compression socks have become increasingly popular with athletes due to perceived enhancement of exercise performance and recovery. However, research examining the efficacy of compression socks to reduce exercise-associated muscle damage has been equivocal, with few direct measurements of markers of muscle damage. OBJECTIVE: To examine the influence of compression socks worn during a marathon on creatine kinase (CK) levels. DESIGN: A randomized controlled trial. SETTING: 2013 Hartford Marathon, Hartford, CT. PARTICIPANTS: Adults (n = 20) randomized to control (CONTROL; n = 10) or compression sock (SOCK; n = 10) groups. MAIN OUTCOME MEASURES: Blood samples were collected 24 hours before, immediately after, and 24 hours following the marathon for the analysis of CK, a marker of muscle damage. RESULTS: Baseline CK levels did not differ between CONTROL (89.3 [41.2] U/L) and SOCK (100.0 [56.2] U/L) (P = .63). Immediately following the marathon (≤1 h), CK increased 273% from baseline (P < .001 for time), with no difference in exercise-induced changes in CK from baseline between CONTROL (+293.9 [278.2] U/L) and SOCK (+233.1 [225.3] U/L; P = .60 for time × group). The day following the marathon (≤24 h), CK further increased 1094% from baseline (P < .001 for time), with no difference in changes in CK from baseline between CONTROL (+ 1191.9 [1194.8] U/L) and SOCK (+889.1 [760.2] U/L; P = .53 for time × group). These similar trends persisted despite controlling for potential covariates such as age, body mass index, and race finishing time (Ps > .29). CONCLUSIONS: Compression socks worn during a marathon do not appear to mitigate objectively measured markers of muscle damage immediately following and 24 hours after a marathon.

Compression Socks Worn During Flight and Hemostatic Balance in Boston Marathon Runners on Oral Contraceptives.

OBJECTIVE: To investigate the effect of oral contraceptive (OC) use and compression socks on hemostatic activation in women flying cross-country to and from a marathon. DESIGN: Prospective study. SETTING: 2015 Boston Marathon. PARTICIPANTS: Women were divided into non-OC using (CONTROL; n = 12), OC-using (OC; n = 15), and OC-using plus compression sock (OC + SOCK; n = 14) groups. INTERVENTION: Women in OC + SOCK wore compression socks during flights to and from the marathon. MAIN OUTCOME MEASURES: Venous blood samples were collected within 24 hours of arriving in Boston (EXPO), immediately after the marathon (RUN), and within 24 hours after a return flight home (Post-Flight) for analysis of thrombin-antithrombin complex (TAT), d-dimer, and tissue plasminogen activator (t-PA). RESULTS: TAT did not increase with exercise (P = 0.48) and was not affected by group (P = 0.08) or the interaction between these 2 factors (P = 0.80). Group, time, and their interaction were significant for d-dimer (all P < 0.05) such that d-dimer increased with acute exercise to a greater extent (Δ d-dimer from expo to postrace = 909.5 ± 1021.9 ng/mL) in the OC + SOCK group relative to OC (Δ d-dimer = 240.0 ± 178.5 ng/mL; P = 0.02) and CONTROL (Δ d-dimer = 230.3 ± 120.3 ng/mL; P = 0.02). There was a significant effect of time, group, and the interaction on t-PA (all P < 0.01) such that t-PA increased with acute exercise to a greater extent (Δ t-PA from expo to postrace = 19.6 ± 10.0 ng/mL) in the CONTROL group relative to OC (Δ t-PA = 4.0 ± 1.8 ng/mL; P < 0.01) and OC + SOCK (Δ t-PA = 3.3 ± 1.2 ng/mL; P < 0.01). CONCLUSIONS: Female runners using OCs did not exhibit disproportionately increased coagulation. The use of compression socks in women on OCs, surprisingly, resulted in a greater increase in d-dimer after exercise.

Influence of Acute Concurrent Exercise Performed in Public Fitness Facilities on Ambulatory Blood Pressure Among Older Adults in Rio de Janeiro City.

Cordeiro, R, Monteiro, W, Cunha, F, Pescatello, LS, and Farinatti, P. Influence of acute concurrent exercise performed in public fitness facilities on ambulatory blood pressure among older adults in Rio de Janeiro city. J Strength Cond Res 32(10): 2962-2970, 2018-The project "Third-Age Academies'" (TAAs) is a public policy providing supervised physical activities to over 40,000 seniors at open-access facilities (squares etc.) in Rio de Janeiro, Brazil. We investigated whether TAA concurrent exercise circuit induced postexercise hypotension (PEH) in individuals older than 60 years. Blood pressure (BP) was measured by 24-hour ambulatory BP monitoring (ABPM) after counterbalanced CEX and nonexercise (CONT) sessions (n = 16; 66.8 ± 1.4 years; systolic/diastolic BP (SBP/DBP): 132.5 ± 4.3/78.0 ± 2.8 mm Hg). For statistical analyses purposes, groups were divided as exhibiting normal SBP (≤120 mm Hg) or high SBP (>120 mm Hg), based on 24-hour ABPM after CONT. The CEX included 2 aerobic and 9 resistance exercises performed alternately in circuit order (40 minutes at 60-70% heart rate reserve using body mass or fixed loads). 24-hour ambulatory BP monitoring lowered in individuals with high BP (n = 11; medicated = 5) (SBP: -6.5 ± 1.9 mm Hg; mean arterial pressure [MAP]: -4.3 ± 1.5 mm Hg; p < 0.015), particularly within the first 5-6 hours after exercise (SBP: -13.5 ± 2.6 mm Hg; DBP: -9.4 ± 2.2 mm Hg; and MAP: -11.4 ± 1.6 mm Hg, p < 0.05). Significant BP lowering was not detected among participants with normal BP (n = 5; medicated = 4). In conclusion, CEX provoked PEH in older adults with prehypertension to established hypertension. Because of the potential of TAAs to reach large numbers of older adults, our findings are encouraging and should be confirmed in subsequent studies.

Small Sample Sizes Confound Understanding of Cardiometabolic Responses to Exercise.

Considerable variability exists in the cardiometabolic disease biomarker response to exercise. We propose that a major contributor to this heterogeneity is underpowered studies due to small sample sizes. To test our hypothesis, we conducted a systematic review to identify meta-analyses/reviews of randomized controlled trials (RCT) and RCT that examined the cardiometabolic disease biomarker response to aerobic and resistance exercise.

Blood pressure response to acute and chronic exercise in chronic kidney disease.

AIM: The current study was designed to determine if a relationship exists between acute and chronic blood pressure responses to aerobic exercise in pre-dialysis patients. METHODS: Pre-dialysis kidney patients attended four sessions before being randomized to the treatment (n = 25) or control group (n = 21). In session 1, resting blood pressure was recorded, and these measurements were repeated during the second visit when peak oxygen uptake (VO2peak ) was assessed. In the third and fourth sessions, blood pressures were taken prior to a 40 min walk or period of seated rest. After the 40 min walk or seated rest, blood pressures were monitored for 60 min in the laboratory and for the subsequent 24 h. After session 4, subjects in the treatment group trained aerobically at a moderate intensity, three times per week for 16 weeks. Control subjects were asked to be sedentary. All measurements were repeated after 16 weeks of training or sedentary living. RESULTS: Training increased VO2peak (mL/kg per minute) in the treatment group (baseline 19.6 ± 6.7 vs 21.2 ± 7.7, P < 0.05), with no change in the control (18.0 ± 6.0 vs 17.5 ± 5.7) group. Post-exercise hypotension occurred at baseline prior to training but was unaffected by 16 weeks of training. CONCLUSION: Post-exercise hypotension occurs in pre-dialysis patients following aerobic exercise, but short-term moderate-intensity continuous aerobic training has no effect upon this response. There seems to be no relationship between the acute and chronic blood pressure responses to exercise in pre-dialysis kidney patients.

Influence of Baseline Psychological Health on Muscle Pain During Atorvastatin Treatment.

BACKGROUND: 3-hydroxy-3-methylglutaryl coenzyme A reductase reductase inhibitors (statins) are generally well tolerated, with statin-associated muscle symptoms (SAMS) the most common side effect (~10%) seen in statin users. However, studies and clinical observations indicate that many of the self-reported SAMS appear to be nonspecific (ie, potentially not attributable to statins). OBJECTIVE: Mental health and well-being influence self-perception of pain, so we sought to assess the effect of baseline well-being and depression on the development of muscle pain with 6 months of atorvastatin 80 mg/d (ATORVA) or placebo in healthy, statin-naive adults. METHODS: The Psychological General Well-being Index (n = 83) and Beck Depression Inventory (n = 55) questionnaires were administered at baseline in participants (aged 59.5 ± 1.2 years) from the effect of Statins on Skeletal Muscle Function and Performance (STOMP) trial (NCT00609063). Muscle pain (Short-Form McGill Pain Questionnaire [SF-MPQ]), pain that interferes with daily life (Brief Pain Inventory [BPI]), and pain severity (BPI) were then measured before, throughout, and after treatment. RESULTS: At baseline, there were no differences in well-being (Psychological General Well-being Index), depression (Beck Depression Inventory), or pain measures (SF-MPQ and BPI) (P values ≥ .05) between the placebo and ATORVA groups. Baseline well-being correlated negatively with baseline BPI pain severity (r = -0.290, P = .008). Baseline depression correlated with baseline pain (SF-MPQ; r = 0.314, P = .020). Baseline well-being and depression did not predict the change in pain severity or interference after 6 months among the total sample or between groups (P values ≥ .05). CONCLUSION: Baseline well-being and depression were not significant predictors of pain after 6 months of ATORVA (P values ≥ .05). Thus, they do not appear to increase the risk of SAMS in otherwise healthy adults.

Precision, Accuracy, and Performance Outcomes of Perceived Exertion vs. Heart Rate Guided Run-training.

Johnson, EC, Pryor, RR, Casa, DJ, Ellis, LA, Maresh, CM, Pescatello, LS, Ganio, MS, Lee, EC, and Armstrong, LE. Precision, accuracy, and performance outcomes of perceived exertion vs. heart rate guided run-training. J Strength Cond Res 31(3): 630-637, 2017-The purpose of this investigation was to compare run-prescription by heart rate (HR) vs. rating of perceived exertion (RPE) during 6 weeks to determine which is superior for consistent achievement of target intensities and improved performance. Forty untrained men participated in this laboratory-controlled and field-controlled trial. Participants were divided into heart rate (HRTG) and rating of perceived exertion training groups (RPETG). All underwent maximal-graded exercise testing and a 12-minute run test before and after training. Intensity was prescribed as either a target HR or RPE that corresponded to 4 relative intensity levels: 45, 60, 75, and 90% V[Combining Dot Above]O2 reserve (V[Combining Dot Above]O2R). Mean exercise intensity over the 6 weeks did not differ between HRTG (65.6 ± 7.2%HRR) and RPETG (61.9 ± 9.0%HRR). V[Combining Dot Above]O2max (+4.1 ± 2.5 ml·kg·min) and 12 minutes run distance (+240.1 ± 150.1 m) improved similarly in HRTG and RPETG (p > 0.05). HRTG displayed lower coefficients of variation (CV) (5.9 ± 4.1%, 3.3 ± 3.8%, and 3.0 ± 2.2%) and %error (4.1 ± 4.7%, 2.3 ± 4.1% and 2.6 ± 3.2%) at 45, 60, and 75% V[Combining Dot Above]O2R compared with RPETG (CV 11.1 ± 5.0%, 7.7 ± 4.1% and 5.6 ± 3.2%; all p < 0.005) %error (15.7 ± 9.2%, 10.6 ± 9.2% and 6.7 ± 3.2%; all p < 0.001), respectively. Overall, HR-prescribed and RPE-prescribed run-training resulted in similar exercise intensity and performance outcomes over 6 weeks. Differences in the CV and %error suggest use of HR monitoring for individuals that are new to running as it improves precision and accuracy but does not increase performance improvements across 6 weeks.

Examination of Lifestyle Behaviors and Cardiometabolic Risk Factors in University Students Enrolled in Kinesiology Degree Programs.

Preventing physical inactivity and weight gain during college is critical in decreasing lifelong obesity and associated disease risk. As such, we sought to compare cardiometabolic risk factors and lifestyle behaviors between college students enrolled in kinesiology and non-kinesiology degree programs to assess whether health and exercise degree programs may influence health behaviors and associated disease risk outcomes. Anthropometrics, fasting blood glucose, insulin, lipid profiles and HbA1c%, blood pressure, and peak oxygen consumption (V[Combining Dot Above]O2peak) were assessed in 247 healthy college students. The homeostasis model assessment of insulin sensitivity (HOMA) was calculated using glucose and insulin levels. Self-reported physical activity from the Paffenbarger questionnaire was collected to estimate the average caloric expenditure due to different types of physical activities. Despite no significant differences in body mass index or waist circumference between groups, kinesiology majors presented with ∼20% lower fasting insulin levels and HOMA (p = 0.01; p < 0.01, respectively) relative to nonmajors. Kinesiology majors reported increased weekly participation in vigorous-intensity sport and leisure activities and, on average, engaged in >300 metabolic equivalent-h·wk, whereas non-kinesiology majors engaged in <300 MET-h wk (p = 0.01). Our data suggest that students enrolled in kinesiology degree programs display improved healthy behaviors and associated outcomes (parameters of glucose homeostasis). Practical outcomes of this research indicate that implementing components of a comprehensive kinesiology curriculum encourages improved health behaviors and associated cardiometabolic risk factors.

Exercise for Hypertension: A Prescription Update Integrating Existing Recommendations with Emerging Research.

Hypertension is the most common, costly, and preventable cardiovascular disease risk factor. Numerous professional organizations and committees recommend exercise as initial lifestyle therapy to prevent, treat, and control hypertension. Yet, these recommendations differ in the components of the Frequency, Intensity, Time, and Type (FITT) principle of exercise prescription (Ex Rx); the evidence upon which they are based is only of fair methodological quality; and the individual studies upon which they are based generally do not include people with hypertension, which are some of the limitations in this literature. The purposes of this review are to (1) overview the professional exercise recommendations for hypertension in terms of the FITT principle of Ex Rx; (2) discuss new and emerging research related to Ex Rx for hypertension; and (3) present an updated FITT Ex Rx for adults with hypertension that integrates the existing recommendations with this new and emerging research.

Effect of statins on skeletal muscle function.

BACKGROUND: Many clinicians believe that statins cause muscle pain, but this has not been observed in clinical trials, and the effect of statins on muscle performance has not been carefully studied. METHODS AND RESULTS: The Effect of Statins on Skeletal Muscle Function and Performance (STOMP) study assessed symptoms and measured creatine kinase, exercise capacity, and muscle strength before and after atorvastatin 80 mg or placebo was administered for 6 months to 420 healthy, statin-naive subjects. No individual creatine kinase value exceeded 10 times normal, but average creatine kinase increased 20.8±141.1 U/L (P<0.0001) with atorvastatin. There were no significant changes in several measures of muscle strength or exercise capacity with atorvastatin, but more atorvastatin than placebo subjects developed myalgia (19 versus 10; P=0.05). Myalgic subjects on atorvastatin or placebo had decreased muscle strength in 5 of 14 and 4 of 14 variables, respectively (P=0.69). CONCLUSIONS: These results indicate that high-dose atorvastatin for 6 months does not decrease average muscle strength or exercise performance in healthy, previously untreated subjects. Nevertheless, this blinded, controlled trial confirms the undocumented impression that statins increase muscle complaints. Atorvastatin also increased average creatine kinase, suggesting that statins produce mild muscle injury even among asymptomatic subjects. This increase in creatine kinase should prompt studies examining the effects of more prolonged, high-dose statin treatment on muscular performance. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00609063.