Hypotensive effects of exercise training: are postmenopausal women with hypertension non-responders or responders?

We tested the hypothesis that increasing the exercise dose or changing the exercise mode would augment hypotensive effects when traditional aerobic exercise training failed to produce it in postmenopausal women. Sixty-five postmenopausal women with essential hypertension were randomly allocated into the continuous aerobic training (CAT) and non-exercising control (CON) groups. CAT group cycled at moderate intensity 3 times a week for 12 weeks. Individuals who failed to decrease systolic blood pressure (BP) were classified as non-responders (n = 34) and performed an additional 12 weeks of exercise training with either increasing the exercise dose or changing the exercise mode. The 3 follow-up groups were continuous aerobic training 3 times a week, continuous aerobic training 4 times a week, and high-intensity interval training. After the first 12 weeks of exercise training, systolic BP decreased by 1.5 mmHg (NS) with a wide range of inter-individual responses (-23 to 23 mmHg). Sixty-seven percent of women who were initially classified as non-responders participated in the second training period. Sixty percent of women who participated in continuous exercise training 3 or 4 times a week at greater exercise intensities reduced systolic BP. All (100%) of the women who performed high-intensity interval training experienced significant reductions in systolic BP. Traditional aerobic exercise was not sufficient to decrease BP significantly in the majority of postmenopausal women. However, those women who were not sensitive to recommended exercise may reduce BP if they were exposed to continuous aerobic exercise at higher intensities and/or volumes or a different mode of exercise.

Influência do treinamento físico nas escolhas alimentares de idosos / Influence of physical training on the food choices of elderly individuals

A prática de treinamento físico influencia o apetite e o paladar de maneira que afeta as escolhas alimentares em indivíduos jovens, geralmente contribuindo para escolhas alimentares mais saudáveis. Os idosos sofrem uma enorme redução no paladar, nos hormônios e nas alterações gastrointestinais, levando também a alterações no apetite. Portanto, o objetivo deste estudo foi testar os efeitos do treinamento combinado (TC) nas escolhas alimentares dos idosos. Cinquenta e dois indivíduos (> 60 anos) foram randomizados em um grupo de TC (exercícios aeróbicos e resistidos) e um grupo controle (GC); 20 indivíduos no grupo TC e 23 indivíduos no grupo GC. Os participantes estavam fisicamente inativos antes do estudo e completaram a intervenção de 16 semanas. Os participantes responderam ao questionário de frequência alimentar contendo 84 itens, antes e depois das intervenções. Houve diferenças nas frequências alimentares entre os grupos, como maior consumo de manteiga e margarina e menor consumo de peixe e sopa no GC em relação ao TC, que foram mantidos mesmo após 16 semanas. No entanto, o maior consumo de adicionais de óleo e tendencia a menor consumo de chantilly no GC foi o mesmo no TC após 16 semanas. Além disso, houve uma tendência a maior consumo de de frutas (3,47 ± 2,05) e tendencia a menor consumo de salgadinhos fritos e sal adicional nas saladas para TC (0,03 ± 0,03 e 0,63 ± 0,48, respectivamente), em comparação ao GC (2,24 ± 1,04; 0,06 ± 0,05 e 0,89 ± 0,3). Portanto, apesar das tendências sutis de mudanças nos hábitos, o treinamento combinado não alterou efetivamente as escolhas alimentares dos idosos.(AU)

Practicing physical training influences appetite and palate in such way that it affects food choices in young individuals, usually contributing to healthier food choices. Elderly individuals undergo a huge reduction in taste, hormones and gastrointestinal changes also leading to appetite changes. Therefore, the aim of this study was to test the effects of combined training (CT) on elderly food choices. Fifty-two individuals (>60yr) were randomly placed into a CT group (aerobic and resistance exercises) and a control group (CG); 20 individuals in the CT group and 23 individuals in the CG group. Participants were physically inactive prior to the study and completed the 16-week intervention. The participants answered the food frequency questionnaire containing 84 items, before and after the interventions. There were differences in food frequencies between groups, such as a higher butter and margarine consumption and a lower fish and soup consumption in CG compared to CT, which were maintained even after 16 weeks. However, higher consumption of additional oil and a tendency to lower consumption of whipped cream in CG had become the same in CT after 16 weeks. Also, there was a trend to higher fruit consumption (3.47±2.05) and trend to lower consumption of fried snacks and additional salt in the salads for CT (0.03±0.03 and 0.63±0.48, respectively), compared to CG (2.24±1.04; 0.06±0.05 and 0.89±0.3). Therefore, despite subtle trends of improved habit changes, the CT did not effectively alter the food choices in elderly participants.(AU)

Association of skeletal muscle and serum metabolites with maximum power output gains in response to continuous endurance or high-intensity interval training programs: The TIMES study - A randomized controlled trial.

BACKGROUND: Recent studies have begun to identify the molecular determinants of inter-individual variability of cardiorespiratory fitness (CRF) in response to exercise training programs. However, we still have an incomplete picture of the molecular mechanisms underlying trainability in response to exercise training. OBJECTIVE: We investigated baseline serum and skeletal muscle metabolomics profile and its associations with maximal power output (MPO) gains in response to 8-week of continuous endurance training (ET) and high-intensity interval training (HIIT) programs matched for total units of exercise performed (the TIMES study). METHODS: Eighty healthy sedentary young adult males were randomized to one of three groups and 70 were defined as completers (> 90% of sessions): ET (n = 30), HIIT (n = 30) and control (CO, n = 10). For the CO, participants were asked to not exercise for 8 weeks. Serum and skeletal muscle samples were analyzed by 1H-NMR spectroscopy. The targeted screens yielded 43 serum and 70 muscle reproducible metabolites (intraclass > 0.75; coefficient of variation < 25%). Associations of baseline metabolites with MPO trainability were explored within each training program via three analytical strategies: (1) correlations with gains in MPO; (2) differences between high and low responders to ET and HIIT; and (3) metabolites contributions to the most significant pathways related to gains in MPO. The significance level was set at P < 0.01 or false discovery rate of 0.1. RESULTS: The exercise programs generated similar gains in MPO (ET = 21.4 ± 8.0%; HIIT = 24.3 ± 8.5%). MPO associated baseline metabolites supported by all three levels of evidence were: serum glycerol, muscle alanine, proline, threonine, creatinine, AMP and pyruvate for ET, and serum lysine, phenylalanine, creatine, and muscle glycolate for HIIT. The most common pathways suggested by the metabolite profiles were aminoacyl-tRNA biosynthesis, and carbohydrate and amino acid metabolism. CONCLUSION: We suggest that MPO gains in both programs are potentially associated with metabolites indicative of baseline amino acid and translation processes with additional evidence for carbohydrate metabolism in ET.

Low-load resistance exercise improves cognitive function in older adults / Exercício resistido com baixa carga melhora a função cognitiva em idosos / Ejercicio resistido com baja carga mejora la función cognitiva en adultos mayores

ABSTRACT Introduction: Resistance exercise (RE) training is widely recommended for increasing muscle strength and mass in older adults. RE is also a potential stimulus to improve cognitive functions (CF), but the best protocol for this purpose is unknown. Objective: To compare the effects of different RE protocols on CF in the same group of individuals. Methods: Twenty-four older adults were randomized (cross over) to control (CON) and lower limb RE protocols with high load (HL - 80% of 1RM), low load (LL - 30% of 1RM) and LL with blood flow restriction (LL-BFR - 30% of 1RM and 50% BFR). For CF assessment, participants underwent the Stroop test before and after each RE protocol. Results: Reduction in response time for Stroop neutral stimuli was greater after LL (effect size (ES) = -0.92) compared to CON (ES = -0.18) and HL (ES = -0.03), but was not different from LL-BFR (ES = -0.24). The reduced response time was associated with reduced parasympathetic modulation and increased cardiac output across protocols. Conclusion: LL was the most effective RE protocol to improve CF of older adults and a potential beneficial effect of LL-BFR on CF (non-significant) was identified. Therefore, LL resistance exercise appears to stimulate acute cognitive improvements in healthy older adults, probably through exercise-induced optimal autonomic modulation changes. Level of Evidence I; Therapeutic studies-Investigating the results of treatment.

RESUMO Introdução: O treinamento com exercício resistido (ER) é amplamente recomendado para aumento de força e massa muscular em idosos. O ER também é um possível estímulo para melhorar funções cognitivas (FC), mas o melhor protocolo para esse fim não é conhecido. Objetivo: Comparar os efeitos de diferentes protocolos de ER sobre a FC de um mesmo grupo de indivíduos. Métodos: Vinte e quarto idosos foram randomizados (cross-over) em grupo controle (CON) e grupos protocolos de ER para membros inferiores com carga alta (CA - 80% 1RM), carga baixa (CB - 30% 1RM) e carga baixa com restrição de fluxo sanguíneo (CB-RFS - 30% 1RM e 50% RFS). Para a avaliação de FC, os participantes realizaram o teste de Stroop antes e depois de cada protocolo de ER. Resultados: A redução do tempo de resposta para o estímulo neutro de Stroop foi maior após o CB (tamanho de efeito [TE] = -0,92) comparado ao CON (TE = -0,18) e CA (TE = -0,03), mas não foi diferente de CB-RFS (TE = -0,24). A redução do tempo de resposta foi associada à redução da modulação parassimpática e ao aumento de débito cardíaco em todos os protocolos. Conclusões: CB foi o protocolo de ER mais eficiente para aumentar a FC em idosos e identificou-se um efeito benéfico em potencial do CB-RFS sobre a FC (não significante). Desta forma, o exercício resistido de CB parece estimular a melhora aguda da função cognitiva em idosos saudáveis, provavelmente devido à alteração ideal da modulação autonômica induzida pelo exercício. Nível de Evidência I; Estudos Terapêuticos - Investigação dos resultados do tratamento.

RESUMEN Introducción: El entrenamiento con ejercicio resistido (ER) es ampliamente recomendado para aumento de fuerza y masa muscular en ancianos. El ER también es un posible estímulo para mejorar las funciones cognitivas (FC), pero el mejor protocolo para este fin no es conocido. Objetivo: Comparar los efectos de diferentes protocolos de ER sobre la FC de un mismo grupo de individuos. Métodos: Veinte y cuatro ancianos fueron aleatorizados (cross-over) en grupo control (CON) y grupos protocolos de ER para extremidades inferiores con carga alta (CA - 80% 1RM), carga baja (CB - 30% 1RM) y carga baja con restricción de flujo sanguíneo (CB-RFS - 30% 1RM y 50% RFS). Para la evaluación de FC, los participantes realizaron el test de Stroop antes y después de cada protocolo de ER. Resultados: La reducción del tiempo de respuesta para el estímulo neutro de Stroop fue mayor después del CB (tamaño de efecto [TE] = -0,92) comparado al CON (TE = -0,18) y CA (TE = -0,03), pero no fue diferente de CB-RFS (TE = -0,24). La reducción del tiempo de respuesta fue asociada a la reducción de la modulación parasimpática y al aumento del gasto cardiaco en todos los protocolos. Conclusiones: CB fue el protocolo de ER más eficiente para aumentar la FC en ancianos y se identificó un efecto beneficioso potencial del CB-RFS sobre la FC (no significativo). De esta forma, el ejercicio resistido de CB parece estimular la mejora aguda de la función cognitiva en ancianos sanos, probablemente debido a la alteración ideal de la modulación autonómica inducida por el ejercicio. Nivel de Evidencia I; Estudios Terapéuticos - Investigación de los resultados del tratamiento.

Cardiovascular Responses to Different Resistance Exercise Protocols in Elderly.

Increase in muscle mass and strength through resistance exercise (RE) has been highly recommended for healthy aging. On the other hand, RE could lead to acute cardiovascular risks prompted mainly by intense blood pressure elevations and cardiac autonomic imbalance. We compared the cardiovascular responses to three different RE protocols performed by 21 healthy elderly on a leg press machine. The protocols tested were high load (80% 1RM) until muscular failure (HL); low load (30% 1RM) until muscular failure (LL); low load, 30 repetitions followed by 3 sets of 15 repetitions, with 50% blood flow restriction (LL-BFR); and a control session (CON). Based on heart rate variability analysis, only LL kept parasympathetic indexes lower than CON at 30 min recovery. By finger photoplethysmography, LL-BFR prompted higher systolic and mainly diastolic blood pressure increments in many sets. The heart rate and cardiac output increase, and total peripheral resistance reduction following exercise were not different among RE protocols. There was no significant post-exercise hypotension and carotid arterial compliance changes. HL seems to be the safer protocol to be recommended for the healthy elderly, because it induces lower blood pressure increments and faster parasympathetic recovery compared to LL and LL-BFR.

Cardiac autonomic and haemodynamic recovery after a single session of aerobic exercise with and without blood flow restriction in older adults.

This study investigated the autonomic and haemodynamic responses to different aerobic exercise loads, with and without blood flow restriction (BFR). In a crossover study, 21 older adults (8 males and 13 females) completed different aerobic exercise sessions: low load without BFR (LL) (40% VO2max), low load with BFR (LL-BFR) (40% VO2max + 50% BFR) and high load without BFR (HL) (70% VO2max). Heart rate variability and haemodynamic responses were recorded during rest and throughout 30 min of recovery. HL reduced R-R interval, the root mean square of successive difference of R-R intervals and high frequency during 30 min of recovery at a greater magnitude compared with LL and LL-BFR. Sympathetic-vagal balance increased the values for HL during 30 min of recovery at a greater magnitude when compared with LL and LL-BFR. Post-exercise haemodynamic showed reduced values of double product at 30 min of recovery compared to rest in LL-BFR, while HL showed higher values compared to rest, LL-BFR and LL. Reduced systolic blood pressure was observed for LL-BFR (30 min) compared to rest. Autonomic and haemodynamic responses indicate lower cardiovascular stress after LL-BFR compared to HL, being this method, besides the functional adaptations, a potential choice to attenuate the cardiovascular stress after exercise in older adults.