Effect of a 12-Week High-Calorie-Expenditure Multimodal Exercise Program on Health Indices in Women With Overweight: Protocol for a Randomized Controlled Trial.

BACKGROUND: High-calorie-expenditure training is common among endurance athletes and is an effective strategy for weight loss. Although many training protocols include walking, running, cycling, and swimming according to a target heart rate, there is limited research on high-calorie-expenditure interventions with multimodal training programs using quantitative methods. OBJECTIVE: The aims of this research protocol are to (1) develop a high-calorie-expenditure training program to cover target calorie expenditure according to the trainability of women classified as overweight (according to a BMI of 25-29.9 kg/m2); (2) determine the effect of high-calorie-expenditure workouts on conditioning, glycemic variables, and body composition; and (3) evaluate the implementation of the intervention and results in comparison with outcomes obtained under a standard-calorie-expenditure training program. METHODS: This is a randomized controlled trial with a pretest-posttest design. Participants include 33 women with a BMI in the overweight range (25-29.9) allocated to three groups: two intervention groups and one control group. The intervention will be conducted for 12 weeks. Participants in the first group will be assigned an exercise program with high energy expenditure of approximately 3000-3500 kilocalories/week in the form of 5 sessions per week with an intensity of 50%-75% maximum oxygen rate (VO2 max) and 60%-80% target heart rate. The second group will be assigned an exercise program with a standard energy expenditure of approximately 1200-1500 kilocalories/week with 3 sessions per week at an intensity of 60%-75% VO2 max, according to The American College of Sports Medicine guideline. The effects of the multimodal training program with daily tasks will be compared to those of the standard-calorie-expenditure and control (no exercise) conditions with respect to changes in glycemic indices and body composition. Daily calories will be calculated through the International Physical Activity Questionnaire and using Nutrition 4 software. RESULTS: Preliminary results show significant weight loss in both the high- and standard-calorie-expenditure groups (P=.003). Significant improvements were also found in muscle percentage (P=.05) and BMI (P=.05) for the high-calorie-expenditure group. Analyses are ongoing for glycemic indices, inflammation factors, and blood parameters. CONCLUSIONS: High-calorie-expenditure training can cause further weight loss than standard exercise, which can eventually lead to greater fat mass reduction and improvement in glycemic indices. These results demonstrate that, in some cases, it may be necessary to increase the activity of women and use multimodal exercise programs with increased volume and intensity to increase the expenditure of exercise and daily activity. We found a net effect of exercise and daily activity at the individual level, whereas the daily lifestyle and physical behaviors of the participants remained constant. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20220202053916N1; https://tinyurl.com/c8jxfw36. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/51599.

The acute effects of endurance exercise on epithelial integrity of the airways in athletes and non-athletes: A systematic review and meta-analysis.

INTRODUCTION: Acute endurance exercise may induce airway epithelium injury. However, the response of epithelial integrity markers of the airways including club cell secretory protein (CC16) and surfactant protein D (SP-D) to endurance exercise have not been systematically reviewed. Therefore, the aim of this systematic review and meta-analysis was to assess the acute effects of endurance exercise on markers of epithelial integrity of the airways (CC16, SP-D and the CC16/SP-D ratio) in athletes and non-athletes. METHODS: A systematic search was performed utilizing PubMed/Medline, EMBASE, Web of Science, and hand searching bibliographies of retrieved articles through to September 2022. Based on the inclusion criteria, articles with available data about the acute effects of endurance exercise on serum or plasma concentrations of CC16, SP-D and CC16/SP-D ratio in athletes and non-athletes were included. Quality assessment of studies and statistical analysis were conducted via Review Manager 5.4 software. RESULTS: The search resulted in 908 publications. Finally, thirteen articles were included in the review. Acute endurance exercise resulted in an increase in CC16 (P = 0.0006, n = 13) and CC16/SP-D ratio (P = 0.005, n = 2) whereas SP-D (P = 0.47, n = 3) did not change significantly. Subgroup analysis revealed that the type (P = 0.003), but not the duration of exercise (P = 0.77) or the environmental temperature (P = 0.06) affected the CC16 response to endurance exercise. CONCLUSIONS: Acute endurance exercise increases CC16 and the CC16/SP-D ratio, as markers of epithelial integrity, but not SP-D in athletes and non-athletes.

Cardiac fibrosis and down regulation of GLUT4 in experimental diabetic cardiomyopathy are ameliorated by chronic exposures to intermittent altitude.

INTRODUCTION: Chronic intermittent hypoxia is considered as a preconditioning status in cardiovascular health to inducing resistance to the low oxygen supply. Diabetic cardiomyopathy leads to inability of the heart to effective circulation of blood preventing of consequent tissue damages so; the aim of this study was elucidation of effect of chronic exposure to hypoxia on Cardiac fibrosis and expression of GLUT4 in experimental diabetic cardiomyopathy. METHODS: A total number of 30 rats were randomly divided into three groups; 1: Normoxia control group (NN, n = 10). 2: Normoxia diabetic group (ND, n = 10) that took fat diet for 2 weeks then were injected by streptozotocin (37 mg/kg) and 3: Hypoxia diabetic group (HD, n = 10): that were exposed to chronic intermittent hypoxia (CIH) (altitude ≈3400 m, 14% oxygen for 8 weeks). After hypoxia challenge, plasma metabolic parameters including: fasting blood glucose (FBS), triglyceride (TG) and total cholesterol (TC) were measured by colorimetric assay. Cardiac expression of GLUT4 protein and cardiac collagen accumulation were determined in the excised left ventricle by western blotting, and Masson trichrome staining respectively. RESULTS: Based on resultant data, FBS, TG and TC were significantly (P < 0.05) decreased in HD vs. ND. Homeostasis Model Assessment (HOMA) were also significantly attenuated after exposed to CIH in HD group compared to ND group (P < 0.05). Significant increase in packed cell volume and hemoglobin concentration was observed in HD group compared to ND group (P < 0.05). Comparison of heart wet weight between three groups showed a significant difference (P < 0.05) with lower amount in HD and ND versus NN. Myocardial fibrosis was significantly more pronounced in ND when compared to NN. Eight weeks exposure to hypoxia ameliorated this increase in HD group. Intermittent hypoxia significantly increased GLUT4 protein expression in HD compared to ND group (P < 0.05). CONCLUSION: Data suggested that CIH might potentiate to improve glucose homeostasis and cardiac tissue structural damages created in type 2 diabetes (T2D).

Acute Exercise and Appetite-Regulating Hormones in Overweight and Obese Individuals: A Meta-Analysis.

In lean individuals, acute aerobic exercise is reported to transiently suppress sensations of appetite, suppress blood concentrations of acylated ghrelin (AG), and increase glucagon-like peptide-1 (GLP-1) and peptide-YY (PYY). Findings in overweight/obese individuals have yet to be synthesised. In this systematic review and meta-analysis, we quantified the effects that acute exercise has on AG and total PYY and GLP-1 in overweight/obese individuals. The potential for body mass index (BMI) to act as a moderator for AG was also explored. Six published studies (73 participants, 78% male, mean BMI: 30.6 kg·m-2) met the inclusion criteria. Standardised mean differences (SMDs) and standard errors were extracted for AG and total PYY and GLP-1 concentrations in control and exercise trials and synthesised using a random effects meta-analysis model. BMI was the predictor in metaregression for AG. Exercise moderately suppressed AG area-under-the-curve concentrations (pooled SMD: -0.34, 95% CI: -0.53 to -0.15). The magnitude of this reduction was greater for higher mean BMIs (pooled metaregression slope: -0.04 SMD/kg·m-2 (95% CI: -0.07 to 0.00)). Trivial SMDs were obtained for total PYY (0.10, 95% CI: -0.13 to 0.31) and GLP-1 (-0.03, 95% CI: -0.18 to 0.13). This indicates that exercise in overweight/obese individuals moderately alters AG in a direction that could be associated with decreased hunger and energy intake. This trial is registered with PROSPERO: CRD42014006265.

Fatigue and soft tissue vibration during prolonged running.

Muscle tuning paradigm proposes that the mechanical properties of soft tissues are tuned in such a way that its vibration amplitude become minimized. Therefore, the vibrations of soft tissue are heavily damped. However, it has been hypothesized that the ability of muscle tuning decreases with fatigue. This study investigated the changes in vibration characteristics of soft tissue with fatigue. Vibrations of the gastrocnemius muscle of 8 runners during a prolonged run protocol on a treadmill at constant velocity (4 ms(-1)) were measured using a tri-axial accelerometer. The vibration amplitude is calculated using the Fourier transform and a wavelet-based method was used to calculate the damping coefficient. The results showed that: (1) the vibration amplitude in longitudinal direction increased with fatigue, which may be interpreted as the decreased muscle function with fatigue. (2) The amplitude increase percent strongly depended on the vibration frequency. (3) The damping coefficient of the gastrocnemius increased with fatigue. A 1-DOF mass-spring-damper model was used in order to validate the wavelet based method and simulate the observed phenomena.

A combined continuous and interval aerobic training improves metabolic syndrome risk factors in men.

Individuals with metabolic syndrome have significantly higher risk of cardiovascular disease and type 2 diabetes leading to premature death mortality. Metabolic syndrome has a complex etiology; thus, it may require a combined and multi-targeted aerobic exercise regimen to improve risk factors associated with it. Therefore, the aim of this study was to evaluate the effect of combined continuous and interval aerobic training on patients with metabolic syndrome. Thirty adult male with metabolic syndrome (54±8 years) were randomly divided into two groups: test training group (TTG; n=15) and control group (CG; n=15). Subjects in TTG performed combined continuous and interval aerobic training using a motorized treadmill three times per week for 16 weeks. Subjects in CG were advised to continue with their normal activities of life. Twenty-two men completed the study (eleven men in each group). At the end of the study, in TTG, there were significant (for all, P<0.05) reductions in total body weight (-3.2%), waist circumference (-3.43 cm), blood pressure (up to -12.7 mmHg), and plasma insulin, glucose, and triacylglyceride levels. Moreover, there were significant (for all, P<0.05) increases VO2max (-15.3%) and isometric strength of thigh muscle (28.1%) and high-density lipoprotein in TTG. None of the above indices were changed in CG at the end of 16-week study period. Our study suggests that adoption of a 16-week combined continuous and interval aerobic training regimen in men with metabolic syndrome could significantly reduce cardiovascular risk factors in these patients.

The effects of single and repeated bouts of soccer-specific exercise on salivary IgA.

OBJECTIVE: Athletes frequently train with a short time recovery between sessions. The present aim was to establish how salivary IgA is altered following two soccer-specific intermittent exercise bouts performed on the same day. DESIGN: Ten males participated in two experimental trials (single session, double session) 1 week apart, in a counterbalanced design. One trial entailed afternoon exercise only (PMEX), in which participants completed soccer-specific intermittent exercise starting at 14:30h. On the other occasion, participants performed two bouts of exercise [starting at 10:30h (AMEX(1)) and at 14:30h (PMEX(2))]. Timed unstimulated saliva samples were collected before and immediately after exercise. RESULTS: Mean salivary IgA levels increased significantly immediately post-exercise in the single afternoon trial (PMEX). Performance of a second soccer-specific exercise bout in 1 day elicited an increase in heart rate and perceived exertion, compared with the single session, but did not appear to suppress salivary IgA outcomes. Performing soccer-specific exercise at these different times of day did not affect the salivary IgA concentration and secretion rate or salivary cortisol in the short term. CONCLUSIONS: These findings suggest that, two 90-min exercise sessions performed at a moderate intensity with a 2.25h rest in between do not necessarily have adverse effects on salivary IgA levels.