Older firefighters are susceptible to age-related impairments in heat dissipation.

PURPOSE: The aging-induced reduction in whole-body heat loss (HL) capacity generates concerns regarding the continued participation of older workers in occupations such as firefighting. We compared HL and change in body heat storage (S) during intermittent exercise in warm/dry and warm/humid conditions among older male firefighters (OLDER, n = 9, age = 54.7 ± 2.1 yr), older (age-matched) nonfirefighters (NON-FF, n = 9, age = 52.8 ± 1.2 yr), and young firefighters (YOUNG, n = 6, age = 26.7 ± 0.8 yr). METHODS: We measured evaporative heat loss and dry heat exchange via the Snellen whole-body direct calorimeter while participants performed four 15-min bouts of cycling at 400 W of metabolic heat production separated by 15-min recovery periods in warm/dry (35 °C, 20% relative humidity) and warm/humid (35 °C, 60% relative humidity) conditions. RESULTS: We found no differences (P > 0.05) in HL or cumulative S (ΔS) between OLDER and NON-FF in the warm/dry (ΔS: OLDER = 233 ± 26 kJ, NON-FF = 270 ± 29 kJ) or warm/humid (ΔS: OLDER = 548 ± 24 kJ, NON-FF = 504 ± 47 kJ) conditions. The OLDER and NON-FF had lower HL than the YOUNG during exercise in both environmental conditions (P < 0.05). The OLDER stored 40% (P > 0.05) and 46% (P = 0.004) more heat than YOUNG in the warm/dry and warm/humid conditions, respectively. The NON-FF stored 63% (P = 0.016) and 34% (P = 0.025) more heat than the YOUNG in the dry and humid conditions, respectively. CONCLUSIONS: Older firefighters and age-matched nonfirefighters demonstrate similar HL and S during work in the heat. Moreover, HL is significantly reduced in older compared to younger firefighters during exercise in both warm/dry and warm/humid conditions. Consequently, older firefighters may be more susceptible to thermal injury while on duty than their younger counterparts.

Increased air velocity during exercise in the heat leads to equal reductions in hydration shifts and interleukin-6 with age.

PURPOSE: The effectiveness of increased air velocity in reducing hydration shifts and physiological strain during work in the heat was examined in young and older males. METHODS: Ten young (mean ± SE, 24 ± 1 years) and 10 older (59 ± 1 years) males, matched for height, mass, and body surface area, cycled 4 × 15-min at moderate-to-heavy heat production (400 W), with 15-min rest separations between exercise bouts (final recovery 30 min), while wearing work clothing in humid heat (35 °C, 60 % relative humidity) under low (~0.5 m s(-1)) and high (~3.0 m s(-1)) air velocity. Rectal temperature (T re) and heart rate were measured continuously, whereas hydration indices and interleukin (IL)-6 were measured at rest (PRE) and following the final recovery (POST). RESULTS: Young and older males experienced similar thermal and cardiovascular strain within the low (T re end-exercise: young = 38.28 ± 0.11, older = 38.31 ± 0.08 °C) and high (T re end-exercise: young = 37.94 ± 0.08, older = 37.87 ± 0.08 °C) air velocity conditions, with a reduced increase in both groups in high compared to low. Percent changes in plasma volume were similarly greater during the low (young = -10.9 ± 1.2, older = -10.8 ± 0.9 %) compared to high (young = -5.7 ± 0.6, older = -6.9 ± 0.7 %) condition for both groups. Despite elevated IL-6 at PRE in the older males, the IL-6 absolute change was similar between young (low = +4.10 ± 0.95, high = +0.99 ± 0.32 pg mL(-1)) and older (low = +3.58 ± 0.83, high = +1.24 ± 0.28 pg mL(-1)) males yet greater during the low compared to high condition. CONCLUSIONS: Increased air velocity was effective in reducing the increase in hydration shifts and physiological strain (i.e. IL-6, thermal and cardiovascular strain) equally in young and older males.

Age-related differences in heat loss capacity occur under both dry and humid heat stress conditions.

This study examined the progression of impairments in heat dissipation as a function of age and environmental conditions. Sixty men (n = 12 per group; 20-30, 40-44, 45-49, 50-54, and 55-70 yr) performed four intermittent exercise/recovery cycles for a duration of 2 h in dry (35°C, 20% relative humidity) and humid (35°C, 60% relative humidity) conditions. Evaporative heat loss and metabolic heat production were measured by direct and indirect calorimetry, respectively. Body heat storage was measured as the temporal summation of heat production and heat loss during the sessions. Evaporative heat loss was reduced during exercise in the humid vs. dry condition in age groups 20-30 (-17%), 40-44 (-18%), 45-49 (-21%), 50-54 (-25%), and 55-70 yr (-20%). HE fell short of being significantly different between groups in the dry condition, but was greater in age group 20-30 yr (279 ± 10 W) compared with age groups 45-49 (248 ± 8 W), 50-54 (242 ± 6 W), and 55-70 yr (240 ± 7 W) in the humid condition. As a result of a reduced rate of heat dissipation predominantly during exercise, age groups 40-70 yr stored between 60-85 and 13-38% more heat than age group 20-30 yr in the dry and humid conditions, respectively. These age-related differences in heat dissipation and heat storage were not paralleled by significant differences in local sweating and skin blood flow, or by differences in core temperature between groups. From a whole body perspective, combined heat and humidity impeded heat dissipation to a similar extent across age groups, but, more importantly, intermittent exercise in dry and humid heat stress conditions created a greater thermoregulatory challenge for middle-aged and older adults.

Inflammatory responses of older firefighters to intermittent exercise in the heat.

PURPOSE: Repeated strenuous work in the heat may predispose firefighters to augmented immune responses and inflammation. This study examined the immune responses in 12 older Firefighters (FF) and 12 older Non-Firefighters (Non-FF), and a group of 6 young FF and 6 young Non-FF, following intermittent exercise in the heat. METHODS: The participants, matched for age, body surface area, body composition, and VO(2peak), cycled 4 × 15 min at moderate-to-high heat production (400 W), each followed by 15-min rest, in dry [10-20% relative humidity (RH)] and humid (60% RH) heat (35 °C). Rectal temperature (T(re)) and heart rate (HR) were measured continuously, and blood samples at baseline (PRE) and following 60-min recovery (POST) were analyzed for Interleukin (IL)-6, Tumor Necrosis Factor (TNF-α), C-reactive protein (CRP), platelet count (PLT), and mean platelet volume (MPV). RESULTS: No differences were observed for T(re), HR, TNF-α, CRP, or PLT between the FF and Non-FF in either condition. The Non-FF had greater changes in IL-6 (Warm/Dry = +1.10 ± 0.18, Warm/Humid = +2.94 ± 0.74 pg mL(-1)), compared to the FF (Warm/Dry = +0.67 ± 0.17, Warm/Humid = +0.70 ± 0.33 pg mL(-1)), and MPV at PRE/POST compared to the FF. Between the young and older FF and Non-FF, no differences in T(re), HR, PLT, or MPV were observed, however, elevated CRP (Warm/Dry) in the older FF, and IL-6 (Warm/Dry) and TNF-α (both conditions) in the older Non-FF, were observed. CONCLUSIONS: The elevated IL-6 in the Non-FF is potentially indicative of increased strain in the Non-FF and/or adaptive changes in the FF due to the occupational demands.

Moderate-intensity intermittent work in the heat results in similar low-level dehydration in young and older males.

Older individuals may be more susceptible to the negative thermal and cardiovascular consequences of dehydration during intermittent work in the heat. This study examined the hydration, thermal, and cardiovascular responses to intermittent exercise in the heat in 14 Young (Y, Mean ± SE; 25.8 ± 0.8 years), Middle-age (MA, 43.6 ± 0.9 years), and Older (O, 57.2 ± 1.5 years) healthy, non-heat acclimated males matched for height, mass, body surface area, and percent body fat. Rectal temperature (Tre), heart rate (HR), local sweat rate (LSR), and hydration indices were measured during 4 × 15-min moderate to heavy cycling bouts at 400 W heat production, each followed by a 15-min rest period, in Warm/Dry (35°C, 20% relative humidity [RH]) and Warm/Humid (35°C, 60% RH) heat. No differences were observed between the age groups for Tre, Tre change, HR, LSR, mass change, urine specific gravity, and plasma protein concentration in either condition, irrespective of the greater level of thermal and cardiovascular strain experienced in the Warm/Humid environment. Plasma volume changes (Dry Y: -5.4 ± 0.7, MA: -6.2 ± 0.9, O: -5.7 ± 0.9%, Humid Y: -7.3 ± 1.0, MA: -7.9 ± 0.8, O: -8.4 ± 1.0%) were similar between groups, as were urine specific gravity and plasma protein concentrations. Thus, physically active Young, Middle-age, and Older males demonstrate similar hydration, thermal, and cardiovascular responses during moderate- to high-intensity intermittent exercise in the heat.

Do older adults experience greater thermal strain during heat waves?

Heat waves are the cause of many preventable deaths around the world, especially among older adults and in countries with more temperate climates. In the present study, we examined the effects of age on whole-body heat loss and heat storage during passive exposure to environmental conditions representative of the upper temperature extremes experienced in Canada. Direct and indirect calorimetry measured whole-body evaporative heat loss and dry heat exchange, as well as the change in body heat content. Twelve younger (21 ± 3 years) and 12 older (65 ± 5 years) adults with similar body weight (younger: 72.0 ± 4.4 kg; older: 80.1 ± 4.2 kg) and body surface area (younger: 1.8 ± 0.1 m(2); older: 2.0 ± 0.1 m(2)) rested for 2 h in a hot-dry [36.5 °C, 20% relative humidity (RH)] or hot-humid (36.5 °C, 60% RH) environment. In both conditions, evaporative heat loss was not significantly different between groups (dry: p = 0.758; humid: p = 0.814). However, the rate of dry heat gain was significantly greater (by approx. 10 W) for older adults relative to younger adults during the hot-dry (p = 0.032) and hot-humid exposure (p = 0.019). Consequently, the cumulative change in body heat content after 2 h of rest was significantly greater in older adults in the hot-dry (older: 212 ± 25 kJ; younger: 131 ± 27 kJ, p = 0.018) as well as the hot-humid condition (older: 426 ± 37 kJ; younger: 317 ± 45 kJ, p = 0.037). These findings demonstrate that older individuals store more heat during short exposures to dry and humid heat, suggesting that they may experience increased levels of thermal strain in such conditions than people of younger age.

Are circulating cytokine responses to exercise in the heat augmented in older men?

Age-related chronic low-grade inflammation may render older individuals more susceptible to heat illnesses. The purpose of this study was to examine the influence of intermittent work in the heat on the circulating cytokine responses of older workers. Fourteen young (aged 25.6 ± 0.7 years) and older (aged 57.7 ± 1.5 years) males, matched for body surface area, cycled for 4 × 15 min (separated by 15-min rest) at moderate to heavy intensity (400 W heat production) in warm/dry (35 °C, 20% relative humidity (RH)) and warm/humid (35 °C, 60% RH) conditions. Rectal (Tre) and mean skin (MTsk) temperatures and heart rate were measured continuously, ratings of perceived exertion and thermal sensation recorded at the end of each exercise bout, and blood samples at baseline (PRE) and following the final 60-min recovery (POST) were analyzed for interleukin (IL)-6, tumor necrosis factor (TNF)-α, and percent changes in blood (BV) and plasma (PV) volumes. No differences were observed between the age groups for Tre, MTsk, heart rate, perceptual strain, or percentage of changes in BV, PV, or ΔTNF-α. Under both conditions, the older males had elevated IL-6 and TNF-α (PRE, POST) compared with the young males. ΔIL-6 tended to be greater in the warm/humid condition (+2.53 ± 0.49 and +1.52 ± 0.41 pg·mL(-1)) compared with the warm/dry condition (+1.02 ± 0.13 and +0.68 ± 0.18 pg·mL(-1)) for older but not young males, respectively. Young and older males experienced similar thermal, cardiovascular, and perceptual strain within the warm/dry and warm/humid conditions.

Age-related decrements in heat dissipation during physical activity occur as early as the age of 40.

Older adults typically experience greater levels of thermal strain during physical efforts in the heat compared to young individuals. While this may be related to an age-dependent reduction in whole-body sweating, no study has clearly delineated at what age this occurs. In the present study, we report direct measurements of human heat dissipation during physical activity in the heat in males ranging in age from 20-70 years. Eighty-five males performed four 15-min bouts of cycling separated by 15-min rest periods, in a calorimeter regulated to 35°C and 20% relative humidity. Direct calorimetry was used to measure total heat loss (whole-body evaporative heat loss and dry heat exchange). We also used indirect calorimetry as a continuous measure of metabolic heat production. Body heat storage was calculated as the temporal summation of heat production and total heat loss over the experimental session. Whole-body sweat rate (WBSR) was calculated from measurements of evaporative heat loss. Males were divided into five age categories for the analysis of WBSR and body heat storage: 20-31 years (n = 18), 40-44 years (n = 15), 45-49 years (n = 15), 50-55 years (n = 21) and 56-70 years (n = 16). Relative to young males, WBSR was reduced in males aged 56-70 during each exercise (all P<0.05), in males aged 50-55 during the second (P = 0.031) and third exercises (P = 0.028) and in males aged 45-49 during the final exercise bout (P = 0.046). Although not significantly different, 40-44 years old males also had a lower rate of heat loss compared to younger males. Over the sum of two hours, the change in body heat content was greater in males 40-70 years compared to young males (all P<0.05). Our findings suggest that middle-aged and older adults have impairments in heat dissipation when doing physical activity in the heat, thus possibly increasing their risk of heat-related illness under such conditions.

Do older firefighters show long-term adaptations to work in the heat?

Older experienced firefighters may show signs of heat adaptation, and thus reduced physiological strain, due to repeated occupational heat stress exposure. The aim was to examine physiological and perceptual strain, and hydration, responses to intermittent exercise in the heat in 12 older Non-Firefighter (Non-FF) and experienced Firefighter (FF) males, pair matched for age (Group mean ± SE: Non-FF = 51.7 ± 1.5, FF = 49.8 ± 1.1 years), VO(2peak) (Non-FF = 39.4 ± 2.2, FF = 40.7 ± 1.8 mL·kg(-1)·min(-1)), body surface area (Non-FF = 1.94 ± 0.04, FF = 2.03 ± 0.03 m(2)), and percent body fat (Non-FF = 24.4 ± 2.3, FF = 19.3 ± 1.8%). Rectal (Tre) and mean skin (MT(sk)) temperatures, heart rate (HR), local sweat rate (LSR), hydration indices, and ratings of thermal sensation and perceived exertion were measured during 4 ×15-min (rest 15-min) moderate-to-heavy cycling bouts (400 W heat production) in Dry and Humid heat (35°C, ∼20 and ∼60% relative humidity, respectively). No differences were observed between the Non-FF and FF for T(re), T(re) change, MT(sk), HR,% max HR, LSR, physiological strain index (PhSI), or % plasma volume change. Plasma protein concentration was reduced at baseline for the Non-FF (7.6 ± 0.1 g·100 mL(-1)) than FF (8.0 ± 0.1 g·100 mL(-1)). The Perceptual Strain Index overestimated PhSI for Non-FF and FF in both thermal conditions. At the end of exercise, the Non-FF showed a greater Tre difference between thermal conditions (0.27 ± 0.05°C) compared to the FF (0.10 ± 0.09°C). Although the Non-Firefighters and Firefighters demonstrate similar cardiovascular and hydration responses during moderate-to-heavy intensity exercise within each of the thermal conditions, the attenuated thermal effects between the two heat stress conditions in the Firefighters suggests a protective adaptation.

Does metformin modify the effect on glycaemic control of aerobic exercise, resistance exercise or both?

AIMS/HYPOTHESIS: Some previous studies suggested that metformin might attenuate the effects of exercise on glycaemia or fitness. We therefore examined whether metformin use influenced changes in glycaemic control, fitness, body weight or waist circumference resulting from aerobic and/or resistance training in people with type 2 diabetes participating in an exercise intervention trial. METHODS: After a 4 week run-in period, participants from the Diabetes Aerobic and Resistance Exercise (DARE) trial were randomly assigned to 22 weeks of aerobic training alone, resistance training alone, combined aerobic and resistance exercise training or a waiting-list control group. Of the 251 randomised, 143 participants reported using metformin throughout the entire study period and 82 reported not using metformin at all. RESULTS: Compared with control, aerobic training led to a significant reduction in HbA1c in the metformin users (-0.57%, 95% CI -1.05, -0.10; -6.3 mmol/mol, 95% CI -11.5, -1.1) but not in the non-metformin users (-0.17, 95% CI -0.78, 0.43; -1.9 mmol/mol, 95% CI -8.5, 4.7). However, there were no significant differences in the changes in HbA1c (or fasting glucose) between metformin users and non-users in any of the exercise groups compared with control (p> 0.32 for all metformin by group by time interactions). Similarly, metformin did not affect changes in indicators of aerobic fitness, strength and body weight or waist circumference (p ≥ 0.15 for all metformin by group by time interactions). CONCLUSIONS/INTERPRETATION: Contrary to our hypothesis and to previous short-term studies, metformin did not significantly attenuate the benefits of exercise on glycaemic control or fitness.

Whole body heat loss is reduced in older males during short bouts of intermittent exercise.

Studies in young adults show that a greater proportion of heat is gained shortly following the start of exercise and that temporal changes in whole body heat loss during intermittent exercise have a pronounced effect on body heat storage. The consequences of short-duration intermittent exercise on heat storage with aging are unclear. We compared evaporative heat loss (HE) and changes in body heat content (ΔHb) between young (20-30 yr), middle-aged (40-45 yr), and older males (60-70 yr) of similar body mass and surface area, during successive exercise (4 × 15 min) and recovery periods (4 × 15 min) at a fixed rate of heat production (400 W) and under fixed environmental conditions (35 °C/20% relative humidity). HE was lower in older males vs. young males during each exercise (Ex1: 283 ± 10 vs. 332 ± 11 kJ, Ex2: 334 ± 10 vs. 379 ± 5 kJ, Ex3: 347 ± 11 vs. 392 ± 5 kJ, and Ex4: 347 ± 10 vs. 387 ± 5 kJ, all P < 0.02), whereas HE in middle-aged males was intermediate to that measured in young and older adults (Ex1: 314 ± 13, Ex2: 355 ± 13, Ex3: 371 ± 13, and Ex4: 365 ± 8 kJ). HE was not significantly different between groups during the recovery periods. The net effect over 2 h was a greater ΔHb in older (267 ± 33 kJ; P = 0.016) and middle-aged adults (245 ± 16 kJ; P = 0.073) relative to younger counterparts (164 ± 20 kJ). As a result of a reduced capacity to dissipate heat during exercise, which was not compensated by a sufficiently greater rate of heat loss during recovery, both older and middle-aged males had a progressively greater rate of heat storage compared with young males over 2 h of intermittent exercise.

The effect of walking on cardiorespiratory fitness in adults with knee osteoarthritis.

Walking programs alone or in combination with behavioral interventions have proven effective at improving quality of life among older adults with osteoarthritis (OA). It is unclear, however, whether the combination of both of these treatments is more effective at improving cardiorespiratory fitness in older adults with knee OA than a walking program alone or than unsupervised self-directed walking. In this study, we assessed cardiorespiratory fitness with 3 programs: a structured supervised community-based aerobic walking program with a behavioral intervention (WB; n = 41); a supervised program of walking only (W; n = 42); and an unsupervised self-directed walking program (n = 32). We measured maximal oxygen uptake (V̇O2peak), exercise test duration, and workload, heart rate, and ventilation at maximum aerobic capacity in older adults with knee OA after 6 months of WB, W, or self-directed walking. Overall, V̇O2peak improved by 4% in female walkers (+0.9 ± 2.5 mL O2·kg(-1)·min(-1); p < 0.001) and 5% in male walkers (+1.3 ± 2.7 mL O2·kg(-1)·min(-1); p < 0.001), and the change in fitness was similar with all 3 walking interventions. In conclusion, low- to moderate-intensity walking may improve and (or) prevent decrements in cardiorespiratory fitness in older adults with OA. This response was comparable in supervised walkers with and without a behavioral intervention and in unsupervised self-directed walkers.

Do older females store more heat than younger females during exercise in the heat?

INTRODUCTION: Aging is associated with a reduction in the body's capacity to dissipate heat. To date, few studies have examined age-related changes in thermoregulatory function during short exercise periods in the heat in older females. PURPOSE: This study aimed to investigate the effects of age on whole-body heat loss during intermittent exercise in the heat in young and older females. METHODS: Direct and indirect calorimetry was used to measure whole-body evaporative heat loss (EHL), change in body heat content, and metabolic heat production. Eleven young (Y) (mean ± SD age = 24 ± 4 yr) and 13 older (O) (51 ± 8 yr) females matched for body surface area (Y, 1.72 ± 0.15; O, 1.75 ± 0.12 m²) and fitness (V(˙)O(2max)) (Y, 36.7 ± 6.8 mL O2·kg⁻¹·min⁻¹; O, 33.8 ± 8.0 mL O2·kg⁻¹·min⁻¹) performed four bouts of 15-min cycling (Ex1, Ex2, Ex3, and Ex4) at a constant rate of heat production (300 W) at 35°C and 20% relative humidity. Each exercise bout was separated by 15 min of rest. RESULTS: EHL was reduced in O compared with Y during Ex1 (O, 199 ± 6 W; Y, 240 ± 9 W; P = 0.001), Ex2 (O, 238 ± 4 W; Y, 261 ± 9 W, P = 0.023), and Ex3 (O, 249 ± 4 W; Y, 274 ± 11 W; P = 0.040). EHL was not different between groups during Ex4 or during the recovery periods. Older females had a greater change in body heat content compared with young females (O, 270 ± 20 kJ; Y, 166 ± 20 kJ; P = 0.001). CONCLUSION: These findings suggest that older females have a lower capacity for whole-body EHL compared with younger females during short intermittent exercise in the heat performed at a fixed rate of metabolic heat production.

Effect of exercise training on physical fitness in type II diabetes mellitus.

UNLABELLED: Few studies have compared changes in cardiorespiratory fitness between aerobic training only or in combination with resistance training. In addition, no study to date has compared strength gains between resistance training and combined exercise training in type II diabetes mellitus (T2DM). PURPOSE: We evaluated the effects of aerobic exercise training (A group), resistance exercise training (R group), combined aerobic and resistance training (A + R group), and sedentary lifestyle (C group) on cardiorespiratory fitness and muscular strength in individuals with T2DM. METHODS: Two hundred and fifty-one participants in the Diabetes Aerobic and Resistance Exercise trial were randomly allocated to A, R, A + R, or C. Peak oxygen consumption (V O(2peak)), workload, and treadmill time were determined after maximal exercise testing at 0 and 6 months. Muscular strength was measured as the eight-repetition maximum on the leg press, bench press, and seated row. Responses were compared between younger (aged 39-54 yr) and older (aged 55-70 yr) adults and between sexes. RESULTS: VO(2peak) improved by 1.73 and 1.93 mL O(2)*kg(-1)*min(-1) with A and A + R, respectively, compared with C (P < 0.05). Strength improvements were significant after A + R and R on the leg press (A + R: 48%, R: 65%), bench press (A + R: 38%, R: 57%), and seated row (A + R: 33%, R: 41%; P < 0.05). There was no main effect of age or sex on training performance outcomes. There was, however, a tendency for older participants to increase VO(2peak) more with A + R (+1.5 mL O(2)*kg(-1)*min(-1)) than with A only (+0.7 mL O(2)*kg(-1)*min(-1)). CONCLUSIONS: Combined training did not provide additional benefits nor did it mitigate improvements in fitness in younger subjects compared with aerobic and resistance training alone. In older subjects, there was a trend to greater aerobic fitness gains with A + R versus A alone.