Effect of aerobic training versus resistance training for improving cardiorespiratory fitness and body composition in middle-aged to older adults: A systematic review and meta-analysis of randomized controlled trials.

This systematic review and meta-analysis aimed to examine the influence of aerobic training (AT) versus resistance training (RT) on cardiorespiratory fitness and body composition in middle-aged to older adults. Four electronic databases including PubMed, Scopus, Cochrane CENTRAL, and web of science, as well as reference lists of included randomized controlled trials (RCTs) were searched from inception to April 2024. Data were pooled by the inverse-variance method and reported as mean differences (MDs) with 95 % confidence intervals (CIs). Thirty-eight RCTs, with a pooled sample of 1682 participants, met our inclusion criteria. Meta-analysis revealed that AT significantly improved VO2max/peak (MD = 1.80, 95 % CI: 0.96 to 2.64, p < 0.0001) and 6-MWT (MD = 18.58, 95 % CI: 10.38 to 26.78, p < 0.00001), and significantly decreased body mass (MD = -1.23, 95 % CI: -1.98 to -0.47, p = 0.001) versus RT. However, changes in lean body mass favored RT over AT. Moreover, changes in VO2max/peak and 6-MWT following AT were significant among both healthy and unhealthy participants, or men and women, after medium-term (< 24 weeks) and long-term (≥ 24 weeks) interventions, and among participants aged ≤65 and >65. Our results propose that AT should be considered an efficient approach to improving cardiorespiratory fitness and overall body composition with aging, particularly in terms of VO2max and 6-MWT performance. However, for improvements in lean body mass, RT may be more beneficial. Therefore, a combination of AT and RT might be optimal for comprehensive fitness and body composition improvements with aging.

Association between serum uric acid and cardiovascular fitness among US adults: A cross-sectional study.

Background: While serum uric acid (SUA) is known as a cardiovascular disease risk factor and is associated with increased cardiovascular mortality, the relationship between SUA and cardiovascular adaptability under exercise stress remains unclear. Aims: This study aims to elucidate the relationship between SUA levels and cardiovascular fitness, particularly as manifested during cardiopulmonary exercise testing. Methods: Utilizing data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004, this study included 5765 participants aged 12-49 years. Heart rate recovery (HRR) during cardiopulmonary exercise testing was measured as an indicator of cardiovascular fitness. Multivariate linear regression analysis was used to explore the association between SUA levels and heart rate recovery at 1 min (HRR1) and 2 min (HRR2) post-exercise. Results: After adjusting for potential confounders, an inverse relationship was found between SUA levels and both HRR1 and HRR2. Multivariate adjusted smoothing spline plots demonstrated a decrease in HRR1 and HRR2 with increasing SUA levels. This negative correlation was observed across nearly all subgroups. Conclusions: Elevated SUA levels are indicative of poorer cardiovascular adaptability in the adult US population.

Interactive Relations of Body Mass Index, Cardiorespiratory Fitness, and Sex to Cognitive Function in Older Adults.

OBJECTIVE: The course of cognitive aging is influenced by multiple health factors. This cross-sectional study investigated the interactive relations between body mass index (BMI), maximum oxygen consumption (VO2max), and sex on neuropsychological outcomes in community-dwelling predominantly older adults. METHODS: Participants were 164 healthy adults [M (SD) = 64.6 (12.5) years, 56% men, 87% white] who participated in an investigation of cardiovascular risk factors and brain health. Multivariable regression analysis, adjusted for age, education, ethnicity, smoking, alcohol consumption, and depression, examined the interactive relations of BMI, VO2max, and sex to multiple neuropsychological outcomes. RESULTS: Significant BMI*VO2max*sex interactions for Grooved Pegboard dominant (p = .019) and nondominant (p = .005) hands revealed that men with lower VO2max (l/min) displayed worse performance with each hand as BMI increased (p's < .02). A significant BMI*sex interaction for Logical Memory-Delayed Recall (p = .036) (after adjustment for blood glucose) showed that men, but not women, with higher BMI demonstrated worse performance (p = .036). Lastly, significant main effects indicated that lower VO2max was related to poorer logical memory, and higher BMI was associated with poorer Trail Making B and Stroop interference scores (p's < .05). CONCLUSIONS: Among men, higher cardiorespiratory fitness may protect against the negative impact of greater BMI on manual dexterity and motor speed, making VO2max a target for intervention. Higher BMI is further associated with poorer executive function and verbal memory (in men), and lower VO2max is associated with poorer verbal memory.

Development of Field Tests for Cardiovascular Fitness Assessment in Wheelchair.

It is essential to consider both physique and physical fitness factors to minimize the risk of injuries and optimize athletic performance among elite athletes. Athletes with disabilities face limitations in fitness assessments compared to their healthy counterparts. The aim of this study was to revalidate established cardiovascular fitness assessment methods and develop field tests for wheelchair athletes. As representatives registered at the Korea Paralympic Committee's Athletes Training Center in Icheon, athletes with physical disabilities participating in para ice hockey (n = 14), who were capable of wheelchair control, were volunteered. Prior to cardiovascular fitness assessments using an ergometer and a shuttle run, demographic characteristics were surveyed, and physical measurements and muscle strength (grip strength) were recorded. All the participants performed one ergometer test based on cardiovascular fitness criteria, and for shuttle run validation, two trials were conducted using existing audio cues (National Physical Fitness 100, 20 m shuttle run). For the development of the shuttle run, considering wheelchair turning, signal-to-sound intervals were increased by 1 s and 1.5 s, respectively, in two trials. An analysis of the correlation with the maximal oxygen consumption (VO2max) in comparison to the reference criterion, an ergometer, demonstrated high correlations in the first trial (r = 0.738) and the second trial (r = 0.780). Similarly, significant correlations were observed with the maximum heart rate (HRmax) in the first trial (r = 0.689) and the second trial (r = 0.896). Thus, the 15 m shuttle run is validated as a field test for assessing cardiovascular fitness in athletes with disabilities. Correlation analysis with maximal oxygen uptake (VO2max) compared to the reference criterion, an ergometer, revealed a correlation of 0.815 with a 1 s interval audio cue and 0.355 with a 1.5 s interval audio cue. A high correlation was observed with the 1 s interval audio cue. Regarding the maximum heart rate (HRmax), the correlations were 0.665 with a 1 s interval audio cue. Once again, a high correlation was noted with the 1 s interval audio cue. The field test selected for measuring cardiovascular fitness in wheelchair athletes involved performing a 15 m shuttle run while in the wheelchair. The test utilized an audio cue with a 1 s increased interval between the signal sounds.

Cardiorespiratory fitness is associated with cognitive performance in 80 + -year-olds: Detangling processing levels.

Cardiorespiratory fitness is known to protect against cognitive decline in older adults. Specifically, it has been shown that physical activity and fitness are beneficial for executive functions that are crucial for independent living up to old age. In this study, 115 individuals aged 80 years and older underwent a cardiorespiratory fitness assessment using the two-minute step test and had their electroencephalogram recorded during a colored flanker task in order to measure executive function performance. Cardiorespiratory fitness was related to quicker responses during the flanker task. A mediation analysis was carried out to determine whether these positive effects were mediated through event-related potentials (N1, N2, or P3) or motor-related cortical potentials (MRCP). Cardiorespiratory fitness was related to better visual discriminative processing as indicated by larger occipital N1 amplitudes. In addition, fitness was associated with larger MRCP amplitudes, which are a correlate of the response generation process. Fitness was not found to have a significant effect on fronto-central N2 or parietal P3, which are thought to capture cognitive control processes such as conflict detection and response inhibition. Moreover, all effects reported were present in all three flanker trial conditions (congruent, neutral, and incongruent). Thus, these results indicate that the quicker response times in fitter people were related to visual processing and motor response generation rather than cognitive control.

Association between the triglyceride-glucose index and impaired cardiovascular fitness in non-diabetic young population.

BACKGROUND: The triglyceride-glucose (TyG) index has been linked to the onset, progression, and prognosis of cardiovascular disease (CVD) in middle-aged and elderly individuals. Nevertheless, the relationship between the TyG index and impaired cardiovascular fitness (CVF) remains unexplored in non-diabetic young population. METHODS: We used data from the National Health and Nutrition Examination Survey (NHANES) study (1999-2004) to conduct a cross-sectional study of 3364 participants who completed an examination of CVF. Impaired CVF was defined as low and moderate CVF levels determined by estimated maximal oxygen consumption (Vo2max), based on sex- and age-specific criteria. The TyG index was calculated by [Formula: see text]. RESULTS: The age (median with interquartile range) of the study population was 28 (19-37) years, and the TyG index (median ± standard deviation) was 8.36 ± 0.52. A significant association between the TyG index and impaired CVF was found in multivariable logistical regression analysis (per 1-unit increase in the TyG index: OR, 1.46; 95% Cl 1.13-1.90). A dose‒response relationship between the TyG index and impaired CVF was presented by restricted cubic splines (RCS). A significant interaction (p = 0.027) between sex and the TyG index for impaired CVF was found in the population aged < 20 years. CONCLUSIONS: In non-diabetic young population, individuals with higher TyG index values are at an increased likelihood of encountering impaired CVF. Furthermore, sex may exert an impact on CVF, as males tend to be more susceptible to impaired CVF under comparable TyG index conditions.

The influence of control beliefs on the cardiovascular fitness of college students: the chain mediating effect of subjective exercise experience and exercise adherence.

PURPOSE: Lack of adequate physical exercise is the main reason for the frequent occurrence of health problems among Chinese college students. The purpose of this study is to explore the effects of control beliefs on cardiovascular fitness among college students and the mediating role of subjective exercise experience and exercise adherence in it. METHODS: The Control Belief Scale, the Subjective Exercise Experience Scale (SEES), and the Exercise Adherence Scale were used to investigate 1854 freshmen and sophomores in Nantong and Suzhou, China. Cardiovascular fitness data for college students from the National Student Physical Health Standard and SPSS 23.0 statistical analysis software were used to carry out statistics and analyses on the questionnaires. Correlation analysis, regression analysis, and mediation models were used to assess control beliefs, subjective exercise experiences, exercise adherence, and cardiovascular fitness. RESULTS: The control belief of college students was directly related to cardiovascular fitness (effect value: 0.121), the mediating effect through subjective exercise experience was not significant, indirectly related through the mediating effect of exercise adherence (effect value: 0.101), and indirectly related through the mediating effect of subjective exercise experience and exercise adherence (effect value: 0. 019). The positive prediction effect of control belief on cardiovascular fitness of college students was significant (ß = 0.267, P < 0.001), and the positive prediction effect of control belief on cardiovascular fitness of college students was still significant (ß = 0.121, P < 0.01) after adding the intermediary variables (subjective exercise experience and exercise adherence). CONCLUSIONS: The cardiovascular fitness of college students was not only directly affected by control beliefs but also affected by the chain mediating effect of subjective exercise experience and exercise adherence. Therefore, it is necessary to improve the control beliefs, subjective exercise experiences, and exercise adherence of college students to improve their cardiovascular fitness level and enhance their physical health.

Effect of Motor Competence and Health-Related Fitness in the Prevention of Metabolic Syndrome Risk Factors.

Purpose: In the last decades we have seen an increase in sedentary behaviors and a decrease in physical activity in children when compared to past generations. This lifestyle is commonly associated with the development of clustering risk factors that define metabolic syndrome (MetS). Knowing that motor competence (MC) development can influence lifelong physical activity habits, it is reasonable to assume that children's MC will directly link to clustered cardiometabolic health outcomes. The aim of this study was to analyze the role of MC in MetS risk factors. Methods: Seventy children with a mean age of 7.49 (SD = 1.28) years were evaluated on motor competence (MCA-Motor Competence Assessment instrument), cardiovascular fitness (PACER test), upper body strength (UBS; handgrip), and the components of MetS, hypertriglyceridemia, hypertension, abdominal obesity, low concentration of high-density lipoprotein cholesterol, and high fasting blood glucose. The composite value of MetS was calculated according to Burns et al. (2017). Multiple standard regressions were performed to explore the effect of different variables on MetS. Motor competence and health-related fitness (cardiovascular fitness and relative upper body strength) were used as independent variables (predictors) and MetS as dependent variable. Results: Overall, the results showed that motor competence (ß = -.072; p < .05) is a significant predictor and this model explained 7,1% of the variance in MetS. Conclusion: Although more studies are needed, our results indicate that MC seems to have a positive role in children's health markers.

This study aimed to analyze the role of MC, cardiorespiratory fitness, and upper body strength in MetS risk factors.The results suggest that upper body strength is the strongest predictor for MetS (negative association), followed by MC (positive association).When the different MC components were entered independently instead of total MC, the upper body strength and locomotor MC were found to be significant predictors of the MetS behavior.Considering our results and the fact that MC levels during childhood positively influence PA levels along lifespan, this study suggests a pathway to follow in future research.

Accelerometer-measured absolute versus relative physical activity intensity: cross-sectional associations with cardiometabolic health in midlife.

BACKGROUND: Observational studies investigating the association between accelerometer-measured physical activity and health all use absolute measures of physical activity intensity. However, intervention studies suggest that the physical activity intensity required to improve health is relative to individual fitness. The aim of this study was to investigate the associations between accelerometer-measured absolute and relative physical activity intensity and cardiometabolic health, and what implications these associations may have on the interpretation of health-associated physical activity. METHODS: A sample of the cross-sectional Swedish CArdioPulmonary bioImage Study (SCAPIS) consisting of 4,234 men and women aged 55-64 years was studied. Physical activity intensity was measured by accelerometry and expressed as absolute (e.g., metabolic equivalents of task) or relative (percentage of maximal oxygen consumption). Fitness was estimated by the submaximal Ekblom-Bak test. A composite ('metabolic syndrome') score combined measures of waist circumference, systolic blood pressure, high-density lipoprotein, triglycerides, and glycated hemoglobin. Associations of absolute and relative physical activity intensity with the health indicators (i.e., fitness and metabolic syndrome score) were studied by partial least squares regression. Analyses were stratified by fitness level. RESULTS: Both absolute and relative physical activity intensity associated with the health indicators. However, the strongest associations for absolute intensity varied depending on fitness levels, whereas the associations for relative intensity were more synchronized across fitness groups. The dose-response relationship between moderate-to-vigorous intensity and the health indicators was stronger for relative than for absolute intensity. The absolute and relative moderate-to-vigorous intensity cut-offs intersected at the 5th fitness percentile, indicating that the absolute intensity cut-off is too low for 95% of individuals in this sample. While 99% of individuals fulfilled the general physical activity recommendations based on absolute intensity measures, only 21% fulfilled the recommendations based on relative intensity measures. In relation to a "sufficient" fitness level, 9% fulfilled the recommendations. CONCLUSIONS: Accelerometer-measured relative physical activity intensity represents the intensity related to health benefits regardless of fitness level. Traditional absolute moderate intensity accelerometer cut-offs are too low for most individuals and should be adapted to the fitness level in the sample studied. Absolute and relative physical activity intensity cannot be used interchangeably.

Enhancing Cardiovascular Health and Functional Recovery in Stroke Survivors: A Randomized Controlled Trial of Stroke-Specific and Cardiac Rehabilitation Protocols for Optimized Rehabilitation.

BACKGROUND: Stroke is a major contributor to disability and mortality globally. It leads to physical impairments, including weakness and cardiovascular deconditioning, posing significant challenges to stroke survivors' quality of life. Exercise-based cardiac rehabilitation has shown promise as a rehabilitation strategy. This study aims to assess and compare the impacts of stroke-specific rehabilitation and individualized cardiac rehabilitation exercises on various health parameters in stroke patients. METHODS: A randomized controlled trial was conducted, involving 38 stroke patients aged 40-75 years. Group A received stroke-specific rehabilitation, which consisted of a combination of range of motion exercises, strength training for the paralyzed side, balance and coordination training, gait training, functional mobility exercises, neuromuscular reeducation, and breathing exercises. This program was conducted five days per week for 12 weeks. Group B received individually designed cardiac rehabilitation exercises, in addition to stroke-specific rehabilitation. They engaged in this exercise for at least 30-45 min per day, four days per week, and incorporated two days of resistive training over a 12-week period. Baseline and post-intervention assessments included measures of cardiac autonomic function, balance (Berg Balance Scale), mobility (Timed Up and Go Test), cardiovascular fitness indicators, respiratory parameters, exercise efficiency, and perceived exertion. RESULTS: Group B receiving individualized cardio rehab showed significant improvements in balance and mobility compared to Group A receiving conventional stroke-specific rehab. Moreover, Group B exhibited enhanced cardiovascular fitness, respiratory performance, exercise efficiency, and autonomic function post-intervention. Notably, Group A displayed no significant improvements in these parameters. CONCLUSIONS: Individualized cardiac rehabilitation exercises demonstrated favorable outcomes in improving certain health parameters, highlighting the potential benefits of individualized rehabilitation strategies for stroke patients.

Changes in physical function and physical activity in patients up to 5 years after bariatric surgery.

BACKGROUND: Bariatric surgery is effective for patients with severe obesity, but relatively little is known about long-term functional outcomes. OBJECTIVE: To describe physical fitness and activity changes among bariatric surgery patients in a clinical trial of physical activity interventions through 5 years postoperatively. SETTING: Large bariatric center in the midwestern United States. METHODS: Preoperatively, 6 months, and 5 years after surgery, 42 bariatric surgery patients wore an accelerometer to track activity and completed strength and cardiovascular endurance testing via treadmill, where estimated metabolic equivalents (METs) and ratings of perceived exertion (RPEs) were obtained. RESULTS: Preoperatively, 25% of patients reported exertion of <3 METs (equivalent to walking 2.5 mi/hr) as an RPE of 16 ("hard to very hard"). This decreased significantly to approximately 5% of patients 6 months and 5 years after surgery. Before surgery, 7.5% achieved ≥6 METs (vigorous activity) at an RPE of 16. This increased significantly to 36.6% at 6 months and 42.1% at 5 years after surgery. Body mass index and age, but no physical activity measure, predicted functional ability over time. The steps/d and exercise bout min/wk increased significantly from before surgery to 6 months postoperatively (4886.5 to 5948.5 steps and 23.8 to 66.6 bout min), but increases were not maintained at 5 years (5677.7 steps and 41.4 bout min). Conversely, moderate to vigorous min/ d increased progressively from before surgery (17.4) to 6 months (32.3) and 5 years (48.1) postoperatively. CONCLUSIONS: Functional abilities of bariatric surgery patients increased postoperatively and were maintained over 5 years. However, treadmill testing suggests that most patients are still unable to perform sustained activities of 6 METs (vigorous) or greater. Research is needed on bariatric patients' long-term function- and intervention- optimizing outcomes.

Recreational 3 × 3 basketball elicits higher heart rate, enjoyment, and physical activity intensities but lower blood lactate and perceived exertion compared to HIIT in active young adults.

This study aimed to assess and compare the physiological [percentage of maximal heart rate (%HRmax), blood lactate (BLa), creatine kinase (CK)], hormonal (testosterone, cortisol), psychological [rating of perceived exertion (RPE), enjoyment] and physical [percentage of moderate-to-vigorous physical activity (%MVPA) and vigorous activity (%VA)] responses of recreational 3 × 3 basketball (3 × 3BB) and high-intensity interval training (HIIT) in active young adults. Twelve apparently healthy male recreational basketball players (age: 23 ± 3 years; body mass: 82 ± 15 kg; stature: 188 ± 15 cm) completed a 3 × 3BB match and HIIT with similar duration. %HRmax, %MVPA and %VA were monitored during the protocols, while BLa, cortisol, and testosterone were measured before and after each protocol. CK was measured before the protocols and at 24 h, while RPE and enjoyment were assessed at the end of each protocol. 3 × 3BB elicited higher %HRmax (p < 0.001; d = -1.6, large), %MVPA (p < 0.001; d = 2.7, very large), %VA (p = 0.030; d = 0.8, moderate), enjoyment (p = 0.014; r-value = -0.500, large), and lower RPE (p = 0.024; r-value = -0.462, moderate) compared to the HIIT condition. Moreover, higher values of BLa were found in HIIT compared to 3 × 3BB at post-condition (p = 0.020; r-value = -0.601, large), while CK analysis showed only an increase within the HIIT condition (p = 0.020; r-value = -0.599, large). A time effect was found for both testosterone (p < 0.001, η2p = 0.526, moderate) and cortisol (p = 0.005, η2p = 0.743, strong), while no between-condition effect or interaction was found (p > 0.05). 3 × 3BB elicits higher %HRmax, enjoyment, and physical activity intensities but lower BLa and RPE compared to HIIT in active young adults and might be considered as a potentially suitable activity to increase participants' health status.

Contributions from incumbent police officer's physical activity and body composition to occupational assessment performance.

Introduction: Police officers must perform various tasks in unpredictable work environments and potentially volatile situations. This study aimed to determine if cardiovascular fitness, body composition, and physical activity levels could predict performance in a Midwest Police Department's Physical Readiness Assessment (PRA). Methods: Researchers collected data from thirty incumbent police officers (33.9 ± 8.3 years, female = 5). Anthropometric data included height, body mass, body fat percentage (BF%), fat-free mass (FFM), and maximal hand grip strength. The police officers also completed a physical activity rating (PA-R) scale to estimate maximal oxygen consumption (V˙O2max) and the International Physical Activity Questionnaire (IPAQ). Police officers then conducted their department's PRA. Stepwise linear regression analyses were used to determine the relationship between predictor variables and PRA performance. Pearson's product-moment correlations investigated relationships between anthropometric, physical fitness, and physical activity variables and PRA performance using SPSS (v.28). The significance level was set at p < 0.05. Results: Descriptive data for the sample includes BF%: 27.85 ± 7.57%, FFM: 65.73 ± 10.72 kg, hand grip strength: 55.51 ± 11.07 kg, weekday sedentary time (WST): 328 ± 28.26 min, weekend day sedentary time (WDST): 310 ± 28.92 min, daily moderate-to-vigorous physical activity (MVPA): 29.02 ± 39.41 min, PRA: 273.6 ± 51.4 s and estimated V˙O2max: 43.26 ± 6.35 mL kg-1 min-1. The stepwise regression analyses indicated that BF% was predictive of PRA time (R2 = 0.32, p < 0.01); estimated V˙O2max predictive of PRA time (R2 = 0.45, p < 0.001). There were significant correlations between BF % and PRA time (r = 0.57, p < 0.001), PA-R and MVPA (r = 0.71, p < 0.001), %BF % and WDST (r = -0.606, p < 0.001), hand grip and FFM (r = 0.602, p < 0.001) and PA-R and PRA time (r = -0.36, p < 0.05). Discussion: The results of this exploratory study highlight that higher estimated V˙O2max and lower BF% were the best predictors for faster PRA completion times, accounting for 45% and 32% of the variance, respectively. The findings of this study support the need for wellness and fitness initiatives in law enforcement agencies focused on increasing cardiovascular fitness and physical activity while decreasing BF% to ensure optimal performance in policing and overall health.

Feasibility of Virtually Delivering Functional Fitness Assessments and a Fitness Training Program in Community-Dwelling Older Adults.

The COVID-19 pandemic limited older adults' access to preventative and diagnostic services and negatively affected accessibility to age-appropriate exercise programs. The purpose of this study was to assess the feasibility of conducting guided virtual functional fitness assessments before and after participation in an 8-week virtual, live fitness program (Vivo) designed for older adults. It was hypothesized there would be no significant difference between in-person and virtual functional fitness assessments and function would improve following the program. Thirteen community-dwelling older adults were recruited, screened, and randomly assigned to in-person-first or virtual-first fitness assessment groups. Validated assessments were delivered using standardized scripts by trained researchers and included Short Physical Performance Battery (SPPB) balance, a 30 s Chair Stand Test, 8 Foot Up-and-Go Test, 30 s Arm Curl Test, and 2 min Step Test. The eight-week, twice-a-week live virtual fitness program involved cardiovascular, balance, agility, Dual-Task, and strength training. Results showed no significant differences between all but one assessment measures, and several measures improved following the eight-week program. Fidelity checks demonstrated the high fidelity of program delivery. These findings illustrate that virtual assessments can be a feasible method to measure functional fitness in community-dwelling older adults.

Exercise Prescription for the Work-Life Population and Beyond.

The background for this paper concerns a high frequency of work-related disorders that may result from physical exposure at work being highly sedentary, repetitive-monotonous, or physically demanding. This may result in levels of physical inactivity or strenuous activity impairing health. The aim is to present an evidence-based exercise prescription for the work-life population and beyond. The exercise program is designed to be feasible for use at the workplace and/or during leisure time and to improve health, workability, productivity, sickness absence, etc. The specific concept of Intelligent Physical Exercise Training, IPET, includes the assessment of several health-related variables, including musculoskeletal disorders, physical capacity, and physical exposure at work and/or daily life activity. An algorithm with cut-points for prescribing specific exercises is provided. Exercise programs in praxis are addressed through descriptions of precise executions of various prescribed exercises and possible alternatives to optimize variation and adherence. Finally, perspectives on the significance of introducing IPET and the ongoing, as well as future lines of development, are discussed.

Economic burden of low cardiorespiratory fitness in Canada.

The objective of this study was to estimate health care and health-related productivity costs associated with low cardiorespiratory fitness (CRF) in Canadian adults. We also estimated costs that would be avoided by a 10 percentage point prevalence reduction in low CRF. A prevalence-based approach was used to estimate the economic costs associated with low CRF. Three pieces of information were used: (1) the pooled relative risk estimates of adverse health outcomes consistently associated with low CRF obtained from meta-analyses of prospective cohort studies; (2) the prevalence of low CRF in Canadian men and women obtained from a nationally representative sample; and (3) the direct (health care) and indirect (lost productivity due to premature mortality) costs of the adverse health outcomes based on the Economic Burden of Illness in Canada data. We estimated the total annual economic burden of low CRF in Canadian adults at CAD$3.6 billion, representing 2.7% of the overall Canadian burden of illness costs in 2021. The three most expensive chronic diseases attributable to low CRF were type 2 diabetes (CAD$1.3 billion), heart disease (CAD$701 million), and depression/anxiety (CAD$565 million). Prescription drug expenditures and hospital care expenditures were the main contributors to the total economic burden. An absolute 10% reduction in the prevalence of low CRF (from 45.5% to 35.5%) would save an estimated CAD$644 million per year in costs. In conclusion, low CRF is an important contributor to the economic burden of illness in Canada. Evidence-based and cost-effective strategies that aim to increase CRF at the population level may help alleviate health care costs and improve health.

Cardiorespiratory fitness, regular physical activity, and autonomic nervous system reactivity to laboratory and daily life stress.

The cross-stressor adaptation hypothesis-which posits that adjustment to physical stress as a result of regular physical activity and its effects on fitness crosses over to psychological stress reactivity-has been around for over four decades. However, the literature has been plagued by heterogeneities preventing definitive conclusions. We address these heterogeneity issues in a combined laboratory and daily life study of 116 young adults (M = 22.48 SD = 3.56, 57.76% female). The exposure, i.e., the potential driver of adaptation, was defined in three ways. First, a submaximal test was performed to obtain aerobic fitness measured as the VO2 max (kg/ml/min). Second, leisure time exercise behavior, and third, overall moderate-to-vigorous physical activity (MVPA), were obtained from a structured interview. Outcomes were autonomic nervous system (ANS) reactivity and affective responsiveness to stressors. ANS activity was measured continuously and expressed as inter-beat-interval (IBI), pre-ejection-period (PEP), respiratory sinus arrythmia (RSA), and non-specific Skin Conductance Responses (ns.SCR). Negative and positive affect were recorded after each experimental condition in the laboratory and hourly in daily life with a nine-item digital questionnaire. Linear regressions were performed between the three exposure measures as predictors and the various laboratory and daily life stress measurements as outcomes. Our results support the resting heart rate reducing effect of aerobic fitness and total MVPA in both the laboratory and daily life. We did not find evidence for the cross-stressor adaptation hypothesis, irrespective of ANS or affective outcome measure or whether the exposure was defined as exercise/MVPA or aerobic fitness.

Body Composition and Physical Fitness in Madeira Youth.

BACKGROUND: Research on composition and physical fitness is lacking in school-aged children from Madeira. This study aimed to examine the frequencies of overweight and obese participants and, in addition, to compare the fitness levels of Madeira youth with reference data. METHODS: The sample comprised 521 participants (n = 258 boys; n = 263 girls) aged 10.0-18.9 years old. METHODS: Height and weight were measured. Body mass index (BMI) was calculated, and percent fat was derived from skinfolds. Tests detailed on FITESCOLA battery were performed. BMI was plotted against U.S. reference data and physical assessment contrasted with the cut-off points of FITESCOLA protocol and corresponding data developed in Portuguese youth. RESULTS: The percentages of overweight and obesity were 15% (overweight) and 14% (obesity) for boys and 16% (overweight) and 6% (obesity) for girls. The median values of fat mass percentage were closely related to the cut-off standards; however, substantial variation was noted. Boys and girls tended to be below the recommendations of cardiorespiratory fitness. CONCLUSIONS: Sport participation should be promoted in Madeira to attain acceptable values of body composition and physical fitness levels.

Are adolescents' physical activity and body-related factors associated with medically attended injuries?

Background: Injuries are the major cause of disability and death during adolescence, representing a significant public health burden among youth. Body-related factors such as body composition and cardiovascular fitness (CVF) may affect adolescents' vulnerability to injuries. As evidence is lacking, we aimed to explore the associations of medically attended injuries with adolescents' physical activity (PA) and body-related factors, and whether these associations are modified by age, gender and family affluence. Methods: We used data on 888 11- to 15-year-old adolescents (mean age = 13.5, 56% boys) from the Health Behaviour in School-aged Children study conducted in 2018 in Slovakia. We used binary logistic regression analysis to assess the association of medically attended injuries with adolescents' PA and body-related factors (body composition, CVF), considering age, gender and family affluence. Results: Adolescents were more likely to report medically attended injuries if they were physically very active (odds ratio/confidence interval OR/CI:2.76/1.83-4.15) or active (OR/CI:1.91/1.27-2.87) rather than inactive. Body-related factors were not associated with medically attended injuries among adolescents. Moreover, age, gender and family affluence did not modify the association of medically attended injuries with adolescents' PA and body-related factors. The only exception was the modifying effect of gender: the association of medically attended injuries with being very active was stronger in boys (OR/CI: 3.04/1.32-6.99). Conclusion: Very physically active adolescent boys are the most vulnerable group of adolescents in terms of injuries. PA promotion programmes should further consider gender-specific strategies aimed at preventing injuries.

Effect of sleep and fatigue on cardiovascular performance in young, healthy subjects.

Physical performance could be negatively affected by sleep deficiency and fatigue. The present study assesses the role of sleep quality, fatigue and motivation on cardiovascular performance (VO2peak, Wmax, and HRmax) in a sample of active young subjects. The current study is a cross-sectional design. Ninety-six university students (males 54.2%; 21.5 ± 2.9 yrs) completed an incremental exercise test on a bicycle ergometer. Sleep, fatigue, and motivation were assessed with the Pittsburgh Sleep Quality Index and two visual analogue scales, respectively. Differences in VO2peak, Wmax, HRmax, self-perceived fatigue and motivation were compared between good and bad sleepers and sleep duration >/<7.5 h, while regression analysis defined the predictors of VO2peak, Wmax, and HRmax. In the male sample, good and bad sleepers' differences were significant only for self-perceived fatigue (p = 0.04). The female sample showed no statistically significant differences between good and bad sleepers and different sleep durations. In the male sample, linear regression analysis showed a significant inverse correlation between Wmax and the PSQI score (-0.4, p = 0.004). The stepwise regression model indicated that sleep (ß = -0.3, p = 0.02) was a significant predictor of VO2peak in males accounting for 20% of the variance, whereas physical performance seems more affected by fatigue (ß = -0.4, p = 0.03) in females. In conclusion, chronic inadequate and self-reported sleep quality seems to be one of the factors compromising cardiovascular performance in males.