scholarly journals Physical Activity, Cardiorespiratory Fitness, and Exercise Training in Primary and Secondary Coronary Prevention

2013 ◽  
Vol 77 (2) ◽  
pp. 281-292 ◽  
Author(s):  
Damon L. Swift ◽  
Carl J. Lavie ◽  
Neil M. Johannsen ◽  
Ross Arena ◽  
Conrad P. Earnest ◽  
...  
2021 ◽  
Vol 12 ◽  
Author(s):  
Kristoffer Jensen Kolnes ◽  
Maria Houborg Petersen ◽  
Teodor Lien-Iversen ◽  
Kurt Højlund ◽  
Jørgen Jensen

In obesity, excessive abdominal fat, especially the accumulation of visceral adipose tissue (VAT), increases the risk of metabolic disorders, such as type 2 diabetes mellitus (T2DM), cardiovascular disease, and non-alcoholic fatty liver disease. Excessive abdominal fat is associated with adipose tissue dysfunction, leading to systemic low-grade inflammation, fat overflow, ectopic lipid deposition, and reduced insulin sensitivity. Physical activity is recommended for primary prevention and treatment of obesity, T2DM, and related disorders. Achieving a stable reduction in body weight with exercise training alone has not shown promising effects on a population level. Because fat has a high energy content, a large amount of exercise training is required to achieve weight loss. However, even when there is no weight loss, exercise training is an effective method of improving body composition (increased muscle mass and reduced fat) as well as increasing insulin sensitivity and cardiorespiratory fitness. Compared with traditional low-to-moderate-intensity continuous endurance training, high-intensity interval training (HIIT) and sprint interval training (SIT) are more time-efficient as exercise regimens and produce comparable results in reducing total fat mass, as well as improving cardiorespiratory fitness and insulin sensitivity. During high-intensity exercise, carbohydrates are the main source of energy, whereas, with low-intensity exercise, fat becomes the predominant energy source. These observations imply that HIIT and SIT can reduce fat mass during bouts of exercise despite being associated with lower levels of fat oxidation. In this review, we explore the effects of different types of exercise training on energy expenditure and substrate oxidation during physical activity, and discuss the potential effects of exercise training on adipose tissue function and body fat distribution.


2016 ◽  
Vol 64 (2) ◽  

Physical activity (PA) and exercise training (ET) are central and indispensable components for primary and secondary prevention of cardiovascular disease (CVD). In healthy individuals, PA reduces all-cause and CV mortality and has confirmed beneficial effects on the cardiovascular risk profile. In secondary prevention, PA counselling und ET are two of the core components of a multidisciplinary cardiac rehabilitation (CR) program. Exercise-based CR is an established strategy in the secondary prevention of CV disease. It improves survival, reduces hospital admissions, improves cardiorespiratory fitness (CRF), and quality of life (QoL). However, these beneficial effects require regular attendance under professional supervision and adherence to recommended guidelines. In patients with heart disease, proper patient assessment with a standardized exercise test as a basis for a tailored ET prescription is required. In healthy subjects this is advocated only in selected groups. Current guidelines recommend at least 150 min/week of moderate-intensity continuous aerobic PA in both healthy individuals as well as those with cardiac disease. In healthy adults, alternatively intensity can be increased and volume can be halved. High intensity interval training (HIIT) is a relatively new training modality and may be used complementary to continuous training in selected patient groups. HIIT seems to be superior compared to moderate continuous exercise in patients with cardio metabolic disease with regard to effects on the CV risk profile, endothelial function, improvement in cardiorespiratory fitness, and a reverse cardiac remodelling in patients with heart failure. One of the major challenges in preventive cardiology is the improvement of long-term adherence to PA recommendations. The aim of this article is to give an overview from the preventive cardiologist’s point of view with a focus on endurance ET prescription for the audience of sports and exercise medicine physicians.


2019 ◽  
Vol 62 (4) ◽  
pp. 327-333 ◽  
Author(s):  
Salvatore Carbone ◽  
Marco Giuseppe Del Buono ◽  
Cemal Ozemek ◽  
Carl J. Lavie

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 170-OR
Author(s):  
JINGYI QIAN ◽  
MICHAEL P. WALKUP ◽  
SHYH-HUEI CHEN ◽  
PETER H. BRUBAKER ◽  
DALE BOND ◽  
...  

Diabetologia ◽  
2021 ◽  
Author(s):  
Trine Moholdt ◽  
Evelyn B. Parr ◽  
Brooke L. Devlin ◽  
Julia Debik ◽  
Guro Giskeødegård ◽  
...  

Abstract Aims/hypothesis We determined whether the time of day of exercise training (morning vs evening) would modulate the effects of consumption of a high-fat diet (HFD) on glycaemic control, whole-body health markers and serum metabolomics. Methods In this three-armed parallel-group randomised trial undertaken at a university in Melbourne, Australia, overweight/obese men consumed an HFD (65% of energy from fat) for 11 consecutive days. Participants were recruited via social media and community advertisements. Eligibility criteria for participation were male sex, age 30–45 years, BMI 27.0–35.0 kg/m2 and sedentary lifestyle. The main exclusion criteria were known CVD or type 2 diabetes, taking prescription medications, and shift-work. After 5 days, participants were allocated using a computer random generator to either exercise in the morning (06:30 hours), exercise in the evening (18:30 hours) or no exercise for the subsequent 5 days. Participants and researchers were not blinded to group assignment. Changes in serum metabolites, circulating lipids, cardiorespiratory fitness, BP, and glycaemic control (from continuous glucose monitoring) were compared between groups. Results Twenty-five participants were randomised (morning exercise n = 9; evening exercise n = 8; no exercise n = 8) and 24 participants completed the study and were included in analyses (n = 8 per group). Five days of HFD induced marked perturbations in serum metabolites related to lipid and amino acid metabolism. Exercise training had a smaller impact than the HFD on changes in circulating metabolites, and only exercise undertaken in the evening was able to partly reverse some of the HFD-induced changes in metabolomic profiles. Twenty-four-hour glucose concentrations were lower after 5 days of HFD compared with the participants’ habitual diet (5.3 ± 0.4 vs 5.6 ± 0.4 mmol/l, p = 0.001). There were no significant changes in 24 h glucose concentrations for either exercise group but lower nocturnal glucose levels were observed in participants who trained in the evening, compared with when they consumed the HFD alone (4.9 ± 0.4 vs 5.3 ± 0.3 mmol/l, p = 0.04). Compared with the no-exercise group, peak oxygen uptake improved after both morning (estimated effect 1.3 ml min−1 kg−1 [95% CI 0.5, 2.0], p = 0.003) and evening exercise (estimated effect 1.4 ml min−1 kg−1 [95% CI 0.6, 2.2], p = 0.001). Fasting blood glucose, insulin, cholesterol, triacylglycerol and LDL-cholesterol concentrations decreased only in participants allocated to evening exercise training. There were no unintended or adverse effects. Conclusions/interpretation A short-term HFD in overweight/obese men induced substantial alterations in lipid- and amino acid-related serum metabolites. Improvements in cardiorespiratory fitness were similar regardless of the time of day of exercise training. However, improvements in glycaemic control and partial reversal of HFD-induced changes in metabolic profiles were only observed when participants exercise trained in the evening. Trial registration anzctr.org.au registration no. ACTRN12617000304336. Funding This study was funded by the Novo Nordisk Foundation (NNF14OC0011493). Graphical abstract


Author(s):  
Tom Martinsson Ngouali ◽  
Mats Börjesson ◽  
Åsa Cider ◽  
Stefan Lundqvist

Swedish physical activity on prescription (PAP) is an evidence-based method to promote physical activity. However, few studies have investigated the effect of Swedish PAP on physical fitness, in which better cardiorespiratory fitness is associated with lower risks of all-cause mortality and diagnose-specific mortality. Direct measures of cardiorespiratory fitness, usually expressed as maximal oxygen uptake, are difficult to obtain. Hence, exercise capacity can be assessed from a submaximal cycle ergometer test, taking the linear relationship between heart rate, work rate, and oxygen uptake into account. The aim of this study was to evaluate exercise capacity in the long term, following PAP treatment with enhanced physiotherapist support in a nonresponding patient cohort. In total, 98 patients (48 women) with insufficient physical activity levels, with at least one component of the metabolic syndrome and nonresponding to a previous six-month PAP treatment, were randomized to PAP treatment with enhanced support from a physiotherapist and additional exercise capacity tests during a two-year period. A significant increase in exercise capacity was observed for the whole cohort at two-year follow-up (7.6 W, p ≤ 0.001), with a medium effect size (r = 0.34). Females (7.3 W, p = 0.025), males (8.0 W, p = 0.018) and patients ≥58 years old (7.7 W, p = 0.002) improved significantly, whereas a nonsignificant increase was observed for patients <58 years old (7.6 W, p = 0.085). Patients with insufficient physical activity levels who did not respond to a previous six-month PAP treatment can improve their exercise capacity following PAP treatment with enhanced support from a physiotherapist during a two-year period. Future studies should include larger cohorts with a control group to ensure valid estimations of exercise capacity and PAP.


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