Search

Background: The interaction between exercise and nutritional supplementation is unclear among older adults at risk of sarcopenia., Objectives: We aimed to examine if β-hydroxy-β-methylbutyrate (HMB) supplementation enhances the effects of exercise on muscle mass, strength, and physical performance and observe potential residual effects in older women with low muscle mass., Methods: This 12-wk, randomized, double-blind, placebo-controlled, 2 × 2 factorial design (exercise-only, HMB-only, both, and none) trial included 156 women aged 65-79 y with skeletal muscle index <5.7 kg/m2, and was followed by a 12-wk observational period. Resistance training twice weekly or education programs every 2 wk and calcium-HMB (1500 mg) or placebo supplements daily were provided. The primary outcome was the change in muscle mass from baseline to postintervention. Secondary outcomes included changes in muscle strength and physical performance., Results: In total, 149 and 144 participants completed the assessment at weeks 12 and 24, respectively. ANOVAs based on the intention-to-treat principle showed no significant interactions between exercise and HMB on any primary outcomes. The main-effect analyses revealed that exercise improved the usual and maximal gait speed by 0.16 m/s (95% CI: 0.10, 0.21 m/s) and 0.15 m/s (95% CI: 0.09, 0.22 m/s), respectively; the knee extensor and hip adductor strength by 22.0 N (95% CI: 10.1, 33.9 N) and 21.8 N (95% CI: 12.9, 30.7 N), respectively; and timed up-and-go and sit-to-stand time by -0.5 s (95% CI: -0.7, -0.3 s) and -1.7 s (95% CI: -2.1, -1.3 s), respectively, relative to education. HMB improved usual gait speed by 0.06 m/s (95% CI: 0.01, 0.11 m/s) relative to placebo. Most improvements disappeared during the subsequent 12-wk observation period., Conclusions: HMB additively improved gait performance with negligible benefit and provided no enhancements in the effects of exercise on other outcomes. Exercise appeared to be the only effective intervention to improve outcomes in older women with low muscle mass.This trial was registered at www.umin.ac.jp/ctr/as UMIN000028560., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.)

Objective: Circulating levels of fibroblast growth factor 21 (FGF21) increase with advancing age and may lead to the development of cardiometabolic diseases via impaired lipid and glucose metabolism. While physical activity can reduce these risks of cardiometabolic dysfunction, it remains obscure whether circulation FGF21 levels are influenced by physical activity. The purpose of this study was to investigate the relations between daily physical activities and circulating FGF21 levels in middle-aged and older adults., Methods: In this cross-sectional study with 110 middle-aged and 102 older adults, circulating (serum) FGF21 levels were evaluated by enzyme-linked immunosorbent assay, and the time spent in light-intensity physical activity (LPA) and moderate-to-vigorous-intensity physical activity (MVPA) was assessed using a uniaxial accelerometer., Results: Serum FGF21 levels in the older group (158 pg/mL) were significantly higher than those in the middle-aged group (117 pg/mL). When we examined the joint association of age (middle-aged or older) and MVPA (lower or higher than the median) groups, serum FGF21 levels in the older and higher MVPA group (116 pg/mL) were significantly lower than those in the older and lower MVPA group (176 pg/mL). However, there was no difference in serum FGF21 levels between the lower and higher MVPA groups in the middle-aged group. In multivariable liner regression analysis, serum FGF21 levels were independently determined by MVPA time after adjusting for potential covariates in older adults (β = -0.209)., Conclusions: These cross-sectional study findings indicate that the time spent in MVPA is an independent determinant of circulating FGF21 levels, and that an age-related increase in serum FGF21 levels may be attenuated by habitually performing MVPA. (250/250 words)., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Physical inactivity and sedentary behaviour (too much sitting) can contribute to renal dysfunction. However, the potential benefits of behavioural change (e.g. replacing sedentary behaviour with physical activity) on renal function are not well understood. We used isotemporal substitution to model potential impacts of behaviours on renal function by replacing time spent in one behaviour to another., Methods: In 174 older Japanese adults (age, 50-83 years; females, 76%), the time spent in sedentary behaviour, light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) were assessed using an uniaxial accelerometer. Renal function was evaluated by the estimated glomerular filtration rate (eGFR) from serum creatinine and cystatin C levels., Results: In univariate analyses, eGFR was significantly, albeit weakly, correlated with time spent in sedentary behaviour (r s  = - 0.229), LPA (r s  = 0.265), and MVPA (r s  = 0.353). In the isotemporal substitution models, replacement of 30 min/day of sedentary behaviour with an equivalent LPA time was not significantly associated with eGFR (β = 2.26, p = 0.112); however, replacement with an equivalent time of MVPA was beneficially associated with eGFR (β = 5.49, p < 0.05)., Conclusions: These cross-sectional findings suggest that sedentary behaviour (detrimentally) and physical activity (beneficially) may affect renal function and that replacing sedentary behaviour with MVPA may benefit renal health in older adults.

The circulatory level of pentraxin 3 (PTX3), an anti-inflammatory cardioprotective protein, has been shown to be lower in obese individuals than in those with normal weight. However, reports on the effects of different weight-loss methods on PTX3 are limited. The present study aimed to investigate the effect of weight loss on circulating PTX3 levels in overweight and obese men and to examine the combined effect of dietary modification and exercise training on PTX3 levels. Forty-eight overweight and obese men were assigned to 2 groups: dietary modification (group D) or exercise training and dietary modification (group DE). Groups D and DE were composed of 27 and 21 participants, respectively. We observed a significant independent relationship between changes in PTX3 and body mass index (BMI) in all participants (β = -0.617, p < 0.01). Subsequently, we compared the effects of the 2 weight-loss methods on plasma PTX3 in groups D and DE. The magnitude of the increase in plasma PTX3 levels was similar in the 2 groups. Interestingly, we observed that PTX3 levels in group DE increased significantly more than those in group D in subjects who achieved normal weight, based on BMI, after interventions. Our study suggested that weight reduction after lifestyle modification significantly increased PTX3 levels in overweight and obese men, and the addition of habitual exercise to dietary modification enhanced the magnitude of the increase in PTX3 levels in obese individuals achieving normal weight after weight loss.

Central systolic blood pressure (cSBP) decreases after a meal or glucose challenge, but this response is impaired in obesity-related disorders. We investigated whether aerobic exercise training improves cSBP regulation during an oral glucose tolerance test (OGTT) in overweight/obese men. Thirteen overweight/obese men and six normal-weight men (as an alternative comparison instead of a no-exercise group) completed a 12-week aerobic exercise training program. Before and after the program, cSBP (i.e., radial second systolic pressure) was measured using an applanation tonometry at fasting and both 60 min and 120 min after 75 g glucose loading. Before and during the program, physical activity (PA) time was recorded using a tri-axial accelerometer. Pre-training, cSBP was significantly decreased with glucose loading in normal-weight men, while cSBP did not change in overweight/obese men. Post-training, a significant decrease in cSBP was observed in both groups following glucose loading. In addition, the increase in vigorous PA time during the exercise program was significantly correlated to the increase in area above the curve for cSBP during OGTT (demonstrating an improvement in the cSBP response to glucose loading) after the exercise program. These findings may provide novel insights into the role of PA in reducing the cardiovascular risk in obesity.

Obesity is reported to be an important factor affecting foot structure and function. For obese individuals, weight reduction or increasing weight physical activity could be an effective approach to improve foot structure and function. The present study sought to determine the effect of weight reduction and increasing physical activity on foot structure and function in obese Japanese and to investigate which intervention is more beneficial. The participants were divided into the weight reduction group (n = 30; body mass index 29.0 ± 2.5 kg/m 2 ), with the intervention consisting of dietary modification, and the increasing physical activity group (n = 15; body mass index 28.2 ± 3.1 kg/m 2 ), with the intervention consisting of walking and jogging. A 3-dimensional foot scanner was used to measure the foot anthropometric data with the participants both sitting and standing. The dorsum height declined and the arch stiffness index increased after the weight reduction intervention, and the truncated foot length decreased and the arch stiffness index increased after the increasing physical activity intervention (p <.05). The arch height index showed a downward trend after the weight reduction intervention (p = .060) and an upward trend after the increasing physical activity intervention (p = .069). Moreover, a greater change was found in the increase of the dorsum height and arch height index and decrease of the truncated foot length in the increasing physical activity group than in the weight reduction group (p <.05). These findings suggest that increasing physical activity might be more effective to improve foot structure and function than weight reduction in obese adults., (Copyright © 2018 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

Aim: We aimed to compare the level of physical function (PF) and habitual exercise between older Japanese and Korean adults., Methods: A comparative study was carried out on 1069 community-dwelling older Japanese and Korean adults (mean age 73.9 ± 5.2 years). The participants were asked to complete a self-reported questionnaire regarding habitual exercise and covariates. PF age, a composite measure of PF, was derived from the 12 items, using principal component analysis. PF age and habitual exercise were compared between the Japanese and Korean adults, using analysis of covariance (ancova) and multivariable logistic regression analysis adjusted for all covariates using propensity scores., Results: ancova showed that PF age in older Japanese adults was significantly younger than in their Korean counterparts. Older Japanese adults exercised significantly less frequently than their Korean counterparts. Furthermore, older Japanese adults practiced significantly less walking, mountain climbing and bicycling, but more calisthenics, resistance training, ball games and dances than their Korean counterparts., Conclusions: We found that older Korean adults had lower PF (3.7 years older in PF age) than their Japanese counterparts. Although the overall frequency and amount of habitual exercise in older Korean adults were higher than those in their Japanese counterparts, particular types of exercise might have contributed to the higher PF levels among older Japanese adults. Thus, older Korean adults might need to engage more in habitual exercises that are specifically effective in maintaining PF. Geriatr Gerontol Int 2018; 18: 576-583., (© 2017 Japan Geriatrics Society.)

Testosterone is a male sex hormone and low circulating testosterone levels are associated with various health disorders in men. Obesity results in reduced circulating testosterone levels in men. Previously, we demonstrated that lifestyle modifications (combination of aerobic exercise and dietary modification) increase circulating testosterone levels in overweight/obese men. However, the effect of regular aerobic exercise on serum testosterone levels remains unclear. The purpose of this study was to investigate the effect of a 12-week aerobic exercise intervention on circulating testosterone levels in normal-weight and overweight/obese men. Sixteen normal-weight men and twenty-eight overweight/obese men completed a 12-week aerobic exercise intervention. Before and after the intervention, we measured serum total testosterone, free testosterone, and bioavailable testosterone levels, and categorized the physical activity levels (light, moderate, or vigorous) in all participants. At baseline, serum total testosterone, free testosterone, and bioavailable testosterone levels were significantly lower in overweight/obese men than in normal-weight men (all p<0.01). After the 12-week aerobic exercise intervention, serum total testosterone, free testosterone, and bioavailable testosterone levels significantly increased in overweight/obese men (p<0.01). In addition, stepwise multivariable linear regression analysis revealed the increase in vigorous physical activity was independently associated with increased serum total testosterone levels (β=0.47, p=0.011). We demonstrated that a 12-week aerobic exercise intervention increased serum total testosterone, free testosterone, and bioavailable testosterone levels in overweight/obese men. We suggest that an increase in vigorous physical activity increased circulating testosterone levels in overweight/obese men., Competing Interests: Conflict of Interest: The authors declare that they have no conflicts of interest., (© Georg Thieme Verlag KG Stuttgart · New York.)

We compared the effects of 12-week programs of resistance training (RT), high-intensity interval aerobic training (HIAT), and moderate-intensity continuous aerobic training (MICT). The primary goal was to evaluate the therapeutic effects of the exercise modalities for the management of nonalcoholic fatty liver disease (NAFLD). A total of 61 sedentary obese men with NAFLD were randomized into one of the following exercise regimens (RT, HIAT, or MICT). Hepatic fat content was decreased to a similar extent in the RT, HIAT, and MICT groups (-14.3% vs. -13.7% vs. -14.3%) without significant changes in weight and visceral fat. The gene expression levels of fatty acid synthesis were significantly decreased in the subjects' monocytes. Hepatic stiffness was decreased only in the HIAT group (-16.8%). The stiffness change was associated with restored Kupffer cell phagocytic function (+17.8%) and decreased levels of inflammation such as leptin (-13.2%) and ferritin (-14.1%). RT, HIAT, and MICT were equally effective in reducing hepatic fat content, but only HIAT was effective in improving hepatic stiffness and restoring Kupffer cell function. These benefits appeared to be independent of detectable weight and visceral fat reductions; the benefits were acquired through the modulation of in vivo fatty acid metabolism and obesity-related inflammatory conditions.

Obesity and increased arterial stiffness are independent risk factors for cardiovascular disease. Arterial stiffness is increased in obese individuals than in age-matched nonobese individuals. We demonstrated that dietary modification and exercise training are effective in reducing arterial stiffness in obese persons. However, the differences in the effect on arterial stiffness between dietary modification and exercise training are unknown. The purpose of the current study was to compare the effect of dietary modification and aerobic exercise training on arterial stiffness and endothelial function in overweight and obese persons. Forty-five overweight and obese men (48 ± 1 year) completed either a dietary modification (well-balanced nutrient, 1680 kcal/day) or an exercise-training program (walking, 40-60 min/day, 3 days/week) for 12 weeks. Before and after the intervention, all participants underwent anthropometric measurements. Arterial stiffness was measured based on carotid arterial compliance, brachial-ankle pulse wave velocity (baPWV), and endothelial function was determined by circulating level of endothelin-1 (ET-1) and nitric oxide metabolite (nitrites/nitrate as metabolite: NOx). Body mass and waist circumference significantly decreased after both intervention programs. Weight loss was greater after dietary modification than after exercise training (-10.1 ± 0.6 kg vs. -3.6 ± 0.5 kg, p < .01). Although arterial stiffness and the plasma levels of ET-1 and NOx were improved after dietary modification or exercise training, there were no differences in those improvements between the 2 types of interventions. Exercise training improves arterial function in obese men without as much weight loss as after dietary modification.

Background: Whole-body vibration training using vertical-vibration machines is called "acceleration training" (AT). The purpose of this study was to elucidate the effect of AT on lower-limb muscular strength and power, functional mobility and self-reported knee function in middle-aged and older Japanese women with knee pain., Methods: Thirty-eight middle-aged and older Japanese women (aged 50-73 years) with knee pain were divided into two groups: (1) the AT group (n=29) engaged in AT three times per week for eight weeks, and (2) the control group (C group, n=9). The AT program consisted of flexibility training, strength training of mainly the quadriceps and surrounding muscles and cool-down exercises. The C group was encouraged to perform the same or similar exercises at home without vibratory stimulus. We evaluated knee strength and power, functional mobility (timed up and go: TUG) and self-reported knee function (Japanese Knee Osteoarthritis Measure: JKOM)., Results: No one in the AT group dropped out during the program. All JKOM categories except degree of pain improved significantly post intervention indicating improved knee function, and TUG was significantly shorter in these participants. All knee strength and power parameters except isometric knee extension peak torque improved significantly. The degree of change in JKOM total score and TUG was significantly different between the two groups., Conclusion: Vibratory stimulus during an eight week AT programme can promote participation and safely improve functional mobility and self-reported knee function better than exercise without vibratory stimulus in middle-aged and older Japanese women with knee pain., Level of Evidence: level 2., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Purpose: The aim of this study was to compare the effects of low-volume, high-intensity aerobic interval training (HAIT) on maximal oxygen consumption (VO₂max), left ventricular (LV) mass, and heart rate recovery (HRR) with high-volume, moderate-intensity continuous aerobic training (CAT) in sedentary adults., Methods: Twenty-four healthy but sedentary male adults (aged 29.2 ± 7.2 years) participated in an 8-week, 3-day a week, supervised exercise intervention. They were randomly assigned to either HAIT (18 min, 180 kcal per exercise session) or CAT (45 min, 360 kcal). VO₂max, LV mass (3T-MRI), and HRR at 1 min (HRR-1) and 2 min (HRR-2) after maximal exercise were measured pre- and post-intervention., Results: Changes in VO₂max during the 8-week intervention were significant (P < 0.01) in both groups (HAIT, 8.7 ± 3.2 ml kg(-1) min(-1), 22.4 ± 8.9%; CAT, 5.5 ± 2.8 ml kg(-1) min(-1), 14.7 ± 9.5%), while the VO₂max improvement in HAIT was greater (P = 0.02) than in CAT. LV mass in HAIT increased (5.1 ± 8.4 g, 5.7 ± 9.1%, P = 0.05), but not in CAT (0.9 ± 7.8 g, 1.1 ± 8.4%, P = 0.71). While changes in HRR-1 were not significant in either group, change in HRR-2 for HAIT (9.5 ± 6.4 bpm, 19.0 ± 16.0%, P < 0.01) was greater (P = 0.03) than for CAT (1.6 ± 10.9 bpm, 3.9 ± 16.2%, P = 0.42)., Conclusions: This study suggests that HAIT has potential as a time-efficient training mode to improve cardiorespiratory capacity and autonomic nervous system function in sedentary adults.

Background: A diet regimen focusing on weight loss is still the most efficient treatment for nonalcoholic fatty liver disease (NAFLD). Recently, specific benefits of exercise against NAFLD independent of weight loss have been reported. Hence, combining exercise with diet-induced weight loss can be expected to have an additive benefit for NAFLD management. We evaluated the effectiveness of diet in conjunction with exercise (DE) compared with that of diet alone (D) on hepatic steatosis and its underlying pathophysiology., Methods: Data obtained from 72 obese, middle-aged men with NAFLD who completed a 3-month program of DE or D in 2011 and 2012 were analyzed. Subjects went through a comprehensive parameters analysis for the pathophysiology of NAFLD., Results: Subjects in the DE group, compared with those in the D group, elicited additive effects on the degree of hepatic steatosis (-82.6% vs. -60.0%) and body weight (-13.3% vs. -8.9%) accompanied by an improvement in serum marker levels: inflammation, ferritin (-16.1% vs. -2.1%); oxidative stress, lipid peroxidation (-31.8% vs. +4.8%); adipokine imbalance, adiponectin, and leptin (+27.4% vs. +2.6% and -74.4% vs. -30.2%). Consequently, subjects in the DE group achieved further attenuation of insulin resistance [homeostatsis model assessment of insulin resistance (HOMA-IR) (-63.6% vs. -40.0%)]. These observed additive benefits in the DE group were closely associated with the increased volume of physical activity., Conclusions: The addition of exercise to a diet regimen potentiates the benefits in NAFLD management through further improvement of hepatic steatosis, inflammatory and oxidative stress levels, and adipokine imbalance, thereby attenuating insulin resistance independent of detectable weight loss.

Background: Reducing body weight and visceral adipose tissue (VAT) are the primary goals for maintaining health in obese individuals as compared to those of normal weight, but it is also important to maintain physical fitness for a healthy life after weight-loss. Acceleration training (AT) has recently been indicated as an alternative to resistance training for elite athletes and also as a component of preventive medicine. However, it is unclear whether combining AT with a weight-loss diet will improve physical fitness in obese individuals. The present study aimed to determine the synergistic effects of AT on body composition and physical fitness with weight-loss program in overweight and obese women., Methods: Twenty-eight obese, middle-aged women were divided into two groups as follows: diet and aerobic exercise group (DA; BMI: 29.3 ± 3.0 kg/m2); and diet, aerobic exercise and acceleration training group (DAA; BMI: 31.2 ± 4.0 kg/m2). Both groups included a 12-week weight-loss program. Body composition, visceral adipose tissue (VAT) area and physical fitness (hand grip, side-to-side steps, single-leg balance with eyes closed, sit-and-reach and maximal oxygen uptake) were measured before and after the program., Result: Body weight, BMI, waist circumference and VAT area decreased significantly in both groups. Hand grip (2.1 ± 3.0 kg), single-leg balance (11.0 ± 15.4 s) and sit-and-reach (6.5 ± 4.8 cm) improved significantly only in the DAA group., Conclusions: Our findings indicate that combining AT with classical lifestyle modifications is effective at reducing VAT, and it may enhance muscle strength and performance in overweight and obese women., (© 2014 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.)

Purpose: The aim of this study was to compare the effects of time-efficient, low-volume interval exercises on cardiorespiratory capacity and left ventricular (LV) mass with traditional continuous exercise in sedentary adults., Methods: Forty-two healthy but sedentary male subjects (age 26.5 ± 6.2 yr) participated in an 8-wk, five times per week, supervised exercise intervention. They were randomly assigned to one of three exercise protocols: sprint interval training (SIT, 5 min, 100 kcal), high-intensity interval aerobic training (HIAT, 13 min, 180 kcal), and continuous aerobic training (CAT, 40 min, 360 kcal). Cardiorespiratory capacity (V˙O2max) and LV mass (3T-MRI) were measured preintervention and postintervention., Results: We observed significant (P < 0.01) increases in V˙O2max in all three groups, and the effect of the HIAT was the greatest of the three (SIT, 16.7% ± 11.6%; HIAT, 22.5% ± 12.2%; CAT, 10.0% ± 8.9%; P = 0.01). There were significant changes in LV mass, stroke volume (SV), and resting HR in both the SIT (LV mass, 6.5% ± 8.3%; SV, 5.3% ± 8.3%; HR, -7.3% ± 11.1%; all P < 0.05) and HIAT (LV mass, 8.0% ± 8.3%; SV, 12.1% ± 9.8%; HR, -12.7% ± 12.2%; all P < 0.01) but not in the CAT (LV mass, 2.5% ± 10.1%; SV, 3.6% ± 6.6%; HR, -2.2% ± 13.3%; all P > 0.05)., Conclusions: Our study revealed that V˙O2max improvement with the HIAT was greater than with the CAT despite the HIAT being performed with a far lower volume and in far less time than the CAT. This suggests that the HIAT has potential as a time-efficient training mode to improve V˙O2max in sedentary adults.

Objective: Our previous study, a 6-month randomised controlled trial, demonstrated that a group-based support promoted weight loss as compared to an education-only intervention. The purpose of this study was to examine weight loss maintenance for 2 years., Methods: Originally, 188 overweight Japanese adults, aged 40-65 years, were randomly assigned to 3 groups: control, education-only or group-based support. After the 6-month intervention, 125 participants in the education-only and the group-based support groups were followed up for 2 years. The primary outcome was the amount of weight lost. The participants were retrospectively grouped into quartiles of percent weight loss for secondary analyses., Results: At the end of follow-up, the amount of weight lost in the education-only and the group-based support groups was the same (3.3 kg). Secondary analyses using data of those who completed the study (n = 100) revealed that the participants in the highest quartile of percent weight loss significantly increased their step counts and moderate-to-vigorous physical activity compared with the lowest quartile. No significant differences were observed in the energy intake among the four groups., Conclusion: The effects of group-based support disappear within 2 years. Increasing physical activity may be a crucial factor for successful maintenance of weight loss.

Background: The purpose of this study was to reveal any association between cardiorespiratory fitness level and excess post-exercise oxygen consumption (EPOC) using three cycling protocols with varying degrees of exercise intensity, i.e., sprint interval training (SIT), high-intensity interval aerobic training (HIAT), and continuous aerobic training (CAT)., Findings: Ten healthy men, aged 20 to 31 years, attended a cross-over experiment and completed three exercise sessions: SIT consisting of 7 sets of 30-s cycling at 120% VO2max with a 15-s rest between sets; HIAT consisting of 3 sets of 3-min cycling at 80~90% VO2max with a 2-min active rest at 50% VO2max between sets; and CAT consisting of 40 min of cycling at 60~65% VO2max. During each session, resting VO2, exercise VO2, and a 180-min post-exercise VO2 were measured. The net exercise VO2 during the SIT, HIAT, and CAT averaged 14.7 ± 1.5, 31.8 ± 4.1, and 71.1 ± 10.0 L, and the EPOCs averaged 6.8 ± 4.0, 4.5 ± 3.3, and 2.9 ± 2.8 L, respectively. The EPOC with SIT was greater than with CAT (P < 0.01) and HIAT (P = 0.12). Correlation coefficients obtained between subjects' VO2max and the ratio of EPOC to net exercise VO2 for SIT, HIAT, and CAT were -0.61 (P = 0.06), -0.79 (P < 0.01), and -0.42 (P = 0.23), respectively., Conclusions: Our data suggest that cardiorespiratory fitness level correlates negatively with the magnitude of EPOC, especially when performing aerobic-type interval training.

Introduction: Astronauts experience weight loss during spaceflight. Future space missions require a more efficient exercise program not only to maintain work efficiency, but also to control increased energy expenditure (EE). When discussing issues concerning EE incurred through exercise, excess post-exercise energy expenditure (EPEE) must also be considered. The aim of this study was to compare the total EE, including EPEE, induced by two types of interval cycling protocols with the total EE of a traditional, continuous cycling protocol., Methods: There were 10 healthy men, ages 20 to 31 yr, who completed 3 exercise sessions: sprint interval training (SIT) consisting of 7 sets of 30-s cycling at 120% VO2max with a 15-s rest between each bout; high-intensity interval aerobic training (HIAT) consisting of 3 sets of 3-min cycling at 80-90% VO2max with a 2-min active rest at 50% VO2max; and continuous aerobic training (CAT) consisting of 40 min of cycling at 60-65% VO2max. During each session, resting metabolic rate, exercise EE, and a 180-min post-exercise EE were measured., Results: The EPEEs during the SIT, HIAT, and CAT averaged 32 +/- 19, 21 +/- 16, and 13 +/- 13 kcal, and the total EE for an entire exercise/ rest session averaged 109 +/- 20, 182 +/- 17, and 363 +/- 45 kcal, respectively. While the EPEE after the CAT was significantly less than after the SIT, the total EE with the CAT was the greatest of the three., Discussion: The SIT and HIAT would be potential protocols to control energy expenditure for long space missions.

Introduction: The purpose of this study was to investigate the effects of 12-week exercise training on circulating retinol-binding protein 4 (RBP4) concentration and cardiovascular disease (CVD) risk factors in obese men., Methods: 29 obese men (age 48 ± 2 years; BMI 29.6 ± 0.7 kg/m(2)) participated in a 12-week exercise program (50-70% maximal heart rates; 3 times/week) without calorie restriction. Anthropometric parameters, CVD risk factors (total cholesterol, high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol, triglycerides (TG), and quantitative insulin sensitivity check index), and circulating RBP4 and adipokine (adiponectin, leptin, and interleukin-6 (IL-6)) concentrations were measured., Results: Exercise training significantly improved in absolute peak oxygen consumption (p < 0.05), and CVD risk factors (p < 0.05), with the exception of HDLC. There was a significant decrease in circulating RBP4, leptin, and IL-6 concentrations (p < 0.05). Stepwise regression analysis revealed that changes in RBP4 concentration were independently related to the changes in TG concentration (β = 0.46, p < 0.05)., Conclusion: These results demonstrate that exercise training without calorie restriction improves several CVD risk factors and circulating RBP4 and adipokine concentrations. Moreover, the change in circulating RBP4 may be more associated with the improvements in TG concentration in obese men., (Copyright © 2012 S. Karger GmbH, Freiburg)

Objectives: The purpose of this study was to examine intervention effects of a community-based prevention program for pre-frail elderly individuals by comparing an intervention group (exercise with nutritional care) with a control group (exercise without nutritional care)., Methods: The study was conducted in Y town and S city in Ibaraki Prefecture in Japan. The subjects comprised 161 pre-frail elderly individuals in the community-based prevention program, who were divided into two groups, the intervention group (N = 81, Y town, mean age : 76.2 +/- 5.7 years), and the control group (N = 81, S city, mean age 76.2 +/- 4.7 years). The items surveyed included age, gender, activities of daily living, functional capacity, and dietary variety score (DVS). Functional fitness measurement items (grip strength, alternate step, 5-repetition sit-to-stand, one-leg balance with eyes open, tandem stance, functional reach (FR), sit and reach, 5-m habitual walk, and timed up and go (TUG)) and blood data were assessed at the beginning and end of the intervention., Results: The DVS of the intervention group was significantly improved compared to that of the control group (P < 0.01). In particular, the food frequencies of fish and shellfish, meat, eggs, milk, fruits, and fat and oil (P < 0.01) were significantly increased in the intervention group, as were those of soybean products, seaweed, and potatoes (P < 0.05). On the other hand, significant increases were seen only in the frequencies of fish and shellfish, meat, and milk in the control group. The intervention group showed significant improvement in five-repetition sit-to-stand, tandem stance, FR, sit and reach, and TUG by the end of the intervention. In addition, the intervention group's performance on one-leg balance with eyes open (P < 0.05) was significantly improved even after adjusting for age, gender, and the functional fitness measurement items which were different at the beginning of the study., Conclusion: This study suggests that a combined exercise and nutrition program for pre-frail elderly individuals improves their food intake and functional fitness.

This study compared the fat metabolism between 'a single bout of 30-min exercise' and 'three bouts of 10-min exercise' of the same intensity (60% maximal oxygen uptake) and total exercise duration (30 min). Nine healthy men participated in three trials: (1) a single 30-min bout of exercise (Single), (2) three 10-min bouts of exercise, separated by a 10-min rest (Repeated) and (3) rest (Rest). Each exercise was performed with a cycle ergometer at 60% of maximal oxygen uptake, followed by 180-min rest. Blood lactate concentration increased significantly after exercise in the Single and Repeated trials (P < 0.05), but the Single trial showed a significantly higher value during the recovery period (P < 0.05). No significant difference was observed in the responses of plasma glycerol concentration. The Repeated trial produced a smaller increase in the ratings of perceived exertion during the exercise (P < 0.01). During the exercise, no significant difference was observed in respiratory exchange ratio (RER) between the Single and Repeated trials. However, the RER values during the recovery period were significantly lower in the Repeated trial than in the Single and Rest trials (P < 0.05), indicating higher relative contribution of fat oxidation in the Repeated trial (P < 0.05). These results suggest that the repetition of 10-min of moderate exercise can contribute to greater exercise-induced fat oxidation compared with a single 30-min bout of continuous exercise., (© 2011 The Authors. Clinical Physiology and Functional Imaging © 2011 Scandinavian Society of Clinical Physiology and Nuclear Medicine.)

Exercise intensity may induce changes in total adiponectin and adiponectin oligomer levels. However, the effects of acute aerobic exercise on total adiponectin and adiponectin oligomers in middle-aged abdominally obese men remain unknown. The purpose of this study was to investigate the influence of aerobic exercise intensity on changes in the concentrations of total adiponectin and adiponectin oligomers (high-molecular weight [HMW] and middle- plus low-molecular weight [MLMW] adiponectin), and the endocrine mechanisms involved in exercise-induced changes in adiponectin oligomer profiles in middle-aged abdominally obese men. Using a crossover design, 9 middle-aged abdominally obese men (age, 54.1 ± 2.4 years; body mass index, 27.9 ± 0.6 kg/m²) underwent 2 trials that consisted of 60 minutes of stationary cycle exercise at either moderate-intensity (ME) or high-intensity (HE) aerobic exercise (50% or 70% of peak oxygen uptake, respectively). Blood samples were collected to measure the concentrations of adiponectin oligomers, hormones (catecholamines, insulin, and growth hormone), metabolites (free fatty acid, glycerol, triglyceride, and glucose), and cytokines (interleukin-6 and tumor necrosis factor-α). After exercise, plasma catecholamine concentrations were higher during HE than during ME (P < .05). Total adiponectin concentration decreased at the end of HE (P < .05), but remained unchanged after ME. The HMW adiponectin concentration did not change at either intensity, whereas the MLMW concentration decreased at the end of HE (P < .05). The ratio of HMW to total adiponectin concentration increased significantly (P < .05), whereas the ratio of MLMW to total adiponectin concentration decreased significantly (P < .05), at the end of HE. The percentage changes in epinephrine concentration from baseline to the end of exercise were correlated with the percentage changes in total adiponectin concentration (r = -0.67, P < .05) and MLMW adiponectin concentration (r = -0.82, P < .05) from baseline to the end of HE. Our results indicate that the change in total adiponectin was mainly due to a change in MLMW adiponectin concentration during high-intensity exercise in middle-aged abdominally obese men. Epinephrine may partially regulate the decrease in total and MLMW adiponectin concentrations during high-intensity exercise., (© 2011 Elsevier Inc. All rights reserved.)

Objective: Square-Stepping Exercise (SSE), composed of movements similar to walking, involves varied movements in multiple directions and is performed on a thin mat (100 x 250 cm) that is partitioned into 40 squares (25 cm each). We introduced SSE to a group of older adults for three months as a supervised intervention. After this intervention period, the participants continued SSE without supervision for four years. The current study was conducted to determine why the participants independently continued SSE., Methods: Among 52 older adults who attended the SSE intervention, 40 continued SSE (continued group) and 12 discontinued (discontinued group). Seven in the continued group were excluded from analyses because of low attendance rates. Each of the remainder (n = 33) was independently interviewed and asked why he/she had continued SSE. The average interview time for the continued group was 12 minutes. Twelve in the discontinued group were investigated for exercise habits by postal questionnaire., Results: The participants in the continued group noted two to six reasons for continuation of SSE. After analyzing data inductively, the answers were categorized as follows: (1) friends and social communication; (2) equitable management of group activity; (3) expectation of health from exercise; (4) simple-easy exercise; and (5) family support for exercise. The participants in the discontinued group reported that 89% of them continually did walking, muscular strength exercise, and calisthenics., Conclusion: We found that reasons why adoption of SSE as an intervention program for older adults enhance their exercise adherence in the long term.

In this study, we wished to determine whether 30 min of moderate-intensity exercise, corresponding to minimal recommended guidelines, attenuates post-prandial capillary triacylglycerol concentrations in obese men. Ten middle-aged, centrally obese men (age 46 +/- 2 years, body mass index 31.6 +/- 1.0 kg · m(-2), waist circumference 104.6 +/- 2.2 cm) completed two 2-day trials (exercise and control) at least one week apart in a randomized, repeated-measures design. On day 1, participants either cycled for 30 min at approximately 60% of maximal heart rate in the afternoon or rested (no exercise). On day 2 of both trials, after a 10-h overnight fast, participants consumed a test meal of moderate fat content (35%) for breakfast. Capillary blood samples were collected in the fasted state (0 h) and at 2, 4, and 6 h post-prandially on day 2. Total area under the capillary triacylglycerol concentration versus time curve was significantly lower on the exercise than control trial (P = 0.023). One 30-min session of moderate-intensity cycling is effective in lowering post-prandial capillary triacylglycerol concentration in obese middle-aged men. These findings may have important implications for exercise recommendations as a means to reduce the risk of cardiovascular disease if such exercise is performed for an extended period.

Aim: To examine the effects of vigorous physical activity (PA) on intra-abdominal fat (IF) levels in obese men., Methods: Thirty-seven obese men (mean age: 47.6+/-8.6 years) engaged in a 12-week aerobic exercise program on a regular basis (3 days/week). We divided them into low volume of vigorous PA group (n=19) or high volume of vigorous PA group (n=18), based on the median time spent (34.3min/week) in vigorous PA (over 6.1 metabolic equivalents assessed by a single-axis accelerometer) throughout the program., Results: Regular exercise reduced IF levels (measured by computed tomography) from 188.1+/-53.9cm(2) to 170.3+/-46.6cm(2) for the low volume of vigorous PA group and from 167.9+/-44.3cm(2) to 137.9+/-40.6cm(2) for the high volume of vigorous PA group. Two-way (time x group) ANOVA revealed no significant interactions for the IF level. However, correlation analysis for all participants showed that time spent in vigorous PA throughout the program significantly correlated to IF reductions after adjusting for initial levels of IF, vigorous PA and weight changes (r=-0.42, P=0.02)., Conclusion: This study suggests that vigorous PA may affect IF reductions in obese men.

Aim: Enhancement of lipoprotein lipase (LPL) activity through drug administration has been shown to increase pre-heparin serum LPL concentrations; however, pre-heparin serum LPL responses to exercise training have not been determined. The present study was undertaken to investigate the effects of 12 weeks of supervised aerobic exercise training on pre-heparin serum LPL concentrations in overweight/obese men., Methods: Fifteen overweight/obese middle-aged men were assigned to one of two 12-week supervised exercise interventions: a walking group (eight participants gradually increasing brisk walking to 60 min/day 3 days a week) or a jogging group (seven participants gradually increasing jogging to 60 min/day 3 days a week). All participants maintained ad libitum diets. Blood samples were collected at baseline and immediately after 12 weeks. The primary outcome was pre-heparin serum LPL., Results: Pre-heparin serum LPL concentrations were increased in the jogging group after 12 weeks compared with the baseline values (mean+/-SEM: 37.6+/-4.7 vs. 51.0+/-6.6 ng/mL, respectively, p= 0.033). In the walking group, pre-heparin serum LPL concentrations remained unchanged after 12 weeks., Conclusions: This study demonstrates that 12 weeks of jogging training increases pre-heparin serum LPL concentrations in overweight/obese middle-aged men.

The effect of habitual exercise on vascular function, including central arterial distensibility and endothelial function, in obese subjects has not yet been clarified. We investigated whether aerobic exercise training affects central arterial distensibility and endothelial function in middle-age overweight and obese men. A total of 21 overweight and obese men (age 50 +/- 2 years, body mass index 30 +/- 1 kg/m(2)) completed a 12-week aerobic exercise intervention. Aerobic exercise training significantly reduced their body weight and resulted in a significant decrease in body mass index. After the weight-reduction exercise program, carotid arterial compliance (determined by simultaneous B-mode ultrasonography and arterial applanation tonometry on the common carotid artery) significantly increased; and the beta-stiffness index, an index of arterial compliance adjusted for distending pressure, significantly decreased. The concentrations of plasma endothelin-1, a potent vasoconstrictor peptide produced by vascular endothelial cells, significantly decreased and plasma nitric oxide (measured as the stable end product [nitrite/nitrate]), a potent vasodilator produced by vascular endothelial cells, significantly increased after the weight-reduction exercise program. In conclusion, weight reduction by aerobic exercise training in overweight and obese men increased the central arterial distensibility. This increase might contribute to the improvement in endothelial function, as assessed by a decrease in endothelin-1 and an increase in nitric oxide, after exercise training-induced weight loss.

The aim of this study was to compare substrate oxidation during aerobic exercise in obese men and postmenopausal obese women. Ten obese men (mean age, 55.4 +/- 2.2 years; body mass index, 27.5 +/- 0.4 kg/m(2); peak oxygen uptake [Vo(2)peak], 44.4 +/- 1.9 mL/kg fat-free mass/min; mean +/- SE] and 10 postmenopausal obese women (mean age, 57.2 +/- 1.2 years; body mass index, 27.9 +/- 0.5 kg/m(2); VO(2)peak, 39.9 +/- 1.3 mL/kg fat-free mass/min) performed a 40-minute bout of cycling exercise at 50% VO(2)peak. Blood samples were collected for assessment of metabolic variables and 17beta-estradiol concentration at baseline and during aerobic exercise. Breath samples were collected to estimate carbohydrate and fat oxidation using a digital computer-based breath-by-breath exercise analysis system during aerobic exercise. Serum 17beta-estradiol concentration was not significantly different between the men and women subjects at baseline (P > .05). Serum free fatty acid concentration tended to be higher in the men than in the women (P = .07) during the exercise, but the respiratory exchange ratio during exercise was lower in women than in men (P < .05). Fat oxidation adjusted for fat-free mass was higher (P < .05) in women than in men. These results suggest that fat utilization was higher during aerobic exercise in postmenopausal obese women than in obese men and did not depend on resting serum 17beta-estradiol concentration.

Aim: To examine the effects of obesity phenotype on abdominal fat responses to regular aerobic exercise., Method: Fifty-seven obese men aged 34-70 years were divided into two groups based on baseline intra-abdominal fat (IF) area measured by computerized tomography: moderate (<200 cm(2)) IF (MIF; n=33, age: 52.9+/-10.6 [SD] yr, body mass index [BMI]: 29.2+/-3.1 kg/m(2)) or high (>or=200 cm(2)) IF (HIF; n=24, age: 53.5+/-9.5 yr, BMI: 30.3+/-3.1 kg/m(2)). The 12-week exercise program consisted primarily of aerobic exercise and met 3 days per week for 90 min per session. Weight, BMI, body composition (by dual-energy X-ray absorptiometry), IF and subcutaneous fat (SF) areas were measured before and after the program., Results: Regular aerobic exercise reduced weight by 2.3+/-2.2 kg in MIF and 3.2+/-3.0 kg in HIF. HIF reduced significantly more IF area than MIF (15.1+/-26.0 cm(2) in MIF and 43.3+/-41.9 cm(2) in HIF), and the difference remained significant after adjusting for baseline fat mass, weight change and total energy intake during the 12-week aerobic exercise., Conclusion: Exercise-induced IF reduction may be remarkably influenced by obesity phenotype.

The present study investigated the effects of acute aerobic exercise on cognitive brain functions of older adults. Twenty-four males (12 older and 12 younger adults) performed a modified flanker task during a baseline session (no exercise) and after light and moderate cycling exercise in counterbalanced order on different days while measures of task performance and the P3 component of an event-related brain potential were collected. The results indicated that, for both age groups, reaction time following moderate exercise was shorter relative to the other sessions, and P3 latencies following both light and moderate exercise were shorter compared with the baseline session. In contrast, P3 amplitude increased only following moderate exercise in younger adults. These findings suggest that light and moderate exercises improve cognitive function across the adult lifespan, although the mechanisms underlying the effects of observed acute aerobic exercise on cognitive function may be age dependent.

The purpose of this study was to evaluate whether strength or recreational activities are a useful addition to aerobic training in patients with chronic obstructive pulmonary disease (COPD). Thirty-three patients with moderate to severe COPD were randomly assigned to 12 weeks of aerobic combined with strength training (AERO+ST) or combined with recreational activities (AERO+RA). The AERO regimen consisted of three weekly 20-min walking exercise sessions; the ST regimen included three series of 10 repetitions of four exercises; and the RA regimen consisted of training using exercise balls to perform smoothly for instrumental activity of daily living. Baseline and after-training measurements of peripheral muscular strength and endurance, cardio respiratory fitness, and 6-min walking distance were obtained, whereas quality of life was assessed with the Short Form 36 questionnaire. Change in grip strength showed a significant difference between the AERO+ST group (8.3+/-6.7%) and the control group (-1.3+/-10.5%), and AERO+RA group (-4.7+/-5.6%) (P<0.05). A significant increase was found in percentage change in peak (.)V(O2) between the AERO+ST group (5.1+/-11.8%) and the control group (-9.2+/-8.6%) (P<0.05). In the health-related quality of life scores, there was a significant difference in mean percentage change in physical functioning between the AERO+ST group (7.9+/-24.4%) and the control group (-14.8+/-19.1%) (P<0.05). A significant difference was found in mean percentage change in social functioning between the AERO+RA group (9.4+/-20.0%) and the control group (-14.9+/-23.2%) (P<0.05). A significant difference in mean percentage change in mental health was also found between the AERO+RA group (12.2+/-12.4%) and the control group (-5.0+/-7.8%) (P<0.05). It is preferable to introduce various forms of exercise that use different muscles involving the whole body, such as recreational activities, as they are an appropriate approach to stimulating physical activity and to improving functional fitness gradually while improving health-related quality of life, though it is necessary to practice exercises for maintenance and improvement in patients with COPD.

Introduction: Few studies have reported the response of high-molecular-weight (HMW) adiponectin to acute aerobic exercise., Purpose: The purpose of this study was to investigate the influence of acute aerobic exercise on HMW adiponectin in healthy men., Methods: Eight healthy men (age, 24.9 +/- 1.8 yr; BMI, 21.9 +/- 0.5 kg x m) participated in this study. They performed two trials. Trial 1 [exercise trial (EX)] consisted of 60-min stationary cycle exercise (50% peak oxygen uptake) followed by 30-min rest. Trial 2 [control trial (CON)] was 90-min rest. Blood samples were drawn to assess hormones (catecholamine and insulin), metabolites (free fatty acid [FFA], glycerol, and glucose), and total and HMW adiponectin concentration., Results: There were significant trial x group interactions in serum FFA and glycerol concentrations (P < 0.05). Serum FFA and glycerol concentrations were higher in EX than in CON (P < 0.05). There were significant trial x group interactions in plasma insulin and glucose concentration (P < 0.05). Plasma insulin and glucose concentrations were lower in EX than in CON (P < 0.05). Total adiponectin, HMW adiponectin concentration, and the ratio of HMW to total adiponectin concentration, however, were unchanged during aerobic exercise and postexercise. Also, those changes did not differ between EX and CON., Conclusion: Our results indicate that total adiponectin and HMW adiponectin concentrations are not regulated by the change of hormones or metabolites during acute moderate-intensity aerobic exercise and postexercise in healthy young men.

Objective: The objective was to test effects of aerobic exercise training on metabolic syndrome (MetSyn) improvement in response to weight reduction., Research Methods and Procedures: A total of 459 overweight and obese women (age, 49 +/- 9 years; BMI, 28 +/- 3 kg/m(2)) were recruited for a baseline examination to test the relationship between cardiorespiratory fitness and metabolic syndrome prevalence; among these, 67 subjects with MetSyn were treated with 14-week weight-loss programs, which included low-calorie diet and aerobic exercise. The MetSyn was defined according to the Examination Committee of Criteria for "Metabolic Syndrome" in Japan. Maximal oxygen uptake (Vo(2max)) during a maximal cycling test was measured as an index of cardiorespiratory fitness at baseline and after the intervention., Results: In the baseline examination, age- and BMI-adjusted odds ratios for MetSyn prevalence in the low, middle, and upper thirds of Vo(2max) were 1.0 (referent), 0.50 (95% confidence interval, 0.26 to 0.95), and 0.39 (95% confidence interval, 0.14 to 0.96), respectively (linear trend, p = 0.02). The adjusted odds ratios for MetSyn improvement in the two interventions with diet alone and diet plus exercise were 1.0 and 3.68 (95% confidence interval, 1.02 to 17.6; p = 0.04), respectively., Discussion: These results suggest that adding aerobic exercise training to a dietary weight-reduction program further improves MetSyn (adjusted odds ratio, 3.68) in obese women, compared with diet alone. Further studies on an association between Vo(2max) change and MetSyn improvement are needed.

Obesity is a risk factor for cardiovascular disease and thromboembolic events. We investigated the effects of weight reduction by a 12-week calorie-restricted diet with or without aerobic exercise (diet group and diet plus exercise group) on leptin and anticoagulation proteins levels. Forty-two obese nondiabetic individuals were evaluated for blood levels of leptin, protein C activity, free protein S antigen and for body fat area calculated on computerized tomography before and after intervention. Before intervention, serum levels of leptin and free protein S antigen correlated positively with several adiposity-related parameters. After the program, body weight and fat area were significantly decreased in both groups. Body mass index and leptin levels decreased in both groups, with a larger change in the diet plus exercise group than in the diet group. Although protein C activity levels did not change in both groups, free protein S antigen levels decreased significantly in the diet plus exercise group. In conclusion, the 12-week programs had significant effects on the initial weight reduction and body fat mass, decreasing lepin levels in obese nondiabetic individuals. To clarify whether aerobic exercise has additional or direct effects on the anticoagulation system, a study in a large number of individuals is needed.

This study evaluated the effects of exercise frequency on functional fitness in older women participating in a 12-week exercise program. Participants (67.8+/-4.6 years) were divided into three different exercise groups (I, II, and III; n=34) and a control group (Group C; n=11). Group I participated in a 90-min exercise program once a week, for 12 weeks, while Group II attended it twice a week, and Group III attended three times a week. The exercise program consisted of a 10-min warm-up, 20 min of walking, 30 min of recreational activities, 20 min of resistance training, and a 10-min cool-down. The following items were measured before and after the program: muscular strength, muscular endurance, dynamic balance, coordination, and cardiorespiratory fitness (6-min walking distance). Comparisons of baseline and post-intervention measures showed significantly greater improvements in body weight, coordination, and cardiorespiratory fitness for Group III compared to the other groups (p<0.05). In addition, the greatest improvements in body fat, muscular endurance, and dynamic balance were also observed in Group III (p<0.05). However, no significant differences were found in muscular strength. Older women who participate in an exercise program three times a week gain greater functional fitness benefits than those who exercise less frequently. In order to improve functional fitness in older women, an exercise frequency of at least three times each week should be recommended.

Objective: Moderate to high intensity exercise training is known to ameliorate the coronary risk factors in relation to an improvement in body composition. However, the benefit of low-intensity and low-volume training for these risk factors remains unclear in elderly people. Therefore, we investigated the effects of low-intensity and low-volume exercise training on blood lipid values and insulin resistance in the elderly., Methods: A total of 56 healthy elderly individuals (42 females and 14 males) aged 64+/-6 years participated in a 12-week exercise program, comprising aerobic training and resistance training., Results: After the program, there were no significant changes in high-density lipoprotein cholesterol, triglyceride serum levels, or in peak oxygen uptake on average. However, the homeostasis of minimal assessment of insulin resistance (HOMA-IR) value was significantly reduced by 21%. The participants were categorized into tertiles based on initial Body Mass Index (BMI). The Middle-BMI group (non-obese subjects) showed reduced HOMA-IR (2.0-->1.3, P<0.01), but this reduction was not associated with the reduction in BMI (r=0.08, P=0.74), whereas the two reductions were significantly associated in the High-BMI group (r=0.61, P=0.01)., Conclusion: Even low-intensity and low-volume exercise training, which would ordinarily be insufficient for improving mean lipid values or aerobic fitness, was found to be effective in improving insulin resistance in the elderly. The improvement in insulin resistance was independent of the improvement in obesity.

Objective: We aimed to evaluate the effect of a community-based health educational program for overweight or obesity persons, as the Kokuho Health-up model Program in Kyowa area of Chikusei-shi., Methods: The subjects were men and women aged 35 to 60 years who participated in annual health check-ups from 1998 to 2003 and were living in Chikusei-shi (Former Kyowa town) Ibaraki prefecture, had a body mass index > or = 25.0 kg/m2 at baseline, and agreed to a 6-month intervention. The participants were divided into 59 persons for the intense intervention group (health checkups, dietary advice, monthly individual health education, and exercise in sports facilities three times/ week), 62 persons for the moderate intervention group (health checkups, dietary advice, monthly individual health education, and exercise in sports facilities or at home once/week), and 34 persons for the control group (only health checkups). Criteria for the metabolic syndrome were those published by the Japanese 8 committee., Result: During the 6-month intervention, the follow-up rate was 86%. At the baseline, there were no differences in physical status or lifestyles among the intervention and control groups. The frequency of use of sports facilities was 6.4 times/month for the intense intervention group and 1.9 times/month for the moderate intervention group. Mean body weight did not change in the control group (70.6 kg to 70.9 kg, P = 0.84) but decreased in the intense intervention group (71.4 kg to 69.5 kg, P < 0.001) and moderate intervention group (69.5 kg to 66.7 kg, P < 0.001). Mean abdominal circumference increased in the control group (91.0 cm to 93.9 cm, P = 0.001) but did not change in intense intervention group (90.1 cm to 90.0 cm, P = 0.29) or moderate intervention group (90.4 cm to 88.7 cm, P = 0.39). The prevalence of metabolic syndrome increased in the control group (18.2% to 40.0%, P = 0.01) but did not change in either of the intervention groups., Conclusions: We found a significant reduction of body weight and an attenuation of the increase of metabolic syndrome in both intensive and moderate intervention groups. The present community-based educational program may be effective for health promotion with overweight or obese middle-aged adults.

Objective: Previous studies have shown that glucose effectiveness and insulin sensitivity are acutely enhanced by exercise at various intensities. The aim of this study was to determine the effects of a single bout of exercise at intensities recommended by the American Diabetes Association (ADA) and the American College of Sports Medicine (ACSM) on glucose uptake-specific glucose effectiveness (S(G)(2)*) and insulin sensitivity (S(I)(2)*). S(G)(2)* and S(I)(2)* were estimated by a two-compartment minimal model., Design: Six healthy men (age, 28.5 +/- 2.0 yr) performed a stable-labeled frequently sampled iv glucose tolerance test (FSIGT) under three separate conditions: without any prior exercise, and immediately after single 20-min bouts of cycle ergometer exercise at an intensity of 50% and 70% of maximal oxygen uptake (Vo(2max)). The exercise intensities were close to the lower and upper boundaries recommended by the ADA and ACSM., Results: Glucose disappearance constant (K(G)), S(G)(2)*, and S(I)(2)* increased after exercise in an intensity-dependent manner. Increases in S(G)(2)* (+237.1 +/- 50.5%), S(I)(2)* (+225.6 +/- 51.9%), and K(G) (+151.7 +/- 16.5%) following exercise at 70% Vo(2max) were statistically significant (P < 0.05), whereas those at 50% Vo(2max) were not., Conclusions: In conclusion, a single bout of exercise acutely improves S(I)(2)* and S(G)(2)* in individuals with normal glucose tolerance in an intensity-dependent manner.

Background and Aims: The purpose of this study was to compare the effects of exercise habituation (3-32 years, mean 13.2 years) on physical vitality among five different groups., Methods: One hundred and two independent, community-dwelling elderly Japanese men, aged 64.6 +/- 6.6 years, were recruited as subjects. The vital age test battery consisted of various coronary heart disease risk factors and physical fitness elements., Results: The results of analysis of variance revealed that vital age as an index of physical vitality was youngest in joggers (47.9 yr, N=18), intermediate in trekkers (55.8 yr, N=20) and walkers (59.1 yr, N=18), and oldest (69.6 yr, N=20) in patients with ischemic heart disease (IHD). The difference between chronological age and vital age was approximately 15 years (p<0.05) in joggers, and 8 years (p<0.05) in trekkers and walkers. The vital age of sedentary persons (N=26) was only 1.9 years (NS) younger than their chronological age, which was similar to the difference (vital age of 64.1 +/- 8.5 yr vs chronological age of 65.7 +/- 5.4 yr) previously observed in similarly aged exercising IHD patients., Conclusions: These results indicate that exercise habituation significantly affects the overall health status of most individuals, irrespective of mode of exercise. Among the three modes of exercise, jogging may be most beneficial. Furthermore, regularly exercising coronary patients may have physical vitality similar to that of sedentary men.

Objective: To determine whether "low-intensity" exercise (walking) and "high-intensity" exercise (aerobic dance), when added to a weight loss diet, have different effects on coronary heart disease (CHD) risk factors and physical fitness., Research Methods and Procedures: Ninety obese women were divided into diet only (DO), diet plus walking (DW), and diet plus aerobic dance (DA) groups. DXA was used to evaluate segmental body composition. Leg-extension strength and maximal oxygen uptake (VO2max) were the indicators of physical fitness. Blood pressure, lipoproteins, and fasting glucose were used as indices for CHD risk factors. These items were measured before and after a 14-week intervention period., Results: Whole-body plus all segmental fat masses were significantly reduced (p < 0.001). Reductions in whole-body and lower-limb fat- and bone-free masses were significantly less (p < 0.01) in the DA group (-1.5 and -0.1 kg, respectively) compared with the DO (-2.1 and -0.4 kg, respectively) and DW (-2.5 and -0.5 kg, respectively) groups. Improvements in leg-extension strength and VO2max were significantly greater (p < 0.05) in the DA group compared with the DO group. The CHD risk factors clearly improved (p < 0.05) within each group. Reductions in low density lipoprotein-cholesterol and fasting glucose were significantly greater (p < 0.05) in the DA group compared with the DO and DW groups., Discussion: Adding higher intensity aerobic dance to a weight-loss diet program may help maintain fat- and bone-free mass and may be more effective in improving CHD risk factors compared with low-intensity walking.

Objective: to determine the effect of dance-based aerobic exercise on indices of falling in older women., Design: an exercise intervention trial with participants assigned either to an exercise group or to a control group., Setting: an exercise hall at a community centre for senior citizens., Participants: thirty-eight healthy women aged 72-87 years, living independently in the community., Intervention: twenty women performed dance-based aerobic exercise for 60 minutes, 3 days a week, for 12 weeks. The exercise included single-leg standing, squatting, marching, and heel touching; and targeted balance, strength, locomotion/agility, and motor processing., Main Outcome Measures: single-leg balance with eyes open/closed and functional reach as balance, hand-grip strength and keeping a half-squat position as strength, walking time around two cones and 3-minute walking distance as locomotion/agility, and hand-reaction time and foot tapping as motor processing., Results: at the pre-test, both exercise and control groups performed similarly in all tests. At the end of the intervention, the exercise group showed significantly greater single-leg balance with eyes closed, functional reach, and walking time around two cones. In contrast, there were no significant improvements in any of the test measures in the control group., Conclusions: dance-based aerobic exercise specifically designed for older women may improve selected components of balance and locomotion/agility, thereby attenuating risks of falling.

Although many investigations have been conducted to determine the effects of exercise and/or diet prescription, seasonal variations in weight loss have not been thoroughly investigated in Japan. The present investigation was undertaken to determine seasonal variations in body composition and anthropometric characteristics during a weight-loss program. One hundred and twenty-seven women [mean (SD) age 44.3 (11.7) years] participated in this study. The subjects were categorized into four groups based on the season in which the weight-loss program was begun: subjects who joined our exercise program in winter (group WE), subjects who joined in summer (group SE), and two control groups, one for winter and one for summer (group WC and group SC, respectively). The subjects of groups WE and SE completed a 3-month exercise and food-restriction program. Analyses of covariance revealed that the subjects of group WE seemed to have attained more desirable changes. This group showed a decrease in body mass (-1.9 (1.5) kg) and percent body fat (-4.6 (4.8)%), while an increase in fat-free mass (1.6 (3.2) kg) during the experimental period. Our data suggest that the better season for desirable weight loss in Japan is winter, compared to summer. These alterations may be attributable, at least in part, to the fact that Japanese people are generally acclimatized to a cold climate in this season. The mechanisms involved in our speculation have not been well validated, but it seems clear that a significant difference in dietary intake might have affected the results of this study.

This study investigated the association of exercise and dietary habits with defecatory dysfunction in patients living with colorectal cancer. We recruited 61 adult patients who had undergone surgery within the past 20 years and attended outpatient clinics at designated cancer hospitals in Japan. Defecatory dysfunction was defined as any symptom caused by issues with colon and anal function, including fecal incontinence, evacuation difficulties, frequent stools, diarrhea, and constipation. Exercise and dietary habits were assessed via a quantitative questionnaire survey. Postoperative defecatory dysfunction occurred in all the patients. Multivariate analysis revealed no association between exercise habits and defecatory dysfunction; however, dietary fiber intake ≥4 times a week was associated with frequent stools (adjusted odds ratio, 5.11; 95% confidence interval, 1.10, 23.70). These findings suggest a need to alleviate defecatory dysfunction by improving one's dietary habits. Interventions aimed at alleviating defecatory dysfunction by improving the dietary habits in patients living with colorectal cancer are needed. [ABSTRACT FROM AUTHOR]

This pilot qualitative study aimed to investigate exercise habits and assess defecatory dysfunction among adult survivors of rectal cancer with and without stomas. Patients were eligible for the study if they had stage I–IV rectal cancer, and less than 5 years had elapsed since surgery. We conducted semi-structured interviews with outpatients visiting two general hospitals in Japan and inquired about their diets, defecation, and exercise habits. The interview data were transcribed verbatim, interpreted, and abstracted to generate coding units; we divided the responses into categories and subcategories. Eleven patients had stomas inserted after surgery while six did not. Content analysis identified four categories common to patients with and without stomas: [diet control], [coping with defecation dysfunction], [compromising with defecation dysfunctions], and [maintenance of exercise habits]. Our results suggest the need for intervening among rectal cancer survivors to address eating habits to alleviate defecation dysfunction and exercise habits to maintain physical function. In clinical practice, symptom relief and exercise instruction may improve the well-being of cancer survivors with bowel dysfunction. [ABSTRACT FROM AUTHOR]

This review examines the influences of physiological aging processes on connective tissue, joint integrity, flexibility (range of motion [ROM]), and physical functions of older adults. Studies that attempted to improve older adults' ROM are also critiqued. Multiple mechanisms of musculoskeletal and soft-tissue degeneration, as well as disease processes (osteoporosis, arthritis, atherosclerosis), contribute to significant decreases in neuromuscular function and ROM in older adults, all of which can be exacerbated by disuse influences. No delineation of disuse effects on the rate of aging-related decrements in ROM can be provided, however, because long-term investigations (with physical activity controls) have not been conducted. Research efforts have documented both upper and lower extremity decrements in ROM with development of physical impairments, reductions in basic and instrumental activities of daily living, and progression of disability. There is limited research evidence that either specialized stretch-training or general-exercise intervention protocols moderately improve ROM in older adults and the frail elderly. [ABSTRACT FROM AUTHOR]

Background: Family support can help older adults better adhere to exercise routine, but it remains unclear whether an exercise program targeting older married couples would have stronger effects on exercise adherence than would a program for individuals. The purpose of this study was to determine the effects of an exercise program on the exercise adherence of older married couples over a 24-week follow-up period.Methods: Thirty-four older married couples and 59 older adults participated in this study as couple and non-couple groups (CG and NCG, respectively). All participants attended an 8-week supervised program (once a week and a home-based exercise program comprising walking and strength exercises) and then participated in a follow-up measurement (24 weeks after post-intervention measurement). Exercise adherence was prospectively measured via an exercise habituation diary during the follow-up period-specifically, we asked them to record practice rates for walking (≥2 days/week) and strength exercises (≥6 items for 2 days/week). A multivariate logistic regression analysis was conducted to obtain the CG's odds ratios (ORs) and 95% confidence intervals (CIs) for adherence to walking and strength exercise adjusted for potential confounders (with NCG as the reference).Results: Although the adherence rate of walking exercise in the CG was significantly higher than that in the NCG (29.2%; P < 0.001), there was no significant difference in the adherence rate of strength exercise between the two groups (P = 0.199). The multivariate logistic regression analysis showed that CG had significantly higher odds of adherence to walking exercise compared with the NCG (3.68 [1.57-8.60]). However, the odds of adherence to strength exercise did not significantly differ between the two groups (1.30 [0.52-3.26]).Conclusions: These results suggest that an exercise program targeting older married couples may be a useful strategy for maintaining walking adherence, even six months after the supervised program has ceased. A blinded randomized controlled trial will be needed to confirm this conclusion.Trial Registration: Retrospectively registered. UMIN Clinical Trials Registry (Registered: 02/11/16) UMIN000024689 . [ABSTRACT FROM AUTHOR]