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Introduction: The Studies Targeting Risk Reduction Interventions through Defined Exercise (STRRIDE) Reunion assessed changes in cardiometabolic health 10 years after study participation. We investigated whether previous supervised exercise interventions affected the maintenance of cardiorespiratory fitness (CRF) parameters [VO2peakand VO2 at anaerobic threshold (AT)] over time; and whether intensity of exercise contributed to any group differences. Methods: CRF was measured via gas exchange during graded maximal exercise testing at baseline, post-intervention, and reunion. Participants (n=49) were originally randomized to either moderate (14 kcal/kg/wk at 40-55% VO2peak) or vigorous intensity exercise (14-21 kcal/kg/wk at 65-80% VO2peak) for eight months. Change scores were calculated as the reunion value minus the baseline value, thus reflecting the original study-related outcomes plus those persisting over the following 10 years (legacy effect). Results: Over the 10-year period, the moderate intensity group experienced significant decreases of 3.8 ± 3.4 mL/kg/min (p<0.01) and 1.7 ± 2.4 mL/kg/min (p<0.05) for VO2peak and AT, respectively. For the vigorous intensity group, reunion VO2peakand AT were not significantly different from baseline (p>0.05). Although not statistically significant between groups, the vigorous intensity participants experienced approximately one-third of the decrement in VO2peak and AT over time compared to the moderate intensity participants. Conclusions: Participants exhibited group-specific differences consistent with an exercise intensity-based legacy effect on measures of CRF 10 years after completing an 8-month exercise intervention. These results suggest that short-term exercise training can provide long-term cardiorespiratory benefits, with vigorous intensity exercise tending to have greater effects on the attenuation of the age-related decline in CRF parameters. [ABSTRACT FROM AUTHOR]

Purpose: To examine the cross-sectional association between cardiorespiratory fitness (CRF) and ideal cardiovascular health (CVH) in middle-aged adults. Methods: The association between CRF and ideal CVH score was examined in 11,590 adults (8,865 men, 2,725 women) from the Aerobics Center Longitudinal Study. CRF was measured as duration in minutes from a maximal treadmill test. The AHA's ideal CVH score was calculated on a 14 point scale using data on smoking status, BMI, physical activity (MET-min/wk), healthy diet, total cholesterol, blood pressure, and fasting plasma glucose recorded between 1987 and 1999. Participants were grouped into categories of inadequate (0-4), average (5-9), and optimum (10-14) based on their CVH score. Three CRF groups were created from age- and sex-specific quintiles based on the previously established cutpoints of treadmill time: low, moderate, and high CRF. We used general linear and logistic regression models adjusted for age, sex, and year of examination to evaluate the association of CRF with ideal CVH score. Results: The mean CVH score for men was 8.4 ± 2.2 and 9.7 ± 2.0 for women. Approximately 33% of men and 57% of women had optimum CVH, while only a small proportion of participants had inadequate CVH (5.1% M, 1.4% F). Treadmill time was moderately correlated (p<0.0001) with CVH score in both men (r=0.56) and women (r=0.50). CRF explained 16% and sex 18% of the variance in CVH score (both p<0.0001). Our adjusted model found that participants in the optimum CVH category had 20% and 43% higher CRF levels than those in the average and inadequate CVH groups (p<0.0001), respectively (Figure 1). The adjusted odds (95% CI) of having optimum CVH were 14.0 (11.0-17.8) and 3.1 (2.4-4.0) times greater for high CRF and moderate CRF, respectively, compared to low CRF (p<0.0001). Discussion: Higher levels of cardiorespiratory fitness are associated with better cardiovascular health profiles in both men and women. Thus, improving fitness represents a strategy to improve cardiovascular and public health. [ABSTRACT FROM AUTHOR]

Purpose: To determine if race and sex differences exist in determinants and timing of dropout among individuals enrolled in an exercise and/or caloric restriction intervention., Methods: A total of 947 adults with dyslipidemia (STRRIDE I, STRRIDE AT/RT) or prediabetes (STRRIDE-PD) were randomized to either inactive control or to 1 of 10 exercise interventions, ranging from doses of 8-23 kcal/kg/week, intensities of 50%-75% V ˙ O 2 peak, and durations of 6-8 months. Two groups included resistance training, and one included a dietary intervention (7% weight loss goal). Dropout was defined as an individual withdrawn from the study, with the reasons for dropout aggregated into determinant categories. Timing of dropout was defined as the last session attended and aggregated into phases (i.e., "ramp" period to allow gradual adaptation to exercise prescription). Utilizing descriptive statistics, percentages were generated according to categories of determinants and timing of dropout to describe the proportion of individuals who fell within each category., Results: Black men and women were more likely to be lost to follow-up (Black men: 31.3% and Black women: 19.6%), or dropout due to work responsibilities (15.6% and 12.5%), "change of mind" (12.5% and 8.9%), transportation issues (6.3% and 3.6%), or reported lack of motivation (6.3% and 3.6%). Women in general noted lack of time more often than men as a reason for dropout (White women: 22.4% and Black women: 22.1%). Regardless of race and sex, most participants dropped out during the ramp period of the exercise intervention; with Black women (50%) and White men (37.1%) having the highest dropout rate during this period., Conclusion: These findings emphasize the importance of targeted retention strategies when aiming to address race and sex differences that exist in determinants and timing of dropout among individuals enrolled in an exercise and/or caloric restriction intervention., Competing Interests: JMJ is on the Scientific Advisory Board for Wondr Health, Inc.; he is a consultant for Education Initiatives, Inc.; and he is the principal investigator for a research contract provided to the University of Kansas Medical Center by Epitomee Medical, Inc. RQW is on the Scientific Advisory Board for Wondr Health, Inc.; she is a Consultant for Fullfill, Inc.; she is the principal investigatory for a contract between Meharry Medical College and Vanderbilt University Medical Center; and she is the principal investigator for a contract between Coalition for Better Health and Vanderbilt University Medical Center. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Collins, Huffman, Wolever, Smith, Siegler, Ross, Jakicic, Costa and Kraus.)