Glenn A. Gaesser

ACSM Position Stand: The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults

SUMMARYACSM Position Stand on The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Adults. Med. Sci. Sports Exerc., Vol. 30, No. 6, pp. 975-991, 1998. The combination of frequency, intensity, and duration of chr

Effect of exercise training intensity on abdominal visceral fat and body composition

UNLABELLED The metabolic syndrome is a complex clustering of metabolic defects associated with physical inactivity, abdominal adiposity, and aging. PURPOSE To examine the effects of exercise training intensity on abdominal visceral fat (AVF) and body composition in obese women with the metabolic syndrome. METHODS Twenty-seven middle-aged obese women (mean +/- SD; age = 51 +/- 9 yr and body mass index = 34 +/- 6 kg x m(-2)) with the metabolic syndrome completed one of three 16-wk aerobic exercise interventions: (i) no-exercise training (Control): seven participants maintained their existing levels of physical activity; (ii) low-intensity exercise training (LIET): 11 participants exercised 5 d x wk(-1) at an intensity < or = lactate threshold (LT); and (iii) high-intensity exercise training (HIET): nine participants exercised 3 d x wk(-1) at an intensity > LT and 2 d x wk(-1) < or = LT. Exercise time was adjusted to maintain caloric expenditure (400 kcal per session). Single-slice computed tomography scans obtained at the L4-L5 disc space and midthigh were used to determine abdominal fat and thigh muscle cross-sectional areas. Percent body fat was assessed by air displacement plethysmography. RESULTS HIET significantly reduced total abdominal fat (P < 0.001), abdominal subcutaneous fat (P = 0.034), and AVF (P = 0.010). There were no significant changes observed in any of these parameters within the Control or the LIET conditions. CONCLUSIONS The present data indicate that body composition changes are affected by the intensity of exercise training with HIET more effectively for reducing total abdominal fat, subcutaneous abdominal fat, and AVF in obese women with the metabolic syndrome.

The validity of regulating blood lactate concentration during running by ratings of perceived exertion

We examined whether ratings of perceived exertion (RPE) observed during an incremental (response) protocol could be used to produce target blood [HLa] of 2.5 mM and 4.0 mM during a 30-min treadmill run at a constant RPE. RPE (15.3, 17.6, 19.1), oxygen uptake (VO2) (3.31, 3.96, 4.00 l.min-1), velocity (V) (198, 218, 223 m.min-1), and heart rate (HR) (179, 185, 190 bpm) at blood [HLa] of 2.5 mM and 4.0 mM, and peak were determined for nine subjects (5 males, 4 females) during incremental exercise. Subjects then completed two 30-min runs at the RPE corresponding to blood [HLa] of 2.5 mM (RPE 2.5 mM) and 4.0 mM (RPE 4.0 mM) measured during the incremental protocol. For both 30-min runs, VO2 was not different from VO2 corresponding to either 2.5 or 4.0 mM blood [HLa] during the incremental test. During the 30-min run at RPE 2.5 mM: (a) only during minutes 25-30 was the blood [HLa] significantly different than 2.5 mM (3.2 +/- 0.6 mM, P < 0.05), (b) for the first 20 min HR was significantly lower than the HR at 2.5 mM during the incremental protocol, and (c) V did not differ from V at 2.5 mM during the incremental protocol. During the 30-min run at RPE 4.0 mM: (a) blood [HLa] was not significantly different from 4.0 mM, (b) HR at every time point was significantly lower than HR 4.0 mM during the incremental protocol, and (c) V was decreased over time by an average of 24.6 m.min-1 (P < 0.05). Because RPE from the response protocol was able to produce a blood [HLa] close to the criterion value during each 30-min run, we conclude that RPE is a valid tool for prescribing exercise intensities corresponding to blood [HLa] of 2.5 mM and 4.0 mM.

Thinness and weight loss : beneficial or detrimental to longevity?

This review examined the hypotheses that 1) low body mass index (BMI) is optimal for longevity and 2) weight loss reduces mortality rates. The preponderance of epidemiological evidence fails to support either of these hypotheses. Indeed, a number of studies show that thinness and weight loss (regardless of initial BMI) are associated with increased mortality rates. These findings cannot be attributed to smoking status or to weight loss resulting from subclinical disease. The effect of intentional weight loss on mortality rates depends upon health status. For overweight individuals in good health, there is no compelling evidence to show that mortality rates are reduced with weight loss. Even among overweight persons with one or more obesity-related health conditions, specific weight loss recommendations may be unnecessary: 1) the reduction in mortality rate associated with intentional weight loss is independent of the amount of weight loss, 2) the reductions in all-cause mortality rate associated with increased physical activity and fitness (23-44%), independent of changes in body weight, are greater than that reported for intentional weight loss (approximately 20%), and 3) many obesity-related health conditions (e.g., hypertension, dyslipidemias, insulin resistance, glucose intolerance) can be ameliorated independently of weight loss. In view of the potential risks associated with weight loss and weight cycling, it is suggested that public health may be better served by placing greater emphasis on lifestyle changes and less attention to weight loss per se.

Rating of perceived exertion and blood lactate concentration during submaximal running

We examined whether the relation between of ratings of perceived exertion (RPE) and exercise intensities associated with the lactate threshold (LT) and blood lactate concentrations (BLC) of 2.5 and 4.0 mM, established with an incremental protocol, held during 30-min treadmill run at constant velocity (V). RPE (11.6, 14.9, 16.8, 18.9), oxygen uptake (VO2) (3.2, 3.7, 3.9, 4.2 l.min-1), and V (168, 196, 215, 227 m.min-1) at LT, BLC of 2.5, and 4.0 mM and peak were determined for nine males during incremental exercise. Subjects then completed three 30-min runs at the V associated with LT and BLC of 2.5 and 4.0 mM, with RPE, VO2, and blood [HLa] determined every 5 min. After min 10 during the 30-min runs, RPE, VO2, and BLC were not significantly different from corresponding values observed during the incremental protocol. Regression equations predicting BLC from RPE were generated from results obtained during the incremental protocol. RPE values from the 30-min runs were used to predict BLC, and the measured BLC was used to validate the use of RPE as a predictor of BLC. Correlations ranged from r = 0.79 to r = 0.98 [total error (TE) ranged from 0.6-1.3 mM]. We conclude that RPE is a physiologically valid tool for prescribing exercise intensity when the intent is to use LT and/or BLC as the intensity criterion.

NIH ImageJ and Slice‐O‐Matic Computed Tomography Imaging Software to Quantify Soft Tissue

Objective: To compare reliability and limits of agreement of soft tissue cross‐sectional areas obtained using Slice‐O‐Matic and NIH ImageJ medical imaging software packages.

Exercise training decreases the growth hormone (GH) response to acute constant-load exercise

To assess the influence of exercise training on the growth hormone (GH) response to acute exercise, six untrained males completed a 20-min, high-intensity, constant-load exercise test prior to and after 3 and 6 wk of training (the absolute power output (PO) during each test remained constant x PO = 182.5 +/- 29.5 W). Training increased (pre- vs post-training) oxygen uptake (VO2) at lactate threshold (1.57 +/- 0.33 L.min-1 vs 1.97 +/- 0.24 L.min-1 P < or = 0.05). VO2 at 2.5 mM blood lactate concentration ([HLa]) (1.83 +/- 0.38 L.min-1 vs 2.33 +/- 0.38 L.min-1, P < or = 0.05), and VO2peak (3.15 +/- 0.54 L.min-1 vs 3.41 +/- 0.47 L.min-1, P < or = 0.05). Power output at the lactate threshold (PO-LT) increased with training from 103 +/- 28 to 132 +/- 23W (P < or = 0.05). Integrated GH concentration (20 min exercise + 45 min recovery) (microgram.L-1 x min) after 3 wk (138 +/- 106) and 6 wk (130 +/- 145) were significantly lower (P < or = 0.05) than pre-training (238 +/- 145). Plasma epinephrine and norepinephrine responses to training were similar to the GH response (EPI-pre-training = 2447 +/- 1110; week 3 = 1046 +/- 144; week 6 = 955 +/- 322 pmol.L-1; P < or = 0.05; NE pre-training = 23.0 +/- 5.2; week 3 = 13.4 +/- 4.8; week 6 = 12.1 +/- 6.8 nmol.L-1; P < or = 0.05). These data indicate that the GH and catecholamine response to a constant-load exercise stimulus are reduced within the first 3 wk of exercise training and support the hypothesis that a critical threshold of exercise intensity must be reached to stimulate GH release.

High-intensity interval training vs. moderate-intensity continuous exercise training in heart failure with preserved ejection fraction: a pilot study.

Heart failure with preserved ejection fraction (HFpEF) is a major cause of morbidity and mortality. Exercise training is an established adjuvant therapy in heart failure; however, the effects of high-intensity interval training (HIIT) in HFpEF are unknown. We compared the effects of HIIT vs. moderate-intensity aerobic continuous training (MI-ACT) on peak oxygen uptake (V̇o₂peak), left ventricular diastolic dysfunction, and endothelial function in patients with HFpEF. Nineteen patients with HFpEF (age 70 ± 8.3 yr) were randomized to either HIIT (4 × 4 min at 85-90% peak heart rate, with 3 min active recovery) or MI-ACT (30 min at 70% peak heart rate). Fifteen patients completed exercise training (HIIT: n = 9; MI-ACT: n = 6). Patients trained 3 days/wk for 4 wk. Before and after training patients underwent a treadmill test for V̇o₂peak determination, 2D-echocardiography for assessment of left ventricular diastolic dysfunction, and brachial artery flow-mediated dilation (FMD) for assessment of endothelial function. HIIT improved V̇o₂peak (pre = 19.2 ± 5.2 ml·kg(-1)·min(-1); post = 21.0 ± 5.2 ml·kg(-1)·min(-1); P = 0.04) and left ventricular diastolic dysfunction grade (pre = 2.1 ± 0.3; post = 1.3 ± 0.7; P = 0.02), but FMD was unchanged (pre = 6.9 ± 3.7%; post = 7.0 ± 4.2%). No changes were observed following MI-ACT. A trend for reduced left atrial volume index was observed following HIIT compared with MI-ACT (-3.3 ± 6.6 vs. +5.8 ± 10.7 ml/m(2); P = 0.06). In HFpEF patients 4 wk of HIIT significantly improved V̇o₂peak and left ventricular diastolic dysfunction. HIIT may provide a more robust stimulus than MI-ACT for early exercise training adaptations in HFpEF.

Exercise and Diet, Independent of Weight Loss, Improve Cardiometabolic Risk Profile in Overweight and Obese Individuals

Abstract Diet and/or exercise are routinely advised as methods for weight loss in overweight/obese individuals, particularly those who are at high risk for cardiovascular disease and type 2 diabetes mellitus. However, physical activity and structured exercise programs rarely result in significant loss of body weight or body fat, and weight-loss diets have extraordinarily high recidivism rates. Despite only modest effects on body weight, exercise and ad libitum nutrient-dense diets for overweight/obese individuals have many health benefits, including skeletal muscle adaptations that improve fat and glucose metabolism, and insulin action; enhance endothelial function; have favorable changes in blood lipids, lipoproteins, and hemostatic factors; and reduce blood pressure, postprandial lipemia and glycemia, and proinflammatory markers. These lifestyle-induced adaptations occur independently of changes in body weight or body fat. Thus, overweight/obese men and women who are at increased risk for cardiovascular disease and type 2 diabetes as a result of sedentary lifestyle, poor diet, and excess body weight should be encouraged to engage in regular physical activity and improve their diet, regardless of whether the healthier lifestyle leads to weight loss.

Assessment of the Aerosport TEEM 100 portable metabolic measurement system.

The present study evaluated the utility of a portable metabolic measurement system, the Aerosport TEEM 100. A total of 505 data points [242 from incremental (INC) and 263 from constant load (CL) exercise] were collected on 12 subjects (age = 25 +/- 4 yr), by placing the Aerosport TEEM 100 medium flow pneumotach and mouthpiece in-line with a validated system, the Rayfield system. When VO2 values were separated into categories (< 1.5, 1.5-2.0, 2.0-2.5, 2.5-3.0, > 3.0 l.min-1), there was a small but statistically significant difference between the two metabolic measurement systems for VO2, VCO2, VE, RER, %ECO2, and %EO2 during both INC and CL exercise and measurement error for VO2 ranged between 2% and 11%. Correlations for VO2 values during INC and CL exercise between the two systems were r = 0.95 (SEest +/- 0.18 l.min-1) and r = 0.96 (SEest +/- 0.29 l.min-1), respectively. Correlations for RER were r = 0.82 (SEest +/- 0.08) and r = 0.47 (SEest +/- 0.11), for INC and CL, respectively. Results from the present investigation indicate that the Aerosport TEEM 100 has utility for the assessment of VO2, but the estimation of carbohydrate and fat utilization from RER should be used with caution.