We sought to explore the utility of the verification trial to confirm individual attainment of 'true' VO2max in altitude-residing, endurance-trained runners during treadmill exercise. 24 elite endurance-trained men and women runners (age=21.5±3.3 yr, ht=174.8±9.3 cm, body mass=60.5±6.7 kg, PR 800 m 127.5±13.1 s) completed a graded exercise test (GXT) trial (VO2max=60.0±5.8 mL·kg(-1)·min(-1)), and returned 20 min after incremental exercise to complete a verification trial (VO2max=59.6±5.7 mL·kg(-1)·min(-1)) of constant load, supramaximal exercise. The incidence of 'true' VO2max confirmation using the verification trial was 24/24 (100%) with all participants revealing differences in VO2max≤3% (the technical error of our equipment) between the GXT and verification trials. These findings support use of the verification trial to confirm VO2max attainment in altitude-residing, endurance-trained runners.
BackgroundLower habitual physical activity and poor cardiorespiratory fitness are common features of the metabolically abnormal obese (MAO) phenotype that contribute to increased cardiovascular disease risk. The aims of the present study were to determine 1) whether community-based exercise training transitions MAO adults to metabolically healthy, and 2) whether the odds of transition to metabolically healthy were larger for obese individuals who performed higher volumes of exercise and/or experienced greater increases in fitness.Methods and resultsMetabolic syndrome components were measured in 332 adults (190 women, 142 men) before and after a supervised 14-week community-based exercise program designed to reduce cardiometabolic risk factors. Obese (body mass index ≥30 kg · m2) adults with two to four metabolic syndrome components were classified as MAO, whereas those with no or one component were classified as metabolically healthy but obese (MHO). After community exercise, 27/68 (40%) MAO individuals (P<0.05) transitioned to metabolically healthy, increasing the total number of MHO persons by 73% (from 37 to 64). Compared with the lowest quartiles of relative energy expenditure and change in fitness, participants in the highest quartiles were 11.6 (95% confidence interval: 2.1–65.4; P<0.05) and 7.5 (95% confidence interval: 1.5–37.5; P<0.05) times more likely to transition from MAO to MHO, respectively.ConclusionCommunity-based exercise transitions MAO adults to metabolically healthy. MAO adults who engaged in higher volumes of exercise and experienced the greatest increase in fitness were significantly more likely to become metabolically healthy. Community exercise may be an effective model for primary prevention of cardiovascular disease.
BackgroundThe purpose of this study was to determine the prevalence of individuals who experienced exercise-induced adverse cardiometabolic response (ACR), following an evidence-based, individualized, community exercise program.MethodsPrevalence of ACR was retrospectively analyzed in 332 adults (190 women, 142 men) before and after a 14-week supervised community exercise program. ACR included an exercise training-induced increase in systolic blood pressure of ≥10 mmHg, increase in plasma triglycerides (TG) of >37.0 mg/dL (≥0.42 mmol/L), or decrease in high-density lipoprotein cholesterol (HDL-C) of >4.0 mg/dL (0.12 mmol/L). A second category of ACR was also defined – this was ACR that resulted in a metabolic syndrome component (ACR-risk) as a consequence of the adverse response.ResultsAccording to the above criteria, prevalence of ACR between baseline and post-program was systolic blood pressure (6.0%), TG (3.6%), and HDL-C (5.1%). The prevalence of ACR-risk was elevated TG (3.2%), impaired fasting blood glucose (2.7%), low HDL-C (2.2%), elevated waist circumference (1.3%), and elevated blood pressure (0.6%).ConclusionEvidence-based practice exercise programming may attenuate the prevalence of exercise training-induced ACR. Our findings provide important preliminary evidence needed for the vision of exercise prescription as a personalized form of preventative medicine to become a reality.
Introduction: It has been estimated that 32% of obese adults in the US are metabolically healthy. This subset of individuals, referred to as metabolically healthy but obese (MHO), appear to be more resistant to the adverse cardiometabolic consequences faced by their metabolically abnormal obese (MAO) counterparts. Cross-sectional observations indicate that increased physical activity and higher fitness contribute to the protective metabolic characteristics in this subset of obese individuals. However, to date no study has investigated whether a community-based exercise intervention designed to increase exercise volume and fitness can transition MAO adults to a MHO phenotype. Identifying the therapeutic dose of exercise required to convert a MAO person to metabolically healthy would yield important clinical information for the primary prevention of cardiovascular disease. Hypothesis: We assessed the following hypotheses: (1) community-based exercise training would transition MAO adults to metabolically healthy, and (2) the odds of successful transition to a metabolically healthy phenotype would be larger for obese individuals who [[Unable to Display Character: –]] (a) performed the highest volume of exercise, and (b) experienced the greatest increase in fitness. Methods: Three-hundred thirty-two healthy adults (190 women, 142 men; aged 28-88 years) engaged in a supervised 14-week community-based exercise program designed to favorably modify cardiovascular disease risk factors. Components of the metabolic syndrome (National Cholesterol Education Program ATP III criteria) were measured before and after the exercise program. Obese (BMI ≥ 30 kg·m 2 ) adults who met 2-4 criteria for metabolic syndrome were classified as metabolically abnormal. Metabolically healthy was defined if obese adults met 0 to 1 criteria for metabolic syndrome. Results: Baseline point prevalence of MAO was 20.5% (N = 68). There was a significant reduction (p<0.05) in point prevalence of MAO to 12.3% by post program as 27/68 individuals (40%) transitioned to MHO. Compared to the lowest quartiles of relative energy expenditure and change in fitness, participants in the highest quartiles were 21.8 (95% CI 4.4[[Unable to Display Character: –]]108.0; p<0.05) and 8.2 (95% CI 3.1[[Unable to Display Character: –]]21.6; p<0.05) times more likely to transition from MAO to MHO, respectively. Conclusions: These findings indicate that supervised community exercise can transition MAO adults to a MHO phenotype. MAO adults who engaged in higher volumes of exercise and those who demonstrated greater improvements in fitness were significantly more likely to become metabolically healthy. Importantly, the unfavourable metabolic characteristics of obesity are not irreversible. Community exercise should be considered an effective model for the primary prevention of cardiovascular disease in MAO adults.
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