Adverse Metabolic Response to Regular Exercise: Is It a Rare or Common Occurrence?

Abstract

BackgroundIndividuals differ in the response to regular exercise. Whether there are people who experience adverse changes in cardiovascular and diabetes risk factors has never been addressed.Methodology/Principal FindingsAn adverse response is defined as an exercise-induced change that worsens a risk factor beyond measurement error and expected day-to-day variation. Sixty subjects were measured three times over a period of three weeks, and variation in resting systolic blood pressure (SBP) and in fasting plasma HDL-cholesterol (HDL-C), triglycerides (TG), and insulin (FI) was quantified. The technical error (TE) defined as the within-subject standard deviation derived from these measurements was computed. An adverse response for a given risk factor was defined as a change that was at least two TEs away from no change but in an adverse direction. Thus an adverse response was recorded if an increase reached 10 mm Hg or more for SBP, 0.42 mmol/L or more for TG, or 24 pmol/L or more for FI or if a decrease reached 0.12 mmol/L or more for HDL-C. Completers from six exercise studies were used in the present analysis: Whites (N = 473) and Blacks (N = 250) from the HERITAGE Family Study; Whites and Blacks from DREW (N = 326), from INFLAME (N = 70), and from STRRIDE (N = 303); and Whites from a University of Maryland cohort (N = 160) and from a University of Jyvaskyla study (N = 105), for a total of 1,687 men and women. Using the above definitions, 126 subjects (8.4%) had an adverse change in FI. Numbers of adverse responders reached 12.2% for SBP, 10.4% for TG, and 13.3% for HDL-C. About 7% of participants experienced adverse responses in two or more risk factors.Conclusions/SignificanceAdverse responses to regular exercise in cardiovascular and diabetes risk factors occur. Identifying the predictors of such unwarranted responses and how to prevent them will provide the foundation for personalized exercise prescription.

Using response variation to develop more effective, personalized behavioral medicine?: evidence from the Resist Diabetes study

“…What can be seen for each measure is that there are some very high responders (e.g., gaining 8.5 kg of lean body mass as assessed by DXA), more usual, modest responders, but clearly for each measure, some participants had no or a negative response. We do not believe a negative response can be described as an adverse response in the absence of an adjustment for measurement error [11]. Some good responders on one measure were poor responders on other measures.…”

“…That is, for any specific exercise stimulus or protocol and with the provision that adherence is high, there is a very wide variation in responsiveness, i.e., "non-and low responders," "moderate and high responders," or "low and high sensitivity" to the stimulus [10]. This has been shown in an amalgamation of different exercise studies [11]. For example, in response to the same resistance training protocol, strength increases can vary from no change in strength to more than doubling strength [7].…”

“…For example, in response to the same resistance training protocol, strength increases can vary from no change in strength to more than doubling strength [7]. What's more, and of particular concern, is that (1) high responsiveness to one stimulus, e.g., resistance training, on one outcome measure such as strength, may not be associated with responsiveness to the stimulus for another health-related outcome measure such as blood pressure [10]; and (2) about 6-8 % of people exposed to the stimulus will show an adverse response [11]. That is, on the appropriate measure for an intervention such as cardiorespiratory fitness for aerobic training, a segment of people actually will show reduced fitness [11].…”

Understanding the individual responsiveness to resistance training periodization

“…To note, adverse responses to exercise can be found for strength (Garcia et al 2014), hemodynamic variables (Loenneke et al 2014), plasma fasting insulin, plasma triglycerides, and plasma high density-lipoprotein variables (Bouchard et al 2012). Because of this, this phenomenon of 'high responders' and 'low responders' may provide a helpful insight into the mechanisms responsible for training adaptations and methods of training prescription (Mann et al 2014).…”

Educação física no ensino médio: desenvolvimento de conceitos e da aptidão física relacionados à saúde

“…A prática regular de exercícios físicos pode apresentar efeitos bené cos à saúde em diferentes populações [1][2] , ainda que esse efeito possa ser contrário em uma parcela de indivíduos 3 . Sua prática pode ser um fator preventivo para diferentes patologias e, em diferentes faixas etárias, a prática de exercícios parece trazer consequências positivas do ponto de vista siológico, psicológico e social [4][5][6] .…”