Effect of high-intensity resistance exercise on cardiometabolic health in older men with osteosarcopenia: the randomised controlled Franconian Osteopenia and Sarcopenia Trial (FrOST)

Abstract

ObjectivesSarcopenia is related to the metabolic syndrome (MetS), a cluster of cardiometabolic risk-factors (CRF). Most exercise trials apply aerobic rather than resistance exercise to address CRF, while the strategy for maintaining muscle and bone is the opposite. However, there is considerable evidence that resistance exercise positively affects CRF. In the present study, we determined the effect of high-intensity resistance exercise training (HIT-RT) on CRF represented by the MetS in older men.MethodsForty-three osteosarcopenic and predominately obese older men (>72 years) living independently in Erlangen-Nürnberg, Germany were randomly assigned to two study arms. The HIT-RT group (n=21) conducted a periodised high intensity/effort protocol dedicated to muscle and bone mass and function two times per week, while the control group (CG: n=22) maintained their habitual physical activities. Both groups were supplemented with protein, cholecalciferol and calcium. Study outcomes presented here were the MetS-Z (MetSZ) score and its underlying risk-factors.ResultsAfter 18 months of intervention, we observed significant effects for the MetSZ score (p<0.001), with significant improvements in the HIT-RT and significant worsening in the CG. In detail, all parameters constituting the MetS contributed to this result, however, only waist-circumference, HDL-cholesterol and mean arterial blood pressure revealed significant effects. No adverse events were reported and high adherence was determined for the HIT-RT-protocol.ConclusionContinuously supervised HIT-RT is an effective, attractive, feasible and safe method to address cardiometabolic risk factors in community-dwelling men aged 72 years and older. Further, considering the proven effects on musculoskeletal risk factors, the present results indicate a more prominent role for HIT-RT within non-pharmacological prevention strategies of older adults.Trial registration numberNCT03453463.

Effects of High-Intensity Resistance Training on Visceral Adipose Tissue and Abdominal Aortic Calcifications in Older Men with Osteosarcopenia – Results from the FrOST Study

“…However, the progression of AAC and its vascular branches could not be prevented in the FrOST study. Therefore, in combination with the results published earlier 7 , 23 we conclude that HIT-RT has a positive effect on the metabolic and cardiovascular risk profile but at least in the FrOST study not on AAC. Perhaps a variation of the exercise protocol with further emphasis on endurance may be more effective for targeting AAC resulting in further optimization of an integrated and cost-effective exercise approach for the elderly.…”

“…Accepting that a body fat rate of 27%–30% constitutes obesity in men 21 most participants (75%–94%) can be considered as (osteosarcopenic) obese and one third of the subjects of the CG and EG respectively were affected by the MetSyn. 22 At baseline VAT volume of the combined group was significantly correlated with BMI (r = 0.66) and MetSyn Z-Score 7 (r = 0.70). In contrast there were no significant correlations between AAC volume of the combined group with BMI (r = 0.1) and MetSyn Z-Score (r = 0.05).…”

“…For the FrOST study, we had previously investigated parameters of adiposity and the effect of HIT-RT on body composition and showed a positive training effect on total body fat mass and abdominal body fat percentage. 7 , 23 …”

“…This might particularly refer to older physically limited cohorts. The FrOST-study, an 18 months high-intensity resistance training (HIT-RT) protocol reported positive effects on musculoskeletal 6 and cardiometabolic risk 7 in a population of older, community dwelling men with osteosarcopenia. Of importance, a high proportion of this cohort suffered from overweight/obesity, MetSyn and related parameters causative for cardiometabolic and cardiovascular risk.…”

Cardiovascular risk moderates the effect of aerobic exercise on executive functions in older adults with subcortical ischemic vascular cognitive impairment

“…Greater changes in fitness level may be required in those at high cardiovascular risk in order to observe changes in cognition. In addition to AT, resistance training is a viable alternative in those at higher cardiovascular risk 55 , particularly as some evidence suggests that higher Framingham risk scores are associated with greater development of impaired mobility in older adults 56 that could impair their ability to reap maximal benefits from AT paradigms. The findings of the current study in combination with previous findings, highlight that “one size does not fit all” and there is a need for further research to identify important moderators of exercise efficacy and provide more precise recommendations for specific groups of individuals.…”