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Effects of creatine supplementation and exercise training on fitness in men 55-75 yr old.

effect of oral creatine supplementation (CR; 5 g/day) in conjunction with exercise training on physical fitness was investigated in men between 55 and 75 yr of age (n = 46). A double-blind randomized placebo-controlled (PL) trial was performed over a 6-mo period. Furthermore, a subgroup (n = 20) completed a 1-yr follow-up. The training program consisted of cardiorespiratory endurance training as well as moderate resistance training (2-3 sessions/wk). Endurance capacity was evaluated during a maximal incremental bicycle ergometer test, maximal isometric strength of the knee-extensor muscles was assessed by an isokinetic dynamometer, and body composition was assessed by hydrostatic weighing. Furthermore, in a subgroup (PL: n = 13; CR: n = 12) biopsies were taken from m. vastus lateralis to determine total creatine (TCr) content. In PL, 6 mo of training increased peak oxygen uptake rate (+16%; P < 0.05). Fat-free mass slightly increased (+0.3 kg; P < 0.05), whereas percent body fat slightly decreased (-1.2%; P < 0.05). The training intervention did not significantly change either maximal isometric strength or body weight. The responses were independent of CR. Still, compared with PL, TCr was increased by approximately 5% in CR, and this increase was closely correlated with initial muscle creatine content (r = -0.78; P < 0.05). After a 1-yr follow-up, muscle TCr was not higher in CR than in PL. Furthermore, the other measurements were not affected by CR. It is concluded that long-term creatine intake (5 g/day) in conjunction with exercise training does not beneficially impact physical fitness in men between 55 and 75 yr of age.

Administration, Oral↗

Exercise training effects on collateral and microvascular resistances in rat model of arterial insufficiency.

Experiments were performed to determine if exercise training reduces collateral or microvascular resistances in the hindlimb of rats with arterial insufficiency. After right femoral arterial ligation (age 10 wk), rats were divided into sedentary (Sed) and treadmill-trained (Tr) groups (7-9 wk, final intensity: 27 m/min, 6 degree grade, 60 min/day). Minimal resistances (mmHg.ml-1.min.100 g) of the total limb (RT), collateral vessels (RC), and the microcirculations distal (Rfmc) and proximal (Rimc) to the ligation site were determined during pump perfusion of the hindlimbs. RT was lower in nonligated (open) and acutely ligated limbs of Tr than Sed rats (open: 0.69 +/- 0.011 vs. 0.93 +/- 0.071; acute: 0.92 +/- 0.028 vs. 1.18 +/- 0.070 mmHg.ml-1.min.100 g) but not in chronically ligated limbs (chronic: 0.88 +/- 0.072 vs. 1.00 +/- 0.046 mmHg.ml-1.min.100 g). RC was similar between the chronically ligated limbs of Sed and Tr rats (1.69 +/- 0.165 vs. 1.97 +/- 0.227 mmHg.ml-1.min.100 g) and was approximately 70% lower than in acutely ligated limbs of both groups. Rfmc and Rimc were not affected by arterial ligation, but Rimc was significantly lower in Tr than in Sed rats (acute: 1.05 +/- 0.026 vs. 1.54 +/- 0.163; chronic: 1.24 +/- 0.071 vs. 1.81 +/- 0.202 mmHg.ml-1.min.100 g). These results indicate that the primary site of vascular adaptations to chronic arterial ligation is in the collateral vessels. Exercise training does not significantly alter the collateralization process but may provide protection against acute arterial occlusion by stimulating microvascular growth.

Animals↗

Exercise training eliminates age-related differences in skeletal muscle insulin receptor and IRS-1 abundance in rats.

Insulin resistance is common in old age, and exercise training can improve insulin sensitivity. The purpose of this study was to determine the influence of age (6 vs 26 months) and exercise training (10 weeks of treadmill running) on insulin signaling protein abundance in skeletal muscle from male Fisher 344 rats. Muscle levels of insulin receptor (IR), insulin receptor substrate-1 (IRS-1), phosphatidylinositol 3-kinase (PI3K), and Akt1, a serine-threonine kinase, were determined. IRS-1 was reduced with aging, IR and PI3K abundance was greater in old rats, and Akt1 was unchanged. IRS-1 was increased by training in old but not young rats, and IR was increased by training in young but not old rats. PI3K tended to increase and Akt1 did not change with training, regardless of age. Aging does not uniformly affect insulin signaling protein abundance, and exercise differentially alters IR and IRS-1 in young and old rats, thereby eliminating age-related differences in these proteins.

Aging↗

Effects of 6 months of moderate aerobic exercise training on immune function in the elderly.

The purpose of this study was to determine the effects of 6 months of moderate aerobic exercise on age-dysregulated measures of T lymphocyte and natural killer (NK) cell number and function. Previously sedentary elderly (age = 65 +/- 0.8 years) subjects were randomly assigned to supervised 3 time/week exercise intervention group (EXC, n = 14) or flexibility/toning control group (FT-CON, n = 15). Fasting resting blood samples were drawn prior to and after the 6 month intervention. The EXC group exhibited a significant (P < 0.05) 20% increase in VO2 max, whereas the FT-CON group had a smaller non-significant (P = 0.07) increase (9%). Immune results revealed that, in general, changes in immune function in response to 6 months of exercise training at an average intensity of 52% heart rate reserve (HRR) were similar when compared to FT-CON who exercised at approximately 21% HRR. There were no intervention-induced changes in total white blood cell, neutrophil, lymphocyte, monocyte, eosinophil, or basophil blood counts. Furthermore, the percentage and number of CD3+, CD4+ and CD8+ T cells in the blood remained unchanged. There was a tendency for the percentage and number of CD4+ and CD8+ näive cells (CD45RA+) to increase and for CD4+ memory cells (CD45RO+) to decrease post-intervention, especially in FT-CON. Both groups exhibited a small intervention-induced increase in the T-cell proliferative response to mitogenic stimulation: the percentage change of which was higher in the EXC group at several doses of Con A. Unstimulated NK cell cytolysis versus K562 cells tended to increase (P < 0.1) in the EXC group with little change in FT-CON. We conclude that 6 months of supervised exercise training can lead to nominal increases in some measures of immune function, while not affecting others, in previously sedentary elderly.

Aged↗

Effects of age and exercise training on size and composition of the rat left main coronary artery.

This study evaluated the effects of age and exercise training on the left main coronary artery (LMCA) in young (Y-5 months) and old (O-27.5 months) female Fischer 344 rats. Both age groups were divided into trained (T) and weight-matched sedentary (S) control groups. Training consisted of 10 weeks of treadmill running progressing to a maximum workload of 15% grade, 1 hr/day, 5 d/wk at speeds of 36 and 15 m/min for the Y and O rats, respectively. Aging resulted in a 40% increase in left ventricle (LV) weight which was proportional to the increased body weight of the old animals. Exercise training produced a mild (approximately 10%) but significant left ventricular hypertrophy (LVH) in both trained groups. Cross-sectional area of the LMCA lumen and wall, wall thickness, and areas of collagen (C), elastin (E), and collagen-to-elastin ratio (C/E) of the LMCA wall were determined morphometrically in all four groups. A method for pinpointing the coronary ostium for use as a reference point was also developed. LMCA lumen area almost doubled (p < .001) across the measured age difference, but was unaffected by training. With aging, the increase in LMCA wall area bordered on significance (p < .053), while wall thickness, C area, and the C/E ratio were unchanged. Our results indicate that there is a disproportionate increase in the cross-sectional area of the rat LMCA with respect to LV mass changes with aging. This finding presumably reflects adaptation of this vessel to elevated resistances further downstream in the coronary circulation so that tissue perfusion can be maintained.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗

Exercise training modifies nutrient self-selection in rats.

Few studies have examined the effects of exercise training on macronutrient self-selection in rats. It has been observed that trained rats decreased carbohydrate and increased fat and protein intakes. In the present experiment, total energy intake and macronutrient self-selection were examined in adult male rats placed on a self-selection regimen and submitted to 2 h of treadmill exercise daily for 20 days at the beginning of the nocturnal period. Two control groups of rats were examined during the same time: a sedentary group that was food and water deprived during the same 2 h while trained rats were exercising, and a control group that was examined only for body weight gain and 24-h food intake. Food intakes of sedentary and trained rats were continuously recorded. At the end of the experiment, body weight of trained rats was lower than that of sedentary and control rats. The 24-h cumulative intake of trained rats was significantly reduced; this reduction was due to a decrease in fat intake, whereas carbohydrate intake was increased. In sedentary rats, 24-h intake was not modified but fat intake was significantly increased from the beginning to the end of the experiment. During the first 6 h of the night, protein and fat intakes of trained rats were reduced, and carbohydrate ingestion remained the same. Daytime food intake represented only 8.7% of the 24-h intake. Exercise training significantly increased this intake. It is noteworthy that during the middle part of the day (3-9 h) trained rats significantly enhanced protein and carbohydrate ingestion.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Upper-limb and lower-limb exercise training in patients with chronic airflow obstruction.

We designed a randomized controlled study to evaluate the benefit of upper-limb exercise training, alone and in combination with walking training, in patients with severe CAO. In an outpatient department supervised by a physiotherapist, we evaluated 28 patients with severe stable CAO (FEV1, 32 percent of predicted). Patients were randomly allocated to either a control (eight), upper-limb (six), lower-limb (seven), or combined (seven) exercise group. The upper-limb group trained with a circuit of upper-limb exercises, the lower-limb group by walking, and the combined group with both. Exercise was for one hour three times per week for eight weeks. Assessment before and after training included pulmonary function, mouth pressures, respiratory muscle endurance, maximal bicycle exercise test, maximal and submaximal arm ergometer, six-minute walking distance, and a scale of well-being (Bandura scale). Twenty-six patients completed the program. There was a significant improvement (Wilcoxon rank sum test) in the following: six-minute walking distance in the lower-limb (p less than 0.005) and combined (p less than 0.003) groups; arm ergometer in the upper-limb (p less than 0.005) and combined (p less than 0.04) groups; and the scale of well-being in the combined (p less than 0.005) group. There was no significant change in any other parameter measured. We conclude that exercise training improves exercise performance in severe CAO, that the training is specific for the muscle group trained, and that upper-limb exercises should be included in training programs for these patients.

Aged↗

Effects of endurance exercise training on left ventricular systolic performance and ventriculoarterial coupling in patients with coronary artery disease.

BACKGROUND: Endurance exercise training can increase left ventricular (LV) ejection fraction during dynamic exercise in coronary artery disease. This adaptation may be mediated by altered cardiac loading conditions rather than an improvement in intrinsic LV systolic function. To minimize these confounding effects, we used isometric handgrip exercise to assess the training-induced changes in LV systolic function and ventriculoarterial coupling. METHODS: Twenty-six patients (52 +/- 2 years of age) trained for 12 months. LV function was assessed with radionuclide ventriculograpy. RESULTS: LV systolic reserve (the change in LV ejection fraction from rest to handgrip exercise) increased from -7.32 +/- 1.2 to -3.4 +/- 1.1 (P =. 033) without acute changes in end-diastolic volume or the effective arterial load. LV end-systolic elastance increased 37% (P =.039) during handgrip exercise. Resting end-diastolic volume increased and the effective arterial load decreased after training. CONCLUSIONS: Data suggest that in coronary artery disease adaptations to exercise training include a lower effective arterial load and an increase in EDV at rest, with an improvement in LV systolic function detectable only during afterload stress.

Arteries↗

Exercise training and sympathetic regulation in experimental heart failure.

In this review, we put forth the hypothesis that reduction in sympathetic outflow after exercise training of animals with heart failure is mediated by reductions in angiotensin II and in angiotensin type 1 receptors. Furthermore, we provide evidence that exercise training provides for an upregulation of the neuronal isoform of nitric oxide synthase in the central nervous system that is sympathoinhibitory.

Angiotensin II↗

Effects of exercise training on left ventricular performance and myocardial perfusion in patients with coronary artery disease.

To determine the effects of exercise training on left ventricular performance and myocardial perfusion in coronary artery disease, rest and exercise radionuclide angiocardiography and thallium-201 scintigraphy were performed before and after 12 weeks of training in 16 coronary patients. After training, 15 of the 16 patients had improved exercise tolerance; total treadmill exercise duration increased from (mean +/- standard error of the mean) 491 +/- 37 to 602 +/- 31 seconds (p less than 0.01), and the estimated rate of oxygen consumption (VO2 max) increased from 29.4 +/- 1.4 to 33.8 +/- 1.2 ml/kg per min (p less than 0.001). Resting left ventricular ejection fraction increased from 52 +/- 4 to 57 +/- 4 percent (p less than 0.02); no change occurred in left ventricular functional reserve assessed by ejection fraction and regional wall motion response to exercise at the same rate-pressure product before and after training. Myocardial perfusion at equivalent pre- and post-training cardiac work loads during exercise and on redistribution was unchanged by training. It is concluded that in patients with coronary heart disease, physical training increases exercise tolerance, and results in minimal improvement in resting left ventricular systolic performance. Functional reserve of both left ventricular systolic performance and the coronary circulation appears to be unchanged by exercise training. These data suggest that the beneficial effects of training for 12 weeks in patients with coronary artery disease predominantly result from factors other than improvement in left ventricular pump performance or perfusion.

Adult↗

The effect of exercise training on the severity and duration of a viral upper respiratory illness.

PURPOSE: The purpose of this investigation was to determine whether exercise training affects the severity and duration of a rhinovirus-caused upper respiratory illness (URI). METHODS: Subjects who were rhinovirus 16 (RV 16) antibody-free completed a graded exercise test. Thirty-four individuals (ages 18-29 yr) of moderate fitness (32 mL.kg-1.min-1 to 60 mL.kg-1.min-1) were randomly assigned to the exercise group (EX) while 16 additional individuals of similar age and fitness served as a nonexercise (NEX) control group. All EX and NEX subjects were inoculated with RV 16 on 2 consecutive days. EX subjects completed 40 min of supervised exercise every other day at 70% of heart rate (HR) reserve for a 10-d period. Every 12 h, all subjects completed a 13-item symptom severity checklist and a physical activity log. Used facial tissues were collected and weighed (symptom severity measure) during these same reporting periods. RESULTS: A two group by nine measure (2 x 9) repeated measures ANOVA procedure showed no difference in symptom questionnaire mean scores and the mucous weights of the EX and NEX groups for days 2-10 of the experiment. A two measure by five measure (2 x 5) repeated measures ANOVA procedure indicated no differences between the pre- and post-exercise questionnaire means for the five sessions that EX subjects exercised. Statistical significance was set at P < 0.05. CONCLUSION: These results suggest that moderate exercise training during a rhinovirus-caused URI under the conditions of this study design do not alter the severity and duration of the illness.

Adolescent↗

Effects of exercise training and detraining on cutaneous microvascular function in man: the regulatory role of endothelium-dependent dilation in skin vasculature.

This study investigated how exercise training and detraining affect the cutaneous microvascular function and the regulatory role of endothelium-dependent dilation in skin vasculature. Ten healthy sedentary subjects cycled on an ergometer at 50% of maximal oxygen uptake (VO(2max)) for 30 min daily, 5 days a week, for 8 weeks, and then detrained for 8 weeks. Plasma nitric oxide (NO) metabolites (nitrite plus nitrate) were measured by a microplate fluorometer. The cutaneous microvascular perfusion responses to six graded levels of iontophoretically applied 1% acetylcholine (ACh) and 1% sodium nitroprusside (SNP) in the forearm skin were determined by laser Doppler. After training, (1) resting heart rate and blood pressure were reduced, whereas VO(2max), skin blood flow and cutaneous vascular conductance to acute exercise were enhanced; (2) plasma NO metabolite levels and ACh-induced cutaneous perfusion were increased; (3) skin vascular responses to SNP did not change significantly. However, detraining reversed these effects on cutaneous microvascular function and plasma NO metabolite levels. The results suggest that endothelium-dependent dilation in skin vasculature is enhanced by moderate exercise training and reversed to the pretraining state with detraining.

Adaptation, Physiological↗

Performance and mood-state parameters during 30-day 6 degrees head-down bed rest with exercise training.

The study was designed to determine if performance and mood impairments occur in bed-rested subjects, and if different exercise-training regimens modify or prevent them. Eighteen normal, healthy men were divided on the basis of age, peak oxygen uptake, and maximal isometric knee extension strength into three similar groups: no exercise (NOE), isotonic exercise (ITE), and isokinetic exercise (IKE). A 15-min battery of 10 performance tests and 8 mood and 2 sleep scales were administered daily during ambulatory control, 30 d of absolute bed rest (BR), and 4 d of ambulatory recovery. Performance test proficiency increased (p < 0.05) for all three groups during BR in 7 of 10 tests and there were no consistent significant differences between the three groups. However, during BR, the ITE group was distinguished from the other groups by a decline (p < 0.05) in the activation mood dimension and in two of its constituent scales (motivation and concentration), and by improvement (p < 0.05) in the trouble-falling-asleep and psychological-tension scales. Since few deleterious changes in performance and mood occurred in the three groups and did not exceed baseline ambulatory levels, we conclude that mood and performance did not deteriorate in response to prolonged BR and were not altered by exercise training. However, the decline in activation mood scales in the ITE group may reflect overtraining or excess total workload in this group.

Adult↗

Effects of exercise training and its cessation on components of the insulin resistance syndrome in obese children.

OBJECTIVE: To determine the effect of exercise training (ET) on components of the insulin resistance syndrome (IRS) in obese children. DESIGN: Randomized, modified cross-over study, with subjects assigned to one of two conditions: (1) 4 months of ET followed by 4 months of no-ET; or (2) 4 months of no-ET followed by 4 months of ET. Measurements were made at three time points: 0, 4 and 8 months. SUBJECTS: 79 obese, but otherwise healthy children (age: 7-11 y, percent fat (%fat) 27-61%). MEASUREMENTS: Plasma lipid and lipoprotein concentrations, plasma insulin and glucose concentrations; %fat; submaximal heart rate (HR) as an index of fitness. EXERCISE TRAINING: ET was offered 5 d/week 40 min/d. For the 73 children who completed 4 months of ET, the mean attendance was 80% (that is, 4 d/week) and the average HR during ET was 157 bpm. RESULTS: Significant (P < 0.05) group x time interactions were found for plasma triglyceride (TG) and insulin concentrations and %fat. The average change for both groups, from just before ET to just after the 4 month ET was -0.24 mmol.l-1 for TG, -25.4 pmol.l-1 for insulin and -1.6 units for %fat. When Group 1 ceased ET, over the following 4 month period the average change for insulin was +26.6 pmol.l-1 and for %fat +1.3 units. CONCLUSION: Some components (plasma TG, insulin, %fat) of the IRS are improved as a result of 4 months of ET in obese children. However, the benefits of ET are lost when obese children become less active.

Analysis of Variance↗

Effects of exercise training on left ventricular volumes and function in patients with nonischemic cardiomyopathy: application of magnetic resonance myocardial tagging.

BACKGROUND: Exercise training is now an accepted component of the therapeutic regimen in patients with heart failure and underlying ischemia, but few data are available on the effects of training in patients with nonischemic dilated cardiomyopathy. METHODS: Twenty-four patients (mean age 55 +/- 9 years, mean ejection fraction 26.6% +/- 10%) were randomized to an exercise (n = 12) or a control (n = 12) group. Patients in the exercise group underwent 5 45-minute sessions of supervised training per week. Before and after the 2-month study period, exercise testing with respiratory gas exchange and lactate analysis was performed, left ventricular volumes and ejection fraction were measured with magnetic resonance imaging, and left ventricular rotation and relaxation velocities were measured with a novel magnetic resonance imaging tagging technique. RESULTS: Training resulted in increases in peak oxygen uptake (VO2) (21.7 +/- 4 mL/kg/min to 25.3 +/- 5 mL/kg/min, P <.05) and VO2 at the lactate threshold (12.8 +/- 4 mL/kg/min to 19.0 +/- 5 mL/kg/min, P <.01). No differences were observed within or between groups in left ventricular end-diastolic volume, end-systolic volume, or ejection fraction. Velocity of left ventricular rotation during systole was unchanged in both groups, and relaxation velocity was higher after training in the exercise group (21.2 +/- 5 degrees/s versus 29.7 +/- 12 degrees/s, P <.05). CONCLUSION: Training resulted in increases in peak VO2 and VO2 at the lactate threshold. Left ventricular volumes and systolic function (ie, ejection fraction and rotation velocity) were unchanged with training, suggesting that training in patients with dilated cardiomyopathy does not lead to further myocardial damage. However, the increase in relaxation velocity after exercise training indicates an improvement in diastolic function. The latter finding suggests an additional potential benefit of exercise training in patients with dilated cardiomyopathy.

Cardiac Output, Low↗

Success and failure of exercise training after myocardial infarction: is the outcome predictable?

One hundred fifty-six patients underwent a 5 week daily exercise training program after recovery from acute myocardial infarction. Outcome was assessed on the basis of exercise testing, integrating the measurements into a single outcome measure consisting of three categories (positive, n = 79; negative, n = 42; no change, n = 35). This composite criterion served as the end point for determining the predictability of a positive (training success) and negative (training failure) outcome. With use of logistic regression analysis, the baseline variables of clinical information, exercise data and psychosocial variables were able to identify patients with training success, as well as patients with failure (correct classification rates 81% and 85%, respectively). The characteristics of patients for whom training was beneficial differed from those of patients with a negative outcome. Work status before infarction was the single most important predictor of success, but it did not determine failure. Psychologic variables (type A behavior, well-being, depression) were important for predicting failure, but not for predicting success. Cardiac state and physical fitness largely determined training success. It is concluded that the physical benefit of exercise training in patients after myocardial infarction is highly predictable. Validation will make it possible to optimally apply exercise training as a therapeutic modality in these patients.

Aged↗

Exercise training is not associated with improved levels of C-reactive protein or adiponectin.

The purpose of this study was to determine the effect of exercise training on the levels of C-reactive protein (CRP) and adiponectin, and to assess whether exercise-induced changes in insulin resistance could be explained in part by changes in these inflammation markers. Study participants included 51 middle-aged (45.3+/-8.3 years; mean+/-SD), overweight (33.7+/-4.8 BMI), insulin-resistant, nondiabetic individuals. Subjects had their insulin sensitivity, body fat, CRP, and adiponectin levels measured, and their predicted maximal fitness calculated before and after 16 weeks of moderate, intense, or no exercise training. Modest improvements in fitness, body composition, and insulin sensitivity were observed, but these changes were not associated with decreased CRP or increased adiponectin levels, even when subjects were stratified by their change in fitness or obesity. Regression analysis demonstrated that the change in percentage of body fat was significantly related to changes in insulin sensitivity, whereas changes in VO2 MAX, CRP, and adiponectin were not. Participation in moderate to intense exercise was not associated with improved measures of chronic inflammation markers, as measured by CRP and adiponectin. Moreover, improvements in insulin sensitivity resulting from exercise or modest weight loss did not appear to be related to changes in these markers.

Adiponectin↗

Short-term exercise training alters responses of porcine femoral and brachial arteries.

The primary purpose of this study was to test the hypothesis that short-term exercise training enhances endothelium-dependent relaxation of porcine femoral and brachial arteries. Miniature swine ran on a treadmill for 1 h at 3.5 miles/h, twice daily, for 7 consecutive days (Trn; n = 8). Compared with sedentary controls (Sed; n = 7), Trn swine exhibited increased skeletal muscle citrate synthase activity (P < 0.05). Vascular rings approximately 3 mm in axial length were prepared from segments of femoral and brachial arteries, and responses to vasoactive agents were determined in vitro. Sensitivity to bradykinin (BK) was enhanced in brachial vascular rings from Trn swine compared with those from Sed swine, as indicated by lower concentration of vasorelaxing agent eliciting 50% of maximal response values [Sed, 8.63 +/- 0.09 (-log M); Trn, 9.07 +/- 0.13; P < 0.05]. This difference between groups was preserved in brachial rings in which formation of nitric oxide and vasodilator prostaglandins were inhibited [Sed, 8.57 +/- 0.17 (-log M); Trn, 8.97 +/- 0.13; P < 0.05]. Sensitivity to BK was not different between Sed and Trn in femoral arterial rings. Relaxation responses to the calcium ionophore A-23187 and sodium nitroprusside were not altered with training. Femoral and brachial arterial rings from Trn swine, compared with those from Sed swine, exhibited augmented vasocontraction across a range of concentrations and increased sensitivity to norepinephrine (all P < 0.05). These findings indicate that responses of porcine femoral and brachial arteries change in response to short-term training. Together with findings from previous studies involving longer term training, our data suggest that vascular adaptations may differ at different time points during long-term endurance exercise training.

Animals↗