KNES 260 final UMD

List the types of physical activity and examples

speed (track/ swimming), strength (weight lifting), skill (golf/ baseball), power (strength/ time), endurance (long distance running).

Which type of physical activity most affects the cardiovascular system?

Endurance training

Why should you be concerned about VO2 max?

-it is closely associated with endurance performance

-there are many health benefits of a high VO2 max

What are the four criteria for assessing an endurance training exercise program?

F- frequency

I- intensity

T- time

T- type

Respiration

O2 diffusion

Ventilation

movement of air in and out of the lungs

Central circulation

Cardiac output, blood moving in and out of the heart

Peripheral circulation

flow to non-exercising regions, muscle blood flow, muscle capillary density.

Muscle metabolism

enzymes, energy stores, myoglobin, mitochondria size/ number, muscle mass, fiber type, and substance delivery.

Absolute vs relative work rates

absolute work rates= same running, cycling, walking, or swim speed

relative work rates- different running, cycling, walking or swim speeds but working at the same % of VO2 max.

Calculating intensity from maximum heart rate

-measure maximal heart rate or estimate it from the equation 220-age in years

-multiply the desired intensity as a fraction of 1.00 by the maximal heart rate.

example: multiply max heart rate by .7% to determine 70% of a person's maximal heart rate.

Karvonen equation

Target Heart Rate= desired intensity (max heart rate- resting heart rate)+resting heart rate

negative= not as easy or simple

positive= valid across entire range of exercise intensities

1978 college of sports medicine position stand

frequency: 3-5x per week

intensity: 50-80% of VO2 max, 50-85% of heart rate reserve and 60-90% of heart rate maximum

time: 15-60 minutes continuously

type: any type of activity that uses large muscle groups can be maintained continuously and is rhythmical and aerobic in nature

1990 college of sports medicine position stand

frequency: 3-5 days per week.

Intensity: 50-85% of vo2 max, 50-80% of heart rate reserve, 60-90% of heart rate maximum

time: 20-60 minutes

type: any activity that uses large muscle groups and can be maintained and is rhythmic and aerobic in nature.

*add strength training to muscle mass.

1995 centers for disease control, American college of sports medicine

Moderate-hard intensity > brisk walking

-preferably everyday

-accumulative> 30 minutes per day

Pros of this program is that its very user friendly and very motivating.

1998 american college of sports medicine position stand

frequency: 3-5 days per week.

Intensity: 40-85% vo2 max or heart rate reserve, 50-90% of HR reserve

time 20-60 minutes continuous or internment

type: any rhythmical aerobic activity that uses large muscle groups

add flexibility and exercise and muscle mass training.

Things to consider when designing a physical activity program

physical abilities or disabilities

motivation

current health/ fitness

goals!

Session duration for measuring change in VO2 max

frequency: 5 sessions per week

duration: 45 minutes/ session

training intensity: > vo2 max

intensity: as high as possible

this is close to athlete training!

What is the best form of exercise?

swimming, walking, and biking are all equally affective

Hickson et al 1977 study

Design: 8 sedentary healthy subjects, aged 20-42 years, 10 weeks of intense training (6 days per week), 3 days cycle ergometer intervals <6x 5 minutes at 100% VO2 max with 2 minutes rest, 3 days of 30 minute running at highest maintainable pace

results: initial VO2 max: 40, final 55 with values continuing to rise, 44% increase in vo2 max over 10 weeks of training, rate of increase was linear.

Seals et al study design

Design: 24 healthy sedentary men and women, 60-69 years old, randomly assigned 14 exercises, 10 sedentary controls, studies at baseline, 6 months of low intensity training at 40% VO2 max, followed by reevaluation then 6 months of high intensity (70% of VO2 max) follows by reevaluation.

Seals et al study results LOW INTENSITY

Low intensity group had an average of 14% increase in vo2 max, but the range of increase was 1-40%, total % increase in vo2 max was 30%

Seals et al study results LOW INTENSITY- HIGH INTENSITY

LI-HI had an average increase of 16% in VO2 max, but the range was 1-39%, total % increase in Vo2 max was 8-49%

Hagberg et al study

47 healthy 70-79 men and women assigned to control or resistive endurance exercise training groups, 6 months of training vo2 max measured after 3 and 6 months.

Hagberg et al study results for endurance training

Endurance training vo2 max initially was 22.5, after 13 weeks it was 25.8%, the final result was 27.1%

Hagberg et al study results for resistive training

resistive training, the initial vo2 max was 22.5, after 13 weeks, it was 23.6, and the final was 23.3.

Hamburg et al study results for control group

initial 22.2, 13 weeks not measured, final 22.0

Overall summary of the effect of exercise training on cardiovascular fitness

Cardiovascular fitness is an individual major CVD risk factor

Can be altered markedly with exercise training

increases by 10-20% in young people with training

increases>30% in young people with intense training

increase is important to training. intensity and increases are similar in older people

Lee, Hsich, Paffenberger exercise intensity and longevity in men, JAMA 1995

17,321 men, Physical activity assessed by Paffenberger questionnaire in 1962 or 66. Mortality assessed in '88, 3728 deaths in the 22-26 year follow up.

conclusion: vigorous but not non-vigorous activities were associated with weight loss> longevity, pertain to only all cause mortality, non-vigorous exercise are beneficial to other aspects of health.

Blair et al

Changes in physical fitness and all-cause mortality, 9777 men, 5-year average follow-up, 223 total deaths, 87 from CVD.

Conclusion: men who maintained or improved to adequate levels of physical fitness were less likely to die from any cause of CVD than unfit men.

Expectations for lipid changes with exercise training

-cholesterol decreases by 10 mg/dl (a large amount)

-LDL cholesterol decreases by 10 mg/dl

HDL cholesterol increases by 5 mg/dl

triglycerides decrease if initially high

Plasma lipid levels in runners and sedentary men

this is the answer

HDL-C levels in older runners

Subject. HDL-C levels

master run. 66

older (lean/untrained). 45

older (obese/untrained). 42

Hagberg study's show______

that older distance runners who have been very sedentary peers than we would expect from above

Rogers et al.: Effect of 7 years of exercise training on plasma lipid levels

cholesterol levels for baseline, 1 year and 7 years.

B: 218,

1: 208,

7: 210

Rogers et al.: Effect of 7 years of exercise training on plasma lipid levels

LDL-C levels for baseline, 1-year and 7 years

B: 150

1: 140

7: 127

Rogers et al.: Effect of 7 years of exercise training on plasma lipid levels

HDL-C levels for baseline, 1-year and 7 years

B: 38

1: 45

7: 53

Rogers et al.: Effect of 7 years of exercise training on plasma lipid levels

Triglyceride levels for baseline, 1-year and 7 years

B: 184

1: 105

7: 123 ( no further effect )

Rogers et al.: EXPERIMENT GROUP effects of low intensity and high-intensity training on plasma lipid concentrations

Baseline levels for Total cholesterol, LDL-C. HDL-C. Tc/HDL, Triglyceride

Baseline TC: 201

Baseline LDL:123

Baseline HDL:52

Baseline TC/HDL: 4.1

Baseline Triglyceride: 128

Rogers et al.: EXPERIMENT GROUP effects of low intensity and high intensity training on plasma lipid concentrations

AFTER 6 MOTNHS OF LI training

TC: 191

LDL: 116

HDL: 51

TC/ HDL: 4.0

Trigliceride: 120

Rogers et al.: EXTPERIMENT GROUP effects of low intensity and high intensity training on plasma lipid concentrations

AFTER A YEAR OF HI TRAINING (another 6 months)

TC: 195

LDL: 117

HDL: 58

TC/ HDL: 3.6

Trigliceride:101

Rogers et al.: CONTROL GROUP effects of low intensity and high intensity training on plasma lipid concentrations

Baseline values

TC: 214

LDL: 136

HDL: 45

TC/ HDL: 5.2

Trigliceride: 167

Rogers et al.: CONTROL GROUP effects of low intensity and high intensity training on plasma lipid concentrations

after 6 months values

TC: 218

LDL: 141

HDL: 45

TC/ HDL: 5.1

Trigliceride:158

Rogers et al.: CONTROL GROUP effects of low intensity and high intensity training on plasma lipid concentrations

after 12 months values

TC: 222

LDL: 139

HDL: 46

TC/ HDL: 5.2

Trigliceride: 187

What were the one year changes observed from baseline values for the exercise group in Rogers et al.

Total cholesterol -4.9

HDL-C: +1.8

HDL2-mass: +26.1

LDL-C: -5.2

None of these changes are statistically different

What were the one year changes observed in the control group of Rogers et al.

Total cholesterol: 1.8

HDL C: 0.5

HDL2-mass: 10.5

LDL-C: 1.3

clearly not statistically different

Why were the results of Rogers et al not statistically different?

* not all participants did the appropriate exercise for the exercise group. If you exercise >8x per week (walking> 8x per week) stat differences were found in exercise groups

* observing genetic differences explains why some people are more responsive to exercise training than others

Genetic and lipid changes with exercise training: change in cholesterol APO T2 genotype and APO T3/4 genotype

APO T2 GENOTYPE: -2

APOT3/4 GENOTYPE: -19

Genetic and lipid changes with exercise training: change in HDL-C APO T2 genotype and APO T3/4 genotype

APO T2 GENOTYPE: +12 (good change and very different)

APOT3/4 GENOTYPE: +2

Genetic and lipid changes with exercise training: change in HDL2-C APO T2 genotype and APO T3/4 genotype

APO e2 GENOTYPE: +9 (good change and very different)

APOe 3/4 GENOTYPE: 0

Which APO gene is more likely to have a greater change in cholesterol

APO e2 is more likely because it is very important in metabolizing cholesterol

genetics and lipid changes with exercise training change in cholesterol, HDL-c and HDL2-c with the LPL Pvull -/- genotype

cholesterol: -14, not a large diff

HDL-C: +11, large diff

HDL2-C: +9, large diff

genetics and lipid changes with exercise training change in cholesterol, HDL-c and HDL2-c with the LPL Pvull + carriers

Cholesterol: -19, not a large diff

HDL-C: +2,

HDL2-C: 0

Which LPL cholesterol genotype has the greater advantages from exercise to get rid of lipids?

LPL-L

Who saw the greatest changes with exercise training in their HDL-C levels?

People with existing high/ normal HDL levels saw the biggest increase, "the rich get richer"

Changes in plasma lipids with diet and diet/ exercise (Men control)

Cholesterol: -5

LDL-C: -8

HDL-C: -2

HDL2-C: -3

2 multiple choice options

Changes in plasma lipids with diet and diet/ exercise (Men diet)

Cholesterol -16

LDL-C: -15

HDL-C: +1

HDL2-C -3 (not good)

Changes in plasma lipids with diet and diet/ exercise (Men D+E)

Cholesterol: -14

LDL-C: -11

HDL-C: +5 (yay)

HDL2-C: +1

Changes in plasma lipids with diet and diet/ exercise (Women Control)

Cholesterol: -1

LDL-C: -1

HDL-C: -2

HDL2-C: -4

2 multiple choice options

Changes in plasma lipids with diet and diet/ exercise (Women diet)

Cholesterol: -15

LDL-C: -11

HDL-C: -6 bad

HDL2-C:-8 bad

Changes in plasma lipids with diet and diet/ exercise (Women D+E)

Cholesterol: -11 yay

LDL-C: -11 yay

HDL-C: +1 small yay

HDL2-C: -1 bruh

How many were able to decrease their systolic blood pressure significantly with exercise training?

76%, the other 24% had small reductions that were not statistically different.

What did the reduction in systolic blood pressure average

10.6 mmHg from an average initial value of 153 mmHg (not thrilled but headed in the right direction)

What is the effect of exercise training on diastolic blood pressure?

81% decreased diastolic blood pressure significantly with exercise training, reduction averaged 8.2 mmHg from an average initial value of 97mmHg. (not thrilled but headed in the right direction)

Blumenthal et al (1991) study design

Subjects: 99 stage 1 hypertensive men and women

randomly assigned to endurance exercise training, strength/ flexibility training or control group

Blood pressure measured before and after 4 months of training

Blumenthal et al (1991) results for endurance group

systolic BP: -8

diastolic BP: -6

2 multiple choice options

Blumenthal et al (1991) results for strength/ flexibility group

systolic BP: -7

diastolic BP: -6

Blumenthal et al (1991) results for control group

systolic BP: -9

diastolic BP: -5

What was the overall outcome of the Blumenthal et al. (1991) study results

They were not statistically different

Blood pressure reductions in hypertensives with HIGHER exercise training intensities

(systolic BP)

Weighted average reduction: 6.8 mmHg

Groups with significant reduction %: 75

Total sample side: 286

Blood pressure reductions in hypertensives with LOWER exercise training intensities

(systolic BP)

Weighted average reduction: 9.5 mmHg

Groups with significant reduction %: 64

Total sample side: 383

Blood pressure reductions in hypertensives with HIGHER exercise training intensities

(diastolic BP)

Weighted average reduction: 6.8 mmHg

Groups with significant reduction %: 73

Total sample side: 237

Blood pressure reductions in hypertensives with LOWER exercise training intensities

(diastolic BP)

Weighted average reduction: 7.0 mmHg

Groups with significant reduction %: 78

Total sample side: 477

What was the shocking result when Blumenthal et al. (1991) found when changing exercise intensities?

Lower intensity training may possibly be beneficial for hypertensives just as much as high intensity training.

Hagberg et al. (1989) study design

-60-69 year old sedentary men and women with essential hypertension.

-control group

- 2 exercise training intensities: 50 and 70% of VO2 max.

-Both groups restudied after 3 and 9 months.

What is essential hypertension?

High blood pressure with no identifiable cause.

Hagberg et al 1989 study results

-moderate intensity saw greater reductions in systolic BP (-20 mmHg) after 9 months, while higher intensity only decreased 10 mmHg.

-diastolic BP saw similar changes in both groups, but low intensity had greater reductions.

-evidence that shows intensity exercise training lowers blood pressure in older hypertensives the same, or more than higher intensity (yay)

Blood pressure reductions in hypertensives with different lengths of exercise training systolic bp 1-10 weeks

Weighted average reduction: -9.5

groups with significant reductions:71

total sample size: 336

2 multiple choice options

Blood pressure reductions in hypertensives with different lengths of exercise training systolic bp 11-20 weeks

Weighted average reduction: -11.1

groups with significant reductions: 65

total sample size: 440

Blood pressure reductions in hypertensives with different lengths of exercise training systolic bp 21+ weeks

Weighted average reduction: -10.9

groups with significant reductions: 64

total sample size: 145

Blood pressure reductions in hypertensives with different lengths of exercise training Diastolic bp 1-10 weeks

Weighted average reduction: 7.1

groups with significant reductions: 79

total sample size: 357

2 multiple choice options

Blood pressure reductions in hypertensives with different lengths of exercise training Diastolic bp 11-20 weeks

Weighted average reduction: 9.3

Groups with significant reductions: 74

Total sample size: 418

Blood pressure reductions in hypertensives with different lengths of exercise training Diastolic bp 21+ weeks

Weighted average reduction: 9.6

Groups with significant reductions: 75

Total sample size: 159

What pattern was noticed with Hagberg (1989) study results?

reductions happen quickly with blood pressure (yay), but do not continue to decrease as significantly with more time (boo)

Taylor-Tolbert, 2009, effect of a single bout of exercise on blood pressure, study design

-11 men, average 60 years old, stage 1 or 2 hypertension

-ambulatory BP was measured for 24 hours on 2 days

-one day was a control day where patients came in with no prior exercise

-day2 was an exercise training day where patients did 3 15 minute exercise sessions at 70% VO2 max

Taylor-Tolbert, 2009, effect of a single bout of exercise on blood pressure, study results

-systolic control day and exercise had similar results but exercise training day has a 15 mmHg reduction for the first few hours, then as time passed the two groups had similar blood pressure levels.

-diastolic blood pressure had similar results. Some evidence indicated a single bout of exercise training can lower blood pressure for the next 24 hours

SIGNIFICANT REDUCTIONS IN BOTH GROUPS

Taylor-Tolbert 2009, age and blood pressure reductions in hypertensives with exercise training SYSTOLIC BP 21-40 age

Weighted average reduction: 6.7

Groups with sig reductions: 28%

total sample size: 157

2 multiple choice options

Taylor-Tolbert 2009, age and blood pressure reductions in hypertensives with exercise training SYSTOLIC BP 41-60 age

Weighted average reduction: 12.4

Groups with sig reductions: 83%

total sample size: 673

Taylor-Tolbert 2009, age and blood pressure reductions in hypertensives with exercise training SYSTOLIC BP 61+ age

Weighted average reduction: 6.8

Groups with sig reductions: 55%

total sample size: 151

Taylor-Tolbert 2009, age and blood pressure reductions in hypertensives with exercise training DIASTOLIC BP 21-40 age

Weighted average reductions: 9.9

Groups with sig reductions: 80%

Total sample size: 131

2 multiple choice options

Taylor-Tolbert 2009, age and blood pressure reductions in hypertensives with exercise training DIASTOLIC BP 41-60 age

Weighted average reductions: 8.5

Groups with sig reductions: 76

Total sample size: 579

Taylor-Tolbert 2009, age and blood pressure reductions in hypertensives with exercise training DIASTOLIC BP 61+ age

Weighted average reductions : 8.8

Groups with sig reductions: 75%

Total sample size: 55

Taylor-Tolbert, effect of race on blood pressure reduction in hypertensives with exercise training

systolic bp caucasians

Weighted average reductions: 7.3

Groups with sig reductions: 4.6%

Total sample size: 458

Taylor-Tolbert, effect of race on blood pressure reduction in hypertensives with exercise training

systolic bp again/ pacific American

Weighted average reduction: 11.9 (has an effect)

Groups with sig reductions: 9.2%

Total sample size: 142

Taylor-Tolbert, effect of race on blood pressure reduction in hypertensives with exercise training

Diastolic bp white

Weighted average reductions : 6.8

Groups with significant reductions: 70%

Total sample size: 409

Taylor-Tolbert, effect of race on blood pressure reduction in hypertensives with exercise training

Diastolic bp Asian/ pacific American

Weighted average reduction: 6.6 (no effect)

Groups with significant reduction: 85%

Total sample size: 156

Gordon et al. study design

-sedentary overweight with high normal blood pressure or hypertension

-randomly assigned to weight loss via diet, exercise training without weight loss or exercise training with weight loss

-intervention length 12 weeks

What combination had the largest reductions in blood pressure according to Gordon et al. study?

Exercise + diet

Did all groups in the Gordon et al. study significantly reduce their systolic and diastolic blood pressure?

Yes

Was there a significant difference in blood pressure reduction when comparing the groups in the Gordon et al. study?

No