Publications by authors named "Ricardo Mora-Rodriguez"

82 Publications

Endurance Exercise Training reduces Blood Pressure according to the Wilder's Principle.

Int J Sports Med 2021 Sep 24. Epub 2021 Sep 24.

Universidad de Castilla-La Mancha, Sport Sciences, Toledo, Spain.

The effect of antihypertensive medicine (AHM) is larger the higher the pre-treatment blood pressure level. It is unknown whether this Wilder's principle, also applies for the exercise-training blood pressure (BP) lowering effect. One hundred seventy-eight (n=178) middle-aged individuals (55±8 y) with metabolic syndrome (MetS), underwent high intensity interval training (3 days·week) for 16 weeks. Participants were divided into medicated (Med; n=103) or not medicated (No Med; n=75) with AHM. Office BP was evaluated before and after the exercise-training. Correlations and stepwise regression analysis were used to determine which variable better predicted the reductions in systolic BP (SBP) with training. After training, participants with hypertension lowered SBP by a similar magnitude regardless of if they were in the Med (-15 mmHg, 95% CI-12,-19; <0.001) or No Med group (-13 mmHg, 95% CI-9,-16; <0.001). However, SBP did not decrease among normotensive groups (=0.847 for Med and =0.937 for No Med). Pre-treatment SBP levels was the best predictor of exercise-training lowering effect (r=-0.650; β=-0.642; <0.001). For each 10 mmHg higher pre-training SBP there were a 5 mmHg deeper SBP reduction (Wilder principle). Furthermore, AHM does not interfere with exercise-training BP-lowering effect.
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http://dx.doi.org/10.1055/a-1548-6985DOI Listing
September 2021

Effectiveness of statins vs. exercise on reducing postprandial hypertriglyceridemia in dyslipidemic population: A systematic review and network meta-analysis.

J Sport Health Sci 2021 Jul 21. Epub 2021 Jul 21.

Exercise Physiology Lab at Toledo, Sports Science Department, University of Castilla-La Mancha, Toledo 45004, Spain. Electronic address:

Background: Individuals at risk of suffering cardiovascular disease (CVD) present with larger increases in blood triglyceride (TG) concentration after a high-fat meal than do healthy individuals. These postprandial hypertriglyceride (PPTG) levels are an independent risk factor for CVD. Prescription of statins and a bout of prolonged exercise are both effective in lowering PPTG levels. We aimed to evaluate the comparative effectiveness of statins vs. a bout of aerobic exercise in reducing fasting and postprandial blood TG concentrations in individuals at high risk of developing CVD.

Methods: Thirty-seven studies from a systematic literature search of the PubMed, EMBASE, and Cochrane databases were included in this review. The selected studies conducted trials involving statin therapy (n = 20) or a bout of aerobic exercise (n = 19) and measured their impact on PPTG levels as the outcome. Two studies analyzed both treatments and were included in duplicate. The meta-analysis was constructed using a random-effects model to calculate the mean difference (MD). The Student t test was used to compare the data sets for statins vs. exercise.

Results: Overall, statin and exercise interventions showed similar reductions in PPTG levels, with an MD of -0.65 mmol/L for statins (95% confident interval (95%CI): -0.54 to -0.77; p < 0.001) and -0.46 mmol/L for exercise (95%CI: -0.21 to -0.71; p < 0.01). However, statins lowered fasting TG levels more than exercise (MD = -1.54 mmol/L, 95%CI: -2.25 to -0.83; p = 0.009).

Conclusion: Although aerobic exercise is effective in lowering blood TG levels, statins seem to be more efficient, especially in the fasted state. A combination of exercise and statins might reveal a valuable approach to the treatment and prevention of CVD. More studies are required to determine the underlying mechanisms and the possible additive effects of these interventions.
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http://dx.doi.org/10.1016/j.jshs.2021.07.006DOI Listing
July 2021

Concurrent endurance and resistance training enhances muscular adaptations in individuals with metabolic syndrome.

Scand J Med Sci Sports 2021 Jul 27;31(7):1440-1449. Epub 2021 Mar 27.

Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain.

The purpose of the study was to determine if concurrent training (endurance and resistance in a single session) elicits leg muscular adaptations beyond the ones obtained by endurance training alone in sedentary individuals with metabolic syndrome (MetS). Sixty-six MetS individuals (37% women, age 56 ± 7 years, BMI 32 ± 5 kg m and 3.8 ± 0.8 MetS factors) were randomized to undergo one of the following 16-week isocaloric exercise programs: (i) 4 + 1 bouts of 4 min at 90% of HR of intense aerobic cycling (IAC + IAC group; n = 33), (ii) 4 IAC bouts followed by 3 sets of 12 repetitions of 3 lower-limb free-weight exercises (IAC + RT group; n = 33). We measured the effects of training on maximal cycling power, leg press maximum strength (1RM), countermovement jump height (CMJ), and mean propulsive velocity (MPV) at workloads ranging from 10% to 100% of baseline 1RM leg press. After intervention, MetS components (Z-score) improved similarly in both groups (p = 0.002). Likewise, maximal cycling power during a ramp test improved similarly in both groups (time effect p < 0.001). However, leg press 1RM improved more in IAC + RT than in IAC + IAC (47 ± 5 vs 13 ± 5 kg, respectively, interaction p < 0.001). CMJ only improved with IAC + RT (0.8 ± 0.2 cm, p = 0.001). Leg press MPV at heavy loads (ie, 80%-100% 1RM) improved more with concurrent training (0.12 ± 0.01 vs 0.06 ± 0.02 m s , interaction p = 0.013). In conclusion, in unconditioned MetS individuals, intense aerobic cycling alone improves leg muscle performance. However, substituting 20% of intense aerobic cycling by resistance training further improves 1RM leg press, MPV at high loads, and jumping ability while providing similar improvement in MetS components.
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http://dx.doi.org/10.1111/sms.13950DOI Listing
July 2021

Effects of antihypertensive medication and high-intensity interval training in hypertensive metabolic syndrome individuals.

Scand J Med Sci Sports 2021 Jul 15;31(7):1411-1419. Epub 2021 Mar 15.

Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain.

Pharmacological and non-pharmacological therapies are simultaneously prescribed when treating hypertensive individuals with elevated cardiovascular risk (ie, metabolic syndrome individuals). However, it is unknown if the interactions between antihypertensive medication (AHM) and lifestyle interventions (ie, exercise training) may result in a better ambulatory blood pressure (ABP) control. To test this hypothesis, 36 hypertensive individuals with metabolic syndrome (MetS) under long-term prescription with AHM targeting the renin-angiotensin-aldosterone system (RAAS) were recruited. Before and after 4 months of high-intensity interval training (HIIT), participants completed two trials in a double-blind, randomized order: (a) placebo trial consisting of AHM withdrawal for 3 days and (b) AHM trial where individuals held their habitual dose of AHM. In each trial, 24-h mean arterial pressure (MAP) was monitored and considered the primary study outcome. Secondary outcomes included plasma renin activity (PRA) and aldosterone concentration to confirm withdrawal effects on RAAS, along with the analysis of urine albumin-to-creatinine ratio (UACR) to assess kidney function. The results showed main effects from AHM and HIIT reducing 24-h MAP (-5.7 mmHg, p < 0.001 and -2.3 mmHg, p = 0.007, respectively). However, there was not interaction between AHM and HIIT on 24-h MAP (p = 0.240). There was a main effect of AHM increasing PRA (p < 0.001) but no effect on plasma aldosterone concentration (p = 0.368). HIIT did not significantly improve RAAS hormones or the UACR. In conclusion, AHM and HIIT have independent and additive effects in lowering ABP. These findings support the combination of habitual AHM with exercise training with the goal to reduce ABP in hypertensive MetS individuals.
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http://dx.doi.org/10.1111/sms.13949DOI Listing
July 2021

Exercise Reduces Medication for Metabolic Syndrome Management: A 5-Year Follow-up Study.

Med Sci Sports Exerc 2021 07;53(7):1319-1325

Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, SPAIN.

Purpose: This study aimed to determine the effects of a 5-yr exercise intervention on metabolic syndrome (MetS) and health-related variables and medication use for MetS management.

Methods: Participants were randomly assigned to an exercise intervention (n = 25, 54 ± 2 yr, 20% women) or control group (n = 26, 54 ± 2 yr, 38% women). The intervention lasted 4 months per year and consisted of high-intensity interval training on a cycloergometer thrice a week. Outcomes were MetS z-score and medication use score, MetS-related variables (including blood pressure, blood glucose homeostasis, and lipid profile), and cardiorespiratory fitness (CRF, as determined by maximal oxygen uptake).

Results: MetS z-score was similarly reduced over time in both groups (P = 0.244 for group-time interaction). A quasi-significant and significant group-time interaction was found for MetS number of factors (P = 0.004) and CRF (P < 0.001), respectively. Thus, MetS factors tended to decrease over time only in the exercise group with no change in the control group, whereas CRF increased from baseline to 5-yr assessment in the exercise group (by 1.1 MET, P < 0.001) but decreased in the control group (-0.5 MET, P = 0.025). Medicine use score increased twofold from baseline to 5-yr follow-up in the control group (P < 0.001) but did not significantly change (10%, P = 0.52) in the exercise group (P < 0.001 for group-time interaction). The proportion of medicated patients who had to increase antihypertensive (P < 0.001), glucose-lowering (P = 0.036), or total medication (P < 0.0001) over the 5-yr period was lower in the exercise than that in the control group.

Conclusions: Exercise training can attenuate the increase in medication that would be otherwise required to manage MetS over a 5-yr period.
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http://dx.doi.org/10.1249/MSS.0000000000002591DOI Listing
July 2021

The use of a graded exercise test may be insufficient to quantify true changes in V̇o following exercise training in unfit individuals with metabolic syndrome.

J Appl Physiol (1985) 2020 10 3;129(4):760-767. Epub 2020 Sep 3.

Exercise Physiology Laboratory at Toledo, University of Castilla-La Mancha, Toledo, Spain.

We studied the accuracy of graded exercise testing (GXT) to assess improvements in maximal oxygen uptake (V̇o) with exercise training in unfit individuals with metabolic syndrome (MetS). Forty-four adults with MetS (58 ± 7 yr, 36% women, BMI 31.8 ± 4.8 kg/m) underwent 4 mo of supervised high-intensity interval exercise training. V̇o was assessed using GXT, followed by a constant-load verification test (VerT) at 110% of the maximal work rate achieved during GXT. V̇o data from GXT and VerT were compared using repeated-measures ANOVA. The mean improvement in V̇o following exercise training was similar when using GXT only or VerT. However, before training, 18 subjects achieved a higher V̇o during the verification test that was (+159 mLO/min) higher than the GXT ( < 0.001). After training, the underestimation of V̇o by GXT was reduced but still present (+64 mLO/min). As a result, improvements in V̇o following exercise training as assessed using GXT only almost doubled the "real" increase in V̇o as measured by VerT in these 18 individuals. In the remaining 26 subjects, GXT scored below VerT only after training (+54 mLO/min, = 0.046). As a consequence, GXT underestimated the actual V̇o increases (-49 mLO/min, = 0.013) in these individuals. Assessment of changes in V̇o following exercise training using only GXT over- or underestimates V̇o gains in unfit individuals with MetS. Thus, a verification test may be required to ) identify the highest V̇o during a maximal exercise test on a cycle ergometer and ) accurately quantify the true changes in cardiorespiratory fitness following exercise training in unfit individuals with MetS. It is unclear whether the traditional GXT is suitable to assess V̇o changes in unfit individuals with metabolic syndrome. Mean changes in V̇o following exercise training were similar using GXT or VerT. However, we showed that the GXT overestimated V̇o improvements in 41% and underestimated V̇o improvements in 59% of subjects. Our data suggest the need for a verification test to appropriately determine training-induced improvements in V̇o in unfit individuals with metabolic syndrome.
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http://dx.doi.org/10.1152/japplphysiol.00455.2020DOI Listing
October 2020

Substitution of parts of aerobic training by resistance training lowers fasting hyperglycemia in individuals with metabolic syndrome.

Appl Physiol Nutr Metab 2021 Jan 13;46(1):69-76. Epub 2020 Jul 13.

Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo 45071, Spain.

We sought to determine the effects of substituting parts of aerobic training (AT) by resistance training (RT) on metabolic syndrome (MetS) factors. MetS patients (aged 56 ± 7 years; body mass index 33 ± 5 kg·m and 3.9 ± 0.8 MetS factors) were randomized to undergo 1 of the following isocaloric, 16-week long exercise programs: () cycling 4 bouts of 4-min at 90% of maximal heart rate (HR) followed by 3 sets of 12 repetitions of 3 lower limb free-weight exercises (high-intensity interval training (HIIT)+RT group; = 33), () cycling 5 bouts of 4 min at 90% of HR (HIIT+HIIT group; = 33), or () no exercise control group ( = 21). We measured the evolution of all 5 MetS components ( score), cardiorespiratory fitness (maximal oxygen uptake), leg strength and power (leg press 1-repetition maximum (1RM) and countermovement jump (CMJ)), fasting blood glucose (FG), fasting insulin, and insulin resistance (homeostasis model assessment 2). Both training groups improved maximal oxygen uptake similarly (170 ± 310 and 190 ± 210 mL O·min;  < 0.001) and score (-0.12 ± 0.29 and -0.12 ± 0.31 for HIIT+RT and HIIT+HIIT, respectively;  < 0.02). However, only HIIT+RT improved CMJ ( = 0.002) and leg press 1RM above the HIIT+HIIT group (21% vs 6%;  < 0.001). Furthermore, FG only decreased in the HIIT+RT group (5%;  = 0.026, time × group). Our findings suggest that substitution of part of HIIT by leg RT improves glucose control in MetS individuals. Most studies addressing the efficacy of endurance versus resistance training are not matched by energy expenditure. We found that substituting 20% of AT with RT reduces hyperglycemia in MetS individuals. Training recommendations to regain glycemic control in MetS individuals should include resistance training.
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http://dx.doi.org/10.1139/apnm-2020-0281DOI Listing
January 2021

Effects of Exercise Training during Christmas on Body Weight and Cardiometabolic Health in Overweight Individuals.

Int J Environ Res Public Health 2020 07 1;17(13). Epub 2020 Jul 1.

Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, 45071 Toledo, Spain.

Individuals with abdominal obesity and metabolic syndrome (MetS) have augmented risk of all-cause mortality. Lifestyle interventions are effective to treat MetS, however, there are periods during the year in which exercise programs are discontinued and improper dietary habits reappear (e.g., Christmas holidays). We aimed to analyze if exercise-training during Christmas holidays would avoid body-weight gains and cardiometabolic deterioration in MetS individuals, using a randomized control trial. Thirty-eight men with MetS undergoing exercise training were randomly allocated to either continue (TRAIN group, n = 16) or discontinue (HOLID group, n = 22) training, during the three weeks of Christmas. Anthropometrics (body weight, fat, and waist circumference), fasting blood metabolites (glucose, insulin, triglycerides, and cholesterol concentrations) and exercise maximal fat oxidation (FO) and oxygen uptake (VO) were determined before and after Christmas. Both groups were similar at baseline in all parameters ( > 0.05). HOLID group increased body weight (91.3 ± 13.0 to 92.0 ± 13.4 kg, = 0.004), mean arterial pressure (94.0 ± 10.6 to 97.1 ± 8.9 mmHg, = 0.026), blood insulin (10.2 ± 3.8 to 12.5 ± 5.4 µIU·mL, = 0.003) and HOMA (3.2 ± 1.3 to 4.1 ± 2.3, = 0.003). In contrast, TRAIN prevented those disarrangements and reduced total (170.6 ± 30.6 to 161.3 ± 31.3 mg·dL, = 0.026) and low-density lipoprotein cholesterol (i.e., LDL-, 104.8 ± 26.1 to 95.6 ± 21.7 mg·dL, = 0.013). TRAIN also prevented the reductions in exercise FO and VO that was observed in the HOLID group ( = 0.002). In conclusion, exercise training during Christmas, prevents body weight gains and the associated cardiovascular (increase in blood pressure and LDL) and metabolic (reduced insulin sensitivity) health risks are an optimal non-pharmacological therapy for that period of the year.
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http://dx.doi.org/10.3390/ijerph17134732DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369896PMC
July 2020

Effects of statins and exercise on postprandial lipoproteins in metabolic syndrome vs metabolically healthy individuals.

Br J Clin Pharmacol 2021 03 12;87(3):955-964. Epub 2020 Jul 12.

Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Spain.

Aims: To determine if the combination of exercise and statin could normalize postprandial triglyceridaemia (PPTG) in hypercholesteraemic individuals.

Methods: Eight hypercholesteraemic (blood cholesterol 182 ± 38 mg dL ; low-density lipoprotein-cholesterol [LDL-c] 102 ± 32 mg dL ) overweight (body mass index 30 ± 4 kg m ) individuals with metabolic syndrome (MetS) were compared to a group of 8 metabolically healthy (MetH) controls (blood cholesterol 149 ± 23 mg dL ; LDL-c 77 ± 23 mg dL , and body mass index 23 ± 2 kg m ). Each group underwent 2 PPTG tests, either 14 hours after a bout of intense exercise or without previous exercise. Additionally, MetS individuals were tested 96 hours after withdrawal of their habitual statin medication to study medication effects.

Results: A bout of exercise before the test meal did not reduce PPTG in MetS (P = .347), but reduced PPTG by 46% in MetH (413 ± 267 to 224 ± 142 mg dL for 5 h incremental area under the curve; P = .02). In both trials (i.e., either after a bout of intense exercise or without previous exercise), statin withdrawal in MetS greatly increased PPTG (average 65%; P < .01), mean LDL-c (average 25%; P < .01), total cholesterol (average 16%; P < .01) and apolipoprotein (Apo) B48 (24%; P < .01), without interference from exercise. However, Apo B100 was not affected by statin withdrawal.

Conclusion: Hypercholesteraemic MetS individuals (compared to MetH controls) fail to show an effect of exercise on reducing PPTG. However, chronic statin medication blunts the elevations in triglyceride after a fat meal (i.e., incremental area under the curve of PPTG) reducing their cardiovascular risk associated with their atherogenic dyslipidaemia. Statin decreases PPTG by reducing the secretion or accelerating the catabolism of intestinal Apo B48.
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http://dx.doi.org/10.1111/bcp.14447DOI Listing
March 2021

Are we ready to measure running power? Repeatability and concurrent validity of five commercial technologies.

Eur J Sport Sci 2021 Mar 26;21(3):341-350. Epub 2020 Apr 26.

Human Performance and Sports Science Laboratory, Faculty of Sport Sciences, University of Murcia, Murcia, Spain.

Training prescription in running activities have benefited from power output (P) data obtained by new technologies. Nevertheless, to date, the suitability of P data provided by these tools is still uncertain. The present study aimed to: (i) analyze the repeatability of five commercially available technologies for running P estimation, and (ii) examine the concurrent validity through the relationship between each technology P and oxygen uptake (VO). On two occasions (test-retest), twelve endurance-trained male athletes performed on a treadmill (indoor) and an athletic track (outdoor) three submaximal running protocols with manipulations in speed, body weight and slope. P was simultaneously registered by the commercial technologies Stryd, Stryd, RunScribe, Garmin and Polar, while VO was monitored by a metabolic cart. Test-retest data from the environments (indoor and outdoor) and conditions (speed, body weight and slope) were used for repeatability analysis, which included the standard error of measurement (SEM), coefficient of variation (CV) and intraclass correlation coefficient (ICC). A linear regression analysis and the standard error of estimate (SEE) were used to examine the relationship between P and VO. Stryd device was found as the most repeatable technology for all environments and conditions (SEM ≤ 12.5 W, CV ≤ 4.3%, ICC ≥ 0.980), besides the best concurrent validity to the VO ( ≥ 0.911, SEE ≤ 7.3%). On the contrary, although the Polar, Garmin and RunScribe technologies maintain a certain relationship with VO, their low repeatability questions their suitability. The Stryd can be considered as the most recommended tool, among the analyzed, for P measurement.
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http://dx.doi.org/10.1080/17461391.2020.1748117DOI Listing
March 2021

Time to exhaustion during cycling is not well predicted by critical power calculations.

Appl Physiol Nutr Metab 2020 Jul 14;45(7):753-760. Epub 2020 Jan 14.

Exercise Physiology Laboratory at Toledo. University of Castilla-La Mancha, Avda Carlos III, s/n, 47051, Toledo, Spain.

Three to 5 cycling tests to exhaustion allow prediction of time to exhaustion (TTE) at power output based on calculation of critical power (CP). We aimed to determine the accuracy of CP predictions of TTE at power outputs habitually endured by cyclists. Fourteen endurance-trained male cyclists underwent 4 randomized cycle-ergometer TTE tests at power outputs eliciting () mean Wingate anaerobic test (WAnT), () maximal oxygen consumption, () respiratory compensation threshold (VT), and () maximal lactate steady state (MLSS). Tests were conducted in duplicate with coefficient of variation of 5%-9%. Power outputs were 710 ± 63 W for WAnT, 366 ± 26 W for maximal oxygen consumption, 302 ± 31 W for VT and 247 ± 20 W for MLSS. Corresponding TTE were 00:29 ± 00:06, 03:23 ± 00:45, 11:29 ± 05:07, and 76:05 ± 13:53 min:s, respectively. Power output associated with CP was only 2% lower than MLSS (242 ± 19 vs. 247 ± 20 W; < 0.001). The CP predictions overestimated TTE at WAnT (00:24 ± 00:10 mm:ss) and MLSS (04:41 ± 11:47 min:s), underestimated TTE at VT (-04:18 ± 03:20 mm:ss; < 0.05), and correctly predicted TTE at maximal oxygen consumption. In summary, CP accurately predicts MLSS power output and TTE at maximal oxygen consumption. However, it should not be used to estimate time to exhaustion in trained cyclists at higher or lower power outputs (e.g., sprints and 40-km time trials). CP calculation enables to predict TTE at any cycling power output. We tested those predictions against measured TTE in a wide range of cycling power outputs. CP appropriately predicted TTE at maximal oxygen consumption intensity but err at higher and lower cycling power outputs.
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http://dx.doi.org/10.1139/apnm-2019-0637DOI Listing
July 2020

Effects of statin therapy and exercise on postprandial triglycerides in overweight individuals with hypercholesterolaemia.

Br J Clin Pharmacol 2020 06 18;86(6):1089-1099. Epub 2020 Feb 18.

Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Spain.

Aims: To determine the effects of statins on postprandial lipaemia (PPL) and to study if exercise could enhance statin actions.

Methods: Ten hypercholesteraemic (blood cholesterol 204 ± 36 mg dL ; low-density lipoprotein-cholesterol 129 ± 32 36 mg dL ) overweight (body mass index 30 ± 4 kg m ), metabolic syndrome individuals chronically medicated with statins (>6 months) underwent 5-hour PPL tests in 4 occasions in a randomized order: (i) substituting their habitual statin medication by placebo for 96 hours (PLAC trial); (ii) taking their habitual statin medicine (STA trial); (iii) placebo combined with a bout of intense aerobic exercise (EXER+PLAC trial); and (iv) combining exercise and statin medicine (EXER+STA trial).

Results: Before the fat meal, statin withdrawal (i.e. PLAC and EXER+PLAC) increased blood triglycerides (TG; 24%), low-density lipoprotein-cholesterol (31%) and total cholesterol (19%; all P < .05) evidencing treatment compliance. After the meal, statin withdrawal increased 5-hour postprandial TG (PPTG) compared to its matched trials (94% higher PLAC vs STA and 45% higher EXER+PLAC vs EXER+STA; P < .05). EXER+PLAC trial did not lower PPTG below PLAC (i.e. incremental AUC of 609 ± 152 vs 826 ± 190 mg dL 5 h; P = .09). Adding exercise to statin did not result in larger reductions in PPTG (i.e. EXER+STA vs STA incremental area under the curve of 421 ± 87 vs 421 ± 84 mg dL 5 h; P = .99).

Conclusion: In hypercholesteraemic metabolic syndrome individuals, chronic statin therapy blunts the elevations in TG after a fat meal (i.e. incremental area under the curve of PPTG) reducing the cardiovascular risk associated to their atherogenic dyslipidaemia. However, a single bout of intense aerobic exercise before the high fat meal, does not reduce PPTG but also does not interfere with the effects of statin treatment.
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http://dx.doi.org/10.1111/bcp.14217DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7256119PMC
June 2020

Exercise Training Adaptations in Metabolic Syndrome Individuals on Chronic Statin Treatment.

J Clin Endocrinol Metab 2020 04;105(4)

Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain.

Background: Statins reduce atherogenic dyslipidemia and cardiovascular disease (CVD) risk in metabolic syndrome (MetS) individuals. Exercise training could also contribute to reduce CVD by improving cardiorespiratory fitness and fat oxidation. However, statin use could interfere with training adaptations.

Methods: A total of 106 MetS individuals were divided into statin users (statin group, n = 46) and statin-naïve (control group, n = 60). Groups were matched by age, weight, and MetS components. Subjects completed 16 weeks of high intensity interval training (HIIT). Before and after HIIT, muscle biopsies were collected to assess mitochondrial content (citrate synthase [CS] activity) and the activity of the rate limiting β-oxidation enzyme (3-hydroxyacyl-CoA-dehydrogenase [HAD]). Fasting plasma glucose, insulin, TG, HDL-c, and LDL-c concentrations were measured. Exercise maximal fat oxidation (FOMAX) and oxygen uptake (VO2PEAK) were determined.

Results: Training improved MetS similarly in both groups (MetS z-score -0.26 ± 0.38 vs. -0.22 ± 0.31; P < 0.001 for time and P = 0.60 for time x group). Before training, the statin group had reduced muscle HAD activity and whole body FOMAX compared to the control group. However, 16 weeks of HIIT increased HAD and FOMAX in both groups (P < 0.03, time-effect). The statin group did not prevent the increases in CS with HIIT observed in the control group (38% vs 64%, respectively; P < 0.001, time-effect). Conversely, with training VO2PEAK improved less in the statin than in the control group (12% vs. 19%, respectively; P = 0.013, time × group effect).

Conclusion: Chronic statin use in MetS does not interfere with exercise training improvements in MetS components, FOMAX, or mitochondrial muscle enzymes (ie, CS and HAD). However, the statin group attenuated the improvements in VO2PEAK with training.

Clinical Trial Information: ClinicalTrials.gov identifier no. NCT03019796, January 13, 2017.
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http://dx.doi.org/10.1210/clinem/dgz304DOI Listing
April 2020

Women with metabolic syndrome show similar health benefits from high-intensity interval training than men.

PLoS One 2019 10;14(12):e0225893. Epub 2019 Dec 10.

Exercise Physiology Laboratory, University of Castilla-La Mancha, Toledo, Spain.

High-intensity interval training (HIIT), is effective to improve cardiorespiratory fitness (CRF) and metabolic syndrome (MetS) components in adults. However, it is unclear if CRF and MetS components respond similarly in men and women after HIIT. For 16 weeks, 63 women (53±7 years) and 56 men (55±8 years) with MetS underwent a three day/week HIIT program. Bodyweight and composition, VO2MAX, surrogate parameters of CRF (Ventilatory threshold (VT), oxygen uptake efficiency slope (OUES) and VE/VCO2 slope), maximal rate of fat oxidation (MFO), and MetS components were assessed before and after training. All reported variables were analyzed by split-plot ANOVA looking for time by sex interactions. Before training men had higher absolute values of VO2MAX (58.6%), and MFO (24.6%), while lower body fat mass (10.5%) than women (all P<0.05). After normalization by fat-free mass (FFM), VO2MAX remained 16.6% higher in men (P<0.05), whereas differences in MFO disappeared (P = 0.292). After intervention VO2MAX (P<0.001), VO2 at VT (P<0.001), OUES (P<0.001), and VE/VCO2 slope (P<0.001) increased without differences by sex (P>0.05). After training MetS Z-score (P<0.001) improved without differences between men and women (P>0.05). From the MetS components, only blood pressure (P<0.001) and waist circumference (P<0.001) improved across time, without differences by sex. In both, women and men, changes in OUES (r = 0.685 and r = 0.445, respectively), and VO2 at VT (r = 0.378, and r = 0.445, respectively), correlated with VO2MAX. While only bodyweight changes correlated with MetS Z-score changes (r = 0.372, and = 0.300, respectively). Despite baseline differences, 16-weeks of HIIT similarly improved MetS, cardiorespiratory and metabolic fitness in women and men with MetS. This suggests that there are no restrictions due to sex on the benefits derived from an intense exercise program in the health of MetS participants. Trial Registration: clinicaltrials.gov NCT03019796.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0225893PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6903716PMC
March 2020

Importance of a verification test to accurately assess V̇O max in unfit individuals with obesity.

Scand J Med Sci Sports 2020 Mar 11;30(3):583-590. Epub 2019 Dec 11.

Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain.

Background: To determine the trustworthiness of graded exercise test to exhaustion (GXT) to assess maximal oxygen uptake ( ) in metabolic syndrome individuals with obesity and poor cardiorespiratory fitness.

Methods: was assessed in 100 metabolic syndrome adults (57 ± 8 years; 34% women), with obesity (BMI 32 ± 5 kg·m ) using GXT followed by supramaximal constant-load verification test (VerT) at 110% of maximal GXT work rate. data from GXT and VerT were compared using paired t test and plotted for Bland-Altman analysis. GXT sensitivity and specificity to detect were also calculated.

Results: Seventy individuals did not achieve plateau during GXT. GXT underestimated in 40 subjects. In these subjects, the magnitude of underestimation with GXT was 9% (167 mLO ·min ; P < .001). In the whole sample (n = 100), bias error differences between GXT and VerT was 63 mLO ·min (3% underestimation). This error was constant regardless of differences in fitness levels among individuals (R = -0.07; homoscedasticity). GXT results were unreliable in 62% of the sample with 16% of false-positive and 46% of false-negative results. Sensitivity and specificity of GTX to assess were low (ie, 23% and 60%, respectively).

Conclusion: Our data indicate that the magnitude (3%-9%) and prevalence (40% of subjects) of underestimation with the use of a GXT alone is high in a large sample of unfit metabolic syndrome individuals with obesity. Our data advocate for the need of using VerT after GXT to avoid significant cardiorespiratory fitness underestimation in metabolic syndrome individuals with obesity and low fitness level.
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http://dx.doi.org/10.1111/sms.13602DOI Listing
March 2020

Post-exercise Hypotension Produced by Supramaximal Interval Exercise is Potentiated by Angiotensin Receptor Blockers.

Int J Sports Med 2019 Nov 2;40(12):756-761. Epub 2019 Sep 2.

Exercise Physiology Lab, Universidad de Castilla-La Mancha, Toledo, Spain.

We studied the effects of supramaximal interval exercise (SIE) with or without antihypertensive medication (AHM) on 21-hr blood pressure (BP) response. Twelve hypertensive patients chronically medicated with AHM, underwent three trials in a randomized order: a) control trial without exercise and substituting their AHM with a placebo (PLAC); b) placebo medicine and a morning bout of SIE (PLAC+SIE), and c) combining AHM and exercise (AHM+SIE). Acute and ambulatory blood pressure responses were measured for 21-hr after treatment. 20  min after treatment, systolic blood pressure (SBP) readings were reduced, similar to readings after PLAC+SIE (-9.7±6.0 mmHg, P<0.001) and AHM+SIE (-10.4±7.9 mmHg, P=0.001). 21 h after treatment, SBP remained reduced after PLAC+SIE (125±12 mmHg, P=0.022) and AHM+SIE (122±12 mmHg, P=0.013) compared to PLAC (132±16 mmHg). The BP reduction in PLAC+SIE faded out at 4 a.m., while in AHM+SIE it continued overnight. At night, BP reduction was larger in AHM+SIE than PLAC+SIE (-5.6±4.0 mmHg, P=0.006). Our data shows that a bout of supramaximal aerobic interval exercise in combination with ARB medication in the morning elicits a sustained blood pressure reduction lasting at least 21-h. Thus, the combination of exercise and angiotensin receptor blocker medication seems superior to exercise alone for acutely decreasing blood pressure.
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http://dx.doi.org/10.1055/a-0927-6957DOI Listing
November 2019

Effectiveness of Aerobic Exercise Programs for Health Promotion in Metabolic Syndrome.

Med Sci Sports Exerc 2019 09;51(9):1876-1883

Exercise Physiology Laboratory at Toledo, University of Castilla-La Mancha, Toledo, SPAIN.

Purpose: Continuous and interval are the two types of aerobic exercise training commonly used for health promotion. We sought to determine which aerobic exercise training program results in larger health improvements in metabolic syndrome (MetS) individuals.

Methods: One hundred twenty-one MetS patients (age, 57 ± 8 yr; weight, 92 ± 15 kg; and MetS factors, 3.8 ± 0.8 components) with low initial cardiorespiratory fitness (CRF) (V˙O2peak, 24.0 ± 5.5 mL·kg·min) were randomized to undergo one of the following 16-wk exercise program: (a) 4 × 4-min high-intensity interval training at 90% of HRMAX (4HIIT group; n = 32), (b) 50-min moderate-intensity continuous training at 70% of HRMAX (MICT group; n = 35), (c) 10 × 1-min HIIT at 100% of HRMAX (1HIIT group; n = 32), or (d) no exercise control group (CONT; n = 22). We measured the evolution of all five MetS components (i.e., MetS Z Score) and CRF (assessed by V˙O2peak) before and after intervention.

Results: MetS Z score decreased 41% after 4HIIT (95% confidence interval [CI], 0.25-0.06; P < 0.01) and 52% in MICT (95% CI, 0.24-0.06; P < 0.01), whereas it did not change in 1HIIT (decreased 24%; 95% CI, -0.16 to 0.03; P = 0.21) and CONT (increased 20%; 95% CI, -0.19 to 0.04; P = 0.22). However, the three exercise groups improved similarly their V˙O2peak (4HIIT, 11%; 95% CI, 0.14-0.33; MICT, 12%; 95% CI, 0.18-0.36; and 1HIIT, 14%; 95% CI, 0.21-0.40 L·min; all P < 0.001).

Conclusions: Our findings suggest that in sedentary individuals with MetS and low initial CRF level any aerobic training program of 16 wk with a frequency of three times per week is sufficient stimulus to raise CRF. However, the more intense but shorter 1HIIT training program is not effective on improving MetS Z score, and thus we caution its recommendation for health promotion purposes in this population.
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http://dx.doi.org/10.1249/MSS.0000000000001983DOI Listing
September 2019

Differing Water Intake and Hydration Status in Three European Countries-A Day-to-Day Analysis.

Nutrients 2019 Apr 3;11(4). Epub 2019 Apr 3.

Institute of Biochemistry, German Sport University Cologne, 50933 Cologne, Germany.

Adequate hydration is essential for maintaining health and functionality of the human body. Studies assessing both daily water intake and hydration status are lacking. This study explored data from the European Hydration Research Study (EHRS) and focused on total water intake (TWI), 24 h hydration status, and day-to-day variations in a sample of 573 healthy adults. TWI was assessed by food records and hydration status (urine osmolality and urine volume) was measured from 24 urine samples collected over seven consecutive days. On all weekdays, mean TWI was higher ( < 0.001 for all days) for the German subjects compared to the Greek and Spanish participants. In 37% of the male and 22% of the female subjects, the individual mean TWI was below the European Food Safety Authority (EFSA) recommendation, with 16% men (4% women) being below the EFSA recommendation on every testing day. Twenty-four hour urine osmolality was lower in women compared to men (595 ± 261 vs. 681 ± 237 mOsmol/kg; < 0.001). More men (40%) showed a urine osmolality ≥800 mOsmol/kg at least on four days of the study period compared to women (26%) and more participants from Spain (46%) compared to Greece (29%) and Germany (11%). A large number of individuals showed an inadequate hydration status on several days per week, which may have a negative health and cognitive impact on daily life.
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http://dx.doi.org/10.3390/nu11040773DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520853PMC
April 2019

Training intensity relative to ventilatory thresholds determines cardiorespiratory fitness improvements in sedentary adults with obesity.

Eur J Sport Sci 2019 May 31;19(4):549-556. Epub 2018 Oct 31.

b Exercise Physiology Lab at Toledo , University of Castilla-La Mancha , Toledo , Spain.

The aim of the present study was to study if training intensity relative to ventilatory thresholds (VTs) determines the improvements in cardiorespiratory fitness (CRF) in middle-aged sedentary individuals with obesity. Before and after 16-weeks of HIIT (43-min alternating bouts at 70/90% of HR), oxygen consumption ( O) and heart rate (HR) at ventilatory threshold 1 ( O HR), ventilatory threshold 2 ( O, HR) and at maximal effort ( O, HR) were assessed during a graded cycle-ergometer exercise test. Retrospectively, participants were divided into two groups based on whether training intensities were under (UNDER; n = 39) or over (OVER; n = 37) VT and VT. At baseline, age, body composition, O O, and HR were similar in both groups. However, O was higher in OVER (P = 0.033), whereas HR and HR were higher in UNDER (P < 0.05). O (9.0%) and HR (2.2%) improved similarly in both groups. O and O improved with training in both groups (P < 0.001) but the improvement was larger in OVER versus UNDER in O (P = 0.013) and tended to be higher in O (P = 0.068). HR increased only in OVER (P < 0.001), whereas HR did not change in any group (P = 0.248). A 16-week programme of HIIT improves O similarly in individuals training at intensities over or under their VTs. However, individuals training over their VTs showed a larger improvements in O expanding exercise workloads fuelled by oxidative metabolism.
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http://dx.doi.org/10.1080/17461391.2018.1540659DOI Listing
May 2019

Validity of Skin, Oral and Tympanic Temperatures During Exercise in the Heat: Effects of Wind and Sweat.

Ann Biomed Eng 2019 Jan 22;47(1):317-331. Epub 2018 Aug 22.

Human Performance and Sports Science Laboratory, University of Murcia, c/Argentina s/n Santiago de la Ribera, Murcia, Spain.

This experiment investigates the validity of six thermometers with different measuring sensors, operation and site of application, to estimate core temperature (T) in comparison to an ingestible thermometric sensor based on quartz crystal technology. Measurements were obtained before, during and after exercise in the heat, controlling the presence of air-cooling and skin sweating. Twelve well-trained men swallowed the ingestible thermometer 6 h before the trial. After pre-exercise resting measurements at 20 °C, subjects entered a heat chamber held at 40 °C. Exercise in the heat consisted of 60 min of pedalling on cycle ergometer at 90% of the individually determined first ventilatory threshold. Results reveal that wind and skin sweat invalidate the use of skin infrared thermometry to estimate T during exercise in the heat. However, better T estimations were obtained in wind-restricted situations. We detected important differences between same-technology devices but different models and brands. In conclusion, there are important limitations to assess T accurately using non-invasive thermometers during and after exercise in the heat. Because some devices showed better validity than others did, we recommended using tympanic Braun, and non-contact skin infrared Medisana or Visiofocus in wind-restricted and no sweat conditions to estimate T during exercise in the heat.
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http://dx.doi.org/10.1007/s10439-018-02115-xDOI Listing
January 2019

Changes in markers for cardio-metabolic disease risk after only 1-2 weeks of a high saturated fat diet in overweight adults.

PLoS One 2018 27;13(6):e0198372. Epub 2018 Jun 27.

Exercise Physiology Lab, University of Castilla-La Mancha, Toledo, Spain.

Purpose: Diets high in saturated fat acids (SFA) have been linked with cardio-metabolic disease risk. The purpose of this study was to determine whether only 1-2 weeks of a high SFA diet could impact disease risk factors in overweight adults who normally eat a relatively low proportion of SFA (i.e., <40% of dietary fat).

Methods: Twelve overweight (BMI: 27±1 kg/m2) young adults were studied before and after a 2-week diet that increased the proportion of SFA (<40% to 60% of dietary fat), while maintaining their daily intake of total fat, carbohydrate, protein, and calories. Insulin resistance, blood pressure, plasma markers of liver damage, total plasma cholesterol concentrations, and fatty acid profile within plasma and skeletal muscle lipid pools were assessed before and after the intervention.

Results: Total plasma cholesterol concentration increased (148±5 vs. 164±8 mg/dl; P<0.05) after only one week, due exclusively to an increase in LDL-cholesterol (78±4 vs. 95±7 mg/dl; P<0.05). After two weeks, plasma aspartate amino transferase (AST) concentration increased (P<0.05) but we found no change in insulin resistance, or resting blood pressure. The diet increase the proportion of SFA in plasma (35±1% vs. 39±2%; P<0.05) and the intramyocellular triglyceride pool (32±1% vs. 37±1%; P<0.05) suggesting the fatty acids in these pools may readily exchange.

Conclusions: Although blood lipids remain within normal clinical range, increasing saturated fat in diet for only 2 weeks raises plasma markers of cardiovascular risk (LDL-cholesterol) and liver damage (AST). In overweight, but healthy-young adults SFA accumulate in plasma and muscle after only 1-2 weeks of dietary increase.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198372PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6021040PMC
December 2018

Movement Velocity as a Measure of Level of Effort During Resistance Exercise.

J Strength Cond Res 2019 Jun;33(6):1496-1504

Human Performance and Sports Science Laboratory, University of Murcia, Murcia, Spain.

Morán-Navarro, R, Martínez-Cava, A, Sánchez-Medina, L, Mora-Rodríguez, R, González-Badillo, JJ, and Pallarés, JG. Movement velocity as a measure of level of effort during resistance exercise. J Strength Cond Res 33(6): 1496-1504, 2019-This study analyzed whether the loss of repetition velocity during a resistance exercise set was a reliable indicator of the number of repetitions left in reserve. After the assessment of one-repetition (1RM) strength and full load-velocity relationship, 30 men were divided into 3 groups according to their 1RM strength per body mass: novice, well trained, and highly trained. On 2 separate occasions and in random order, subjects performed tests of maximal number of repetitions to failure against loads of 65, 75, and 85% 1RM in 4 exercises: bench press, full squat, prone bench pull, and shoulder press. For each exercise, and regardless of the load being used, the absolute velocities associated with stopping a set before failure, leaving a certain number of repetitions (2, 4, 6, or 8) in reserve, were very similar and showed a high reliability (coefficient of variation [CV] 4.4-8.0%). No significant differences in these stopping velocities were observed for any resistance training exercise analyzed between the novice, well trained and highly trained groups. These results indicate that by monitoring repetition velocity one can estimate with high accuracy the proximity of muscle failure and, therefore, to more objectively quantify the level of effort and fatigue being incurred during resistance training. This method emerges as a substantial improvement over the use of perceived exertion to gauge the number of repetitions left in reserve.
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http://dx.doi.org/10.1519/JSC.0000000000002017DOI Listing
June 2019

Exercise Periodization over the Year Improves Metabolic Syndrome and Medication Use.

Med Sci Sports Exerc 2018 Oct;50(10):1983-1991

Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, SPAIN.

Purpose: We aimed to determine if yearly repeated exercise training reduces metabolic syndrome (MetS) and the use of medicines to control MetS components.

Methods: Fifty-five MetS individuals were randomized into a TRAIN group that underwent two yearly programs of 16-wk high-intensity interval training or a nonexercising CONT group. We measured the evolution of all five MetS components, cardiorespiratory fitness (assessed by V˙O2PEAK) and medicine use, at baseline (0 months), mid (12 months), and end-point (24 months). Testing took place 8 months after the last training session to assess the chronic effects of training.

Results: Daily physical activity (wristband activity monitors) and calorie intake (3-d nutritional diary) remained similar to baseline at 1 and 2 yr in each group and were not different between groups. Blood triglycerides and glucose concentrations did not significantly vary in any group. However, waist circumference increased only in CONT after 2 yr (107 ± 2 cm to 111 ± 3 cm; P = 0.004). Mean arterial pressure decreased in TRAIN (101 ± 2 mm Hg to 94 ± 2 mm Hg; P = 0.002), whereas it remained unchanged in CONT (98 ± 2 mm Hg to 99 ± 2 mm Hg; P = 1.000) after 2 yr. Starting from similar levels at baseline, after 2 yr V˙O2PEAK was higher (2.32 ± 0.14 L·min vs 1.98 ± 0.11 L·min; P = 0.049) and medicine use lower (1.27 ± 0.22 vs 2.23 ± 0.43; P = 0.043) in TRAIN than CONT. The reduction in MAP in TRAIN commanded a parallel reduction in MetS Z-score from baseline to 2 yr (0.30 ± 0.1 to 0.07 ± 0.1; P = 0.013).

Conclusions: Two yearly 16-wk high-intensity interval training programs are enough exercise to chronically lower MetS while preventing the reductions in cardiorespiratory fitness associated to aging. Of clinical relevance, yearly exercise training halts the increase in medicine use that occurs in non-exercising MetS individuals.
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http://dx.doi.org/10.1249/MSS.0000000000001659DOI Listing
October 2018

Intense aerobic exercise lowers blood pressure in individuals with metabolic syndrome taking antihypertensive medicine.

Blood Press Monit 2018 Oct;23(5):230-236

Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo.

Objective: There is a growing tendency for physicians to prescribe exercise in accordance with the 'exercise is medicine' global health initiative. However, the exercise-pharmacologic interactions for controlling blood pressure are not well described. Our purpose was to study whether angiotensin II receptor type 1 blocker (ARB) antihypertensive medicine enhances the blood pressure-lowering effects of intense exercise.

Participants And Methods: Fifteen hypertensive individuals with metabolic syndrome chronically medicated with ARB underwent two exercise trials in a blind randomized order. One trial was conducted after taking their habitual dose of ARB (ARB MED trial) and another after 48 h of placebo medicine (i.e. dextrose; PLAC trial).

Results: After placebo medication, brachial systolic blood pressure increased by 5.5 mmHg [P=0.009; effect size (ES)=0.476] and diastolic by 2.5 mmHg (P=0.030; ES=0.373). Exercise reduced systolic and diastolic blood pressures to the same extent in ARB MED and PLAC trials (7 and 8 mmHg, respectively, for systolic and 5 and 4 mmHg, respectively, for diastolic, all P<0.05). Pulsatile measures of arterial stiffness did not reveal an interaction effect between exercise and medication. However, postocclusion reactive hyperemia increased after exercise only in the ARB MED trial (361±169 to 449±240% from baseline; P=0.033; ES=0.429).

Conclusion: ARBs and a bout of intense exercise each have an independent effect on lowering blood pressure in hypertensive individuals, and these effects are additive.
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http://dx.doi.org/10.1097/MBP.0000000000000328DOI Listing
October 2018

Hormonal and neuromuscular responses during a singles match in male professional tennis players.

PLoS One 2018 6;13(4):e0195242. Epub 2018 Apr 6.

Exercise Physiology Laboratory at Toledo, University of Castilla-La Mancha, Toledo, Spain.

We sought to measure the response of cortisol concentrations around a professional tennis match and its association with hydration status and neuromuscular performance. Nine professional male tennis players were tested in a rest day, and 2-week after, during the first match of a professional tournament played in a clay-court. Salivary concentrations of cortisol (SalCC) were measured in a resting day (9:00 am and 8:00 pm), at the match day (9:00 am and 8:00 pm) and immediately before and after the match. Hydration status was assessed before the match (urine specific gravity; USG) while fluid turnover was tracked during the match. Finally, counter movement jump (CMJ) and handgrip isometric strength (HS) were measured before and after the match. SalCC, either in the morning (P = 0.161) and afternoon (P = 0.683) was similar in rest and match days. However, SalCC increased after the match (P = 0.033). Participants started the match hypohydrated (USG = 1.026±0.002) and during the match lost 1.0±0.3% of body weight despite 1.035±0.124 L/h of fluid ingested. CMJ and HS did not change post-match (P = 0.210 and P = 0.881, respectively). Correlations between the elevations in SalCC and dehydration (% BW loss) during the match were significant (r = -0.632; P = 0.034). Professional male tennis players did not show an anticipatory increase in SalCC the day of the match and neither signs of neuromuscular fatigue after it. During the match, the mild dehydration (i.e., <1.5%) was associated with the increases in cortisol levels which suggests that dehydration may be an added stress to be considered.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0195242PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889166PMC
July 2018

Use of nutritional supplements and ergogenic aids in professional tennis players.

Nutr Hosp 2017 Nov 17;34(5):1463-1468. Epub 2017 Nov 17.

.

Introduction: Nutritional supplements and ergogenic aids (NS&EA) are used between training/matches with the goal of enhancing tennis performance. Scientific literature about prevalence and use of NS&EA in professional tennis players is scarce.

Objective: The aim of the study was to describe the NS&EA used by professional tennis players during a season.

Methods: Using a validated self-administered questionnaire, 62 professional male and 9 professional female tennis players (11% in their gender specific top 100 tennis world ranking (i.e.,ATP/WTA)) registered all the used NS&EA.

Results: Eighty-one percent of the participants declared taking at least one NS&EA. Strength and conditioning trainers (S&C) and tennis coaches were the professionals who recommended most of the NS&EA in the players outside the TOP-100 (OT100; 50.7% and 39.1%, respectively). However, sports nutritionist were the principal advisors in the top-100 tennis players (T100; 62.5%). Sports drinks were the NS&EA most commonly used by all participants (81.7%). T100 participants used caffeine (p = 0.042), creatine (p = 0.001), iron (p = 0.013) and CHO-protein mix (p = 0.033) significantly more frequently that OT100 players.

Conclusions: There is a high prevalence of NS&EA use among professional tennis players independently of their tennis ranking position. However, T100 tennis player have an increased use of certain substances such us caffeine, creatine, iron and CHO-Protein mix. For the rest of the studied NS&EA the use was similar between T100 and OT100 players. It is possible that the differences in NS&EA use between groups could be related to the different professionals on charge of nutritional advice in T100 vs OT100.
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http://dx.doi.org/10.20960/nh.1404DOI Listing
November 2017

Objective and subjective measures of exercise intensity during thermo-neutral and hot yoga.

Appl Physiol Nutr Metab 2018 Apr 23;43(4):397-402. Epub 2017 Nov 23.

a College of Health Professions, Central Michigan University, Mount Pleasant, MI 48859, USA.

While hot yoga has gained enormous popularity in recent years, owing in part to increased environmental challenge associated with exercise in the heat, it is not clear whether hot yoga is more vigorous than thermo-neutral yoga. Therefore, the aim of this study was to determine objective and subjective measures of exercise intensity during constant intensity yoga in a hot and thermo-neutral environment. Using a randomized, crossover design, 14 participants completed 2 identical ∼20-min yoga sessions in a hot (35.3 ± 0.8 °C; humidity: 20.5% ± 1.4%) and thermo-neutral (22.1 ± 0.2 °C; humidity: 27.8% ± 1.6%) environment. Oxygen consumption and heart rate (HR) were recorded as objective measures (percentage of maximal oxygen consumption and percentage of maximal HR (%HRmax)) and rating of perceived exertion (RPE) was recorded as a subjective measure of exercise intensity. There was no difference in exercise intensity based on percentage of maximal oxygen consumption during hot versus thermo-neutral yoga (30.9% ± 2.3% vs. 30.5% ± 1.8%, p = 0.68). However, exercise intensity was significantly higher during hot versus thermo-neutral yoga based on %HRmax (67.0% ± 2.3% vs. 60.8% ± 1.9%, p = 0.01) and RPE (12 ± 1 vs. 11 ± 1, p = 0.04). According to established exercise intensities, hot yoga was classified as light-intensity exercise based on percentage of maximal oxygen consumption but moderate-intensity exercise based on %HRmax and RPE while thermo-neutral yoga was classified as light-intensity exercise based on percentage of maximal oxygen uptake, %HRmax, and RPE. Despite the added hemodynamic stress and perception that yoga is more strenuous in a hot environment, we observed similar oxygen consumption during hot versus thermo-neutral yoga, classifying both exercise modalities as light-intensity exercise.
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http://dx.doi.org/10.1139/apnm-2017-0495DOI Listing
April 2018

Effects of aerobic interval training on arterial stiffness and microvascular function in patients with metabolic syndrome.

J Clin Hypertens (Greenwich) 2018 01 6;20(1):11-18. Epub 2017 Nov 6.

Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain.

The authors determined the effect of high-intensity aerobic interval training on arterial stiffness and microvascular dysfunction in patients with metabolic syndrome with hypertension. Applanation tonometry was used to measure arterial stiffness and laser Doppler flowmetry to assess microvascular dysfunction before and after 6 months of stationary cycling (training group; n = 23) in comparison to a group that remained sedentary (control group; n = 23). While no variable improved in controls, hypertension fell from 79% (59%-91%) to 41% (24%-61%) in the training group, resulting in lower systolic and diastolic pressures than controls (-12 ± 3 and -6 ± 2 mm Hg, P < .008). Arterial stiffness declined (-17% augmentation index, P = .048) and reactive hyperemia increased (20%, P = .028) posttreatment in the training group vs controls. Blood constituents associated with arterial stiffness and a prothrombotic state (high-sensitivity C-reactive protein, fibrinogen, platelets, and erythrocytes) remained unchanged in the training and control groups. In summary, 6 months of an intense aerobic exercise program reduced both arterial stiffness and microvascular dysfunction in patients with metabolic syndrome despite unchanged blood-borne cardiovascular risk factors. Training lowers blood flow resistance in central and peripheral vascular beds in a coordinated fashion, resulting in clinically relevant reductions in hypertension.
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http://dx.doi.org/10.1111/jch.13130DOI Listing
January 2018

Time course of recovery following resistance training leading or not to failure.

Eur J Appl Physiol 2017 Dec 30;117(12):2387-2399. Epub 2017 Sep 30.

Human Performance and Sports Science Laboratory, University of Murcia, C/Argentina, s/n, Santiago de la Ribera, Murcia, Spain.

Purpose: To describe the acute and delayed time course of recovery following resistance training (RT) protocols differing in the number of repetitions (R) performed in each set (S) out of the maximum possible number (P).

Methods: Ten resistance-trained men undertook three RT protocols [S × R(P)]: (1) 3 × 5(10), (2) 6 × 5(10), and (3) 3 × 10(10) in the bench press (BP) and full squat (SQ) exercises. Selected mechanical and biochemical variables were assessed at seven time points (from - 12 h to + 72 h post-exercise). Countermovement jump height (CMJ) and movement velocity against the load that elicited a 1 m s mean propulsive velocity (V1) and 75% 1RM in the BP and SQ were used as mechanical indicators of neuromuscular performance.

Results: Training to muscle failure in each set [3 × 10(10)], even when compared to completing the same total exercise volume [6 × 5(10)], resulted in a significantly higher acute decline of CMJ and velocity against the V1 and 75% 1RM loads in both BP and SQ. In contrast, recovery from the 3 × 5(10) and 6 × 5(10) protocols was significantly faster between 24 and 48 h post-exercise compared to 3 × 10(10). Markers of acute (ammonia, growth hormone) and delayed (creatine kinase) fatigue showed a markedly different course of recovery between protocols, suggesting that training to failure slows down recovery up to 24-48 h post-exercise.

Conclusions: RT leading to failure considerably increases the time needed for the recovery of neuromuscular function and metabolic and hormonal homeostasis. Avoiding failure would allow athletes to be in a better neuromuscular condition to undertake a new training session or competition in a shorter period of time.
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http://dx.doi.org/10.1007/s00421-017-3725-7DOI Listing
December 2017
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