Cardiorespiratory Fitness In Adults Research Articles

Does greater adherence to a healthy dietary pattern correspond to a better body composition and cardiorespiratory fitness in adults with overweight and primary hypertension? Data from the EXERDIET-HTA study.

Cardiovascular events are positively associated with primary hypertension (HTN), obesity, and low cardiorespiratory fitness (CRF) and negatively with healthy dietary patterns, such as Healthy Diet Indicator (HDI), Mediterranean diet (MD), and the Dietary Approaches to Stop Hypertension (DASH). The aim is to analyze the association between healthy dietary patterns with body composition and CRF. Body composition (bioimpedance) and CRF [peak oxygen uptake (V̇O2peak)] were assessed in 165 participants with HTN and overweight/obesity. There were (1) a positive association (unadjusted) between fat-free mass (%) with DASH and MD (P = 0.03) and a negative association between fat mass (%) and MD (P = 0.03); (2) positive associations (adjusted) between V̇O2peak (l·min-1) with DASH (P = 0.007), HDI (P = 0.017), and MD (P = 0.010) and V̇O2peak (ml·kg-1·min-1) with DASH (P = 0.005); (3) a negative relationship (unadjusted and adjusted) between energy intake and DASH (P = 0.004). In conclusion, these findings highlight the cardiovascular health protection provided by healthy dietary patterns associated with healthier CRF and body composition in people with a profile of HTN and overweight.

Visceral adiposity: A major mediator of the relationship between epicardial adiposity and cardiorespiratory fitness in adults

Background and aimsEpicardial adiposity has been positively associated with visceral adipose tissue (VAT). Few studies have examined the association between cardiorespiratory fitness (CRF) and epicardial adiposity. Furthermore, whether this relationship was independent of VAT remains unexplored. Our purpose was to investigate the contribution of VAT in the relationships between CRF, physical activity (PA) and epicardial adipose tissue (EAT) in asymptomatic women and men. Methods and resultsWe examined the associations between EAT and VAT measured by magnetic resonance imaging, CRF measured by cardiopulmonary exercise testing, and PA assessed using pedometers and a 3-day PA journal in 239 apparently healthy adults (43 % women). Participants were compared according to EAT tertiles and CRF level in both sexes. Participants with the highest EAT level presented more VAT (p < 0.001), lower CRF (p < 0.01), and a more deteriorated cardiometabolic health score (p < 0.01) than those with the lowest EAT level. CRF was negatively associated with EAT in both sexes (p < 0.01). No significant relationship was found with PA (p = NS). Stepwise multivariable regression analyses showed that VAT explained most of the variance in EAT in women and men. Mediation analyses confirmed that VAT was a mediator of the association between CRF and EAT in both sexes. ConclusionIn women and men, VAT appears as a major mediator of the association between CRF and EAT thereby suggesting that managing VAT by improving CRF could help in the prevention of cardiometabolic disorders related to excess EAT.

High-intensity interval training and cardiorespiratory fitness in adults: An umbrella review of systematic reviews and meta-analyses.

High-intensity interval training (HIIT) is characterized by repeated bouts of relatively intense exercise interspersed with recovery periods. Previous studies have evaluated this exercise strategy with various population subgroups, regimens, and comparator groups, limiting the generalizability of findings. We performed a novel umbrella review to generate an up-to-date synthesis of the available evidence regarding the effect of HIIT on cardiorespiratory fitness (CRF) in adults as compared to non-exercise control and traditional continuous forms of exercise such as moderate-intensity continuous training (MICT). An umbrella review was conducted in accordance with the Preferred Reporting Items for Overviews of Reviews guideline. Seven databases (MEDLINE, EMBASE, Cochrane Database, CINAHL, Scopus, SPORTDiscus, and Web of Science) were searched until February 2024. Systematic reviews with meta-analyses comparing HIIT and active/non-active control conditions were included. Literature search, data extraction, and methodological quality assessment (AMSTAR-2) were conducted independently by two reviewers. Twenty-four systematic reviews with meta-analyses, representing 429 primary studies and 12 967 unique participants, met the inclusion criteria. Most of the systematic reviews received moderate-to-critically low AMSTAR-2 scores. The data showed that HIIT, including the particularly intense variant "sprint interval training" (SIT), significantly increases CRF in adults compared to non-exercise control (standardized mean difference [SMD]: 0.28 to 4.31; weighted mean difference [WMD]: 3.25 to 5.5 mL/kg/min) and MICT (SMD: 0.18 to 0.99; WMD: 0.52 to 3.76 mL/kg/min). This effect was consistently observed across specific groups of individuals (e.g., apparently healthy adults, individuals with overweight/obesity, older adults, and high-level athletes) and HIIT modalities (e.g., low-volume HIIT, whole-body HIIT, home-based HIIT, aquatic HIIT, and short SIT). Existing evidence from systematic reviews consistently supports the effect of HIIT on enhancing CRF in adults when compared to non-exercise control and MICT. Our findings offer a comprehensive basis that may potentially contribute to informing physical activity guidelines aimed at improving CRF in the general population.

SAFETY, EFFICACY, AND IMPLEMENTATION OF HOME-BASED HIGH-INTENSITY INTERVAL TRAINING FOR PATIENTS WITH CARDIAC DISEASE: A SYSTEMATIC REVIEW

INTRODUCTION &amp; AIMS High-intensity interval training (HIIT) is safe and more effective than moderate-intensity continuous training for improving cardiorespiratory fitness in adults with cardiac disease. Home-based delivery of cardiac rehabilitation has been introduced to increase the uptake and participation of programs. The aim of this systematic review was to investigate the safety, efficacy, and implementation of home-based HIIT programs for patients with cardiac disease. METHODS A systematic review of the literature was conducted in three electronic databases (MEDLINE, CINAHL and EMBASE) before 2nd October 2023. Studies were included if they were written in English, peer-reviewed and compared home-based HIIT to other centre-based or home-based exercise interventions. A secondary analysis investigating intervention safety, efficacy and implementation was conducted using the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. RESULTS Five studies, involving 153 participants (62 for home-based HIIT and 91 for other home-based or centre-based exercise interventions) were included in the analysis. There were no differences in functional capacity or quality of life (QOL) between home-based HIIT and other centre-based or home-based exercise interventions (p &amp;gt; 0.05). Across all the studies, the reporting rates were highest for program effectiveness (75%) and adoption (75%), followed by reach (70%), implementation (40%), and maintenance (10%). Adverse events were reported during the home-based HIIT intervention in two studies (3%). Participant attrition within home-based HIIT interventions was 8-12%. In studies where adherence to the home-based HIIT protocol was reported, this ranged between 36% and 85%. CONCLUSIONS Home-based HIIT resulted in similar effects in functional capacity and QOL as other centre-based and home-based exercise interventions for patients with cardiac disease. HIIT in the home appears to be safe and effective, however adherence to the protocol varies. Further high-quality studies are needed to inform best practices for prescribing HIIT in the home.

Comparative efficacy of exercise training modes on systemic metabolic health in adults with overweight and obesity: a network meta-analysis of randomized controlled trials.

This network meta-analysis (NMA) was conducted to compare and rank the effects of training interventions including aerobic exercise (AE), resistance training (RT), combined aerobic and resistance training (CT), and high-intensity interval training (HIIT) on vital metabolic indicators in adults with overweight and obesity. PubMed, Cochrane, Embase, and Web of Science were searched from 1990 to February 2023. Articles were included if they described randomized controlled trials (RCTs) examining the effects of exercise training on anthropometry parameters, lipid profiles, glucose metabolism, blood pressure, and cardiorespiratory fitness in adults with overweight and obesity. Weighted mean difference with 95% CI was calculated. A total of 28 studies with 1,620 patients were included. Results revealed that AE exerts best effects on weight loss (-2.35 [-4.05, -0.64]) and body mass index (-0.9 [-1.38, -0.42]), while HIIT is the most effective in reducing waist circumference (-5.93 [10.71, -1.15]), percentage body fat (-3.93 [-5.73, -2.12]), serum triglycerides (-20.55 [-37.20, -3.91]), and fasting blood glucose (-14.31 [-22.47, -6.16]) and improving VO2 max (7.41 [4.37, 10.45]). However, no significant benefit was observed in terms of total cholesterol and blood pressure. AE is the optimal exercise type for reducing body weight and BMI, while HIIT exerts the most beneficial effects on improving body composition, cardiorespiratory fitness, and metabolic abnormalities in adults with overweight and obesity. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023444322, identifier CRD42023444322.

Effectiveness of digital health interventions to increase cardiorespiratory fitness: A systematic review and meta-analysis.

Interventions using commercial digital health tools do favorably affect health outcomes. However, the effect of digital tools on cardiorespiratory fitness, a more novel indicator cardiovascular risk, is unclear. Synthesize the digital health intervention literature and answer the following question: What is the effect of interventions using mobile health apps, wearable activity trackers, and/or text messaging on cardiorespiratory fitness? A systematic review and a meta-analysis (PROSPERO CRD42023423925) were conducted to evaluate the immediate digital health intervention effect on adult cardiorespiratory fitness. In March 2023, a search of databases Embase, MEDLINE, CINHAL, and Cochrane Library was completed. Studies were included if the intervention used a mobile health app, text messaging, and/or activity tracker. Studies were excluded if an objective measure of fitness was not used; the sample included children; the setting was hospital-based; and the digital health technology was only used for data collection or described as virtual reality. Using a random-effects model, two separate meta-analyses were completed: one for single-group studies and one for multi-group studies. Standardized mean difference effect sizes (Cohen's d) were calculated. Study quality was evaluated with the Cochrane Risk of Bias tool and ROBINS-I tool. Fifty-three studies (3657 individuals) with pre-post designs (12 single-group, 41 multi-group) were included. Most studies targeted participants with a specific chronic health condition. Digital health interventions in the single-group studies had a moderate-to-large effect size (d = 0.62, 95% confidence interval (CI) [0.41-0.84], p < 0.001), and multi-group studies had small-to-moderate effect size (d = 0.38, 95% CI 0.21-0.55, p < 0.001). Significant heterogeneity of effects was observed in both the single-group and multi-group studies. Interventions using text messaging, a mobile app, or activity tracker alone or in combination are effective in improving cardiorespiratory fitness in adults, particularly for those with a chronic health condition.

Time of eating and mortality in U.S. adults with heart failure: Analyses of the National Health and Nutrition Examination Survey 2003–2018

Background and aimsPromising associations have been demonstrated between delayed last eating occasion and cardiorespiratory fitness in adults with heart failure (HF), however, it is unknown if time of eating is associated with clinical endpoints such as mortality. This study aimed to examine associations between time of eating variables and all-cause and cardiovascular mortality in the National Health and Nutrition Examination Survey (NHANES). Methods and resultsParticipants self-disclosed HF diagnosis. Two dietary recalls were obtained and categorical variables were created based on mean time of first eating occasion (8:31 AM), last eating occasion (7:33 PM) and eating window (11.02 h). Mortality was obtained through linkage to the National Death Index. Covariate-adjusted Cox proportional hazard regression models were created examining the association between time of eating and mortality.Participants (n = 991) were 68 (95 % CI 67–69) years of age, 52.6 (95 % CI 49.0–56.3)% men and had a body mass index of 32.5 (95 % CI 31.8–33.2) kg/m2 with follow up time of 68.9 (95 % CI 64.8–72.9) person-months. When models were adjusted for time of eating variables and all other covariates, extending the eating window beyond 11.02 h was associated with decreased risk of cardiovascular (HR 0.36 [95 % CI 0.16–0.81]), but not all-cause mortality. Time of first and last eating occasions were not associated with mortality. ConclusionsIn adults with HF, an extended eating window is associated with reduced risk for cardiovascular mortality. Randomized controlled trials should examine if extending the eating window can improve prognostic indicators such as cardiorespiratory fitness in this population.

Muscular Adaptations to Concurrent Resistance Training and High-Intensity Interval Training in Adults with Type 2 Diabetes: A Pilot Study.

This pilot study aimed to compare the effects of eight weeks of concurrent resistance training (RT) and high-intensity interval training (HIIT) vs. RT alone on muscle performance, mass and quality in adults with type 2 diabetes (T2DM). Twelve T2DM adults were randomly allocated to the RT + HIIT (n = 5) or RT (n = 7) group. Before and after training, maximal oxygen uptake (VO2max), muscle strength and power were evaluated by calorimetry, dynamometry and one-repetition maximum (1RM) test. Quadriceps muscle volume was determined by MRI, and muscle quality was estimated. After RT, VO2max (+12%), knee muscle power (+20%), quadriceps muscle volume (+5.9%) and quality (leg extension, +65.4%; leg step-up, +223%) and 1RM at leg extension (+66.4%), leg step-up (+267%), lat pulldown (+60.9%) and chest press (+61.2%) significantly increased. The RT + HIIT group improved on VO2max (+27%), muscle volume (+6%), muscle power (+9%) and 1RM at lat pulldown (+47%). No other differences were detected. Among groups, changes in muscle quality at leg step-up and leg extension and VO2max were significantly different. The combination of RT and HIIT effectively improves muscle function and size and increases cardiorespiratory fitness in adults with T2DM. However, HIIT combined with RT may interfere with the development of muscle quality.

O.1.1-9 Clinical symptoms and body composition correlates with cardiorespiratory fitness in adults with bipolar disorder: FINEXT-BD study

Abstract Purpose Bipolar disorder (BD) is a mental illness involving mood disorder, characterized by alternating normal mood, manic and depressive symptom. People with BD are associated with an unhealthy lifestyle. Assessment of cardiorespiratory fitness (CRF) indicates the overall health and can be directly measured and assessed by the cardiopulmonary exercise test and peak oxygen uptake (VO2peak), respectively. The CRF in the BD population may be altered due to sex, age, depression symptoms, and inactivity. The aim of this study was to analyze possible correlations of CRF with clinical symptoms and body composition variables. Methods Participants (n = 53, 44.9 ± 13.2 yr old) with BD were assessed with (1) body mass index and fat body mass (FBM) percentage; (2) upright bicycle ergometer using an incremental ramp protocol to get the VO2peak; and (3) symptoms of the disease [Hamilton Depression Rating Scale (HRSD) and Clinical Global Impressions Scale (CGI-S)]. Correlation analyses were performed among clinical symptoms, BMI, and VO2peak. Results The studied population showed overweight based on BMI (29.4±6.8 kg/m2), and obesity taking into account the fat mass percentage (33.6±10.6 %). According to Kaminsky et al., participants were classified in the 40th percentile with a low physical condition (VO2peak =25.8±8.4 mL·kg-1·min-1). Spearman's rho correlation coefficients demonstrated an inverse relationship between VO2peak (mL·kg−1·min−1) and HRSD (B=-0.286; P = 0.040); VO2peak (mL·kg−1·min−1) and CGI-S (B=-0.277; P = 0.047); and VO2peak (mL·kg−1·min−1) and FBM (B=-0.606; P &amp;lt; 0.001). Conclusions In population with BD a significantly higher CRF was detected in those with lower clinical symptoms, as well as lower FBM. Exercise interventions for improving CRF should be promoted in this population to better control clinical symptoms.

HAPI Fit: An Exercise Intervention to Improve Peak Aerobic Capacity in Young Adults Born Very Preterm.

Individuals born preterm have reduced aerobic capacity, which could be related to impaired organ development. Their capacity to improve aerobic capacity with exercise training could therefore be limited but this remains unknown. We aimed to test an exercise intervention to improve cardiorespiratory fitness in adults born preterm. 21 very preterm and 37 full-term individuals, aged 18-33 years, took part in a 14-week supervised exercise intervention of cardiovascular, resistance and flexibility training (2 groups and 1 individual sessions/week). Adherence and compliance to intervention was recorded. Primary outcome was change in peak oxygen consumption (peak O2) measured pre- and post-intervention. Within and between-groups differences were estimated using non-parametric tests. Of 219 eligible individuals, 58 were enrolled and 14 participants dropped out over the course of the intervention. Among the 44 who completed the intervention, mean adherence was 82% and 66% for group and individual sessions, respectively. Compliance with training requirement varied between 71-100%. There was no difference in adherence between the preterm and full-term groups. Because only one preterm male met adherence criteria, subsequent analyses were done exclusively on females. Both the term and preterm groups achieved higher peak O2 following the intervention [term = +4.2 (standard deviation 4.3) mL·min-1·kg-1, P < 0.01; preterm = +4.7 (2.9) mL·min-1·kg-1, P < 0.01]. There was no between-group difference in the response to the intervention (P = 0.729). Recruitment and adherence to an exercise intervention are challenging. Results could indicate improvements in cardiorespiratory fitness in young women born preterm following current exercise program. Adaptation of this intervention is needed for wider uptake.

The combined association of dietary inflammatory index and resting metabolic rate on cardiorespiratory fitness in adults

BackgroundNo study has examined the combined association of dietary inflammatory index (DII) of the diet and resting metabolic rate (RMR) on cardiorespiratory fitness (CRF). Therefore, we investigated the combined association between DII and RMR on CRF.MethodsThis cross-sectional study was conducted on 270 adult subjects. The DII was calculated using a validated semi-quantified food frequency questionnaire. RMR was measured using an indirect calorimetric method. Socioeconomic status, anthropometric measures, body composition and blood pressure were documented by a trained interviewer. CRF was assessed by using Bruce protocol. Binary logistic regression was performed to find the association of CRF with DII/RMR categories in various models.ResultsThe participants categorized into four groups including: (1) low DII/high RMR, (2) low DII/low RMR, (3) high DII/low RMR, (4) high DII/high RMR. The mean of VO2Max (mL/kg/min), VO2max (L/min) and VO2max relative to lean body mass (LBM) was lower in participants that were classified as high DII/low RMR compared to those in low DII/high RMR. After controlling for age, sex, education status, smoking status, and physical activity those who were in the high DII/low RMR group, compared to the low DII/high RMR group were 28% less likely to have higher VO2max (ml/kg/min) (OR 0.72; 95% CI 0.18, 0.82, p = 0.04). Moreover, had 25% lower odds of VO2max (L/min) which was significant (OR 0.75, 95% CI 0.11, 0.89, p = 0.03). In addition, were 21% less likely to have higher VO2max (LBM) (OR 0.79; 95% CI 0.30, 0.92, p = 0.02).ConclusionsOverall, consumption of a pro-inflammatory diet in combination with low RMR status is associated with lower odds of CRF compared to those who had anti-inflammatory diet in combination with high RMR status among Iranian healthy adults. This study suggests that researchers should focus on combined relationships rather than single pair-wise associations for having a better judgment.

The impact of excessive epicardial adipose tissue accumulation on cardiorespiratory fitness in adults without cardiac disease: a cross-sectional magnetic resonance imaging study

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Canadian Institutes of Health Research. Background/Introduction Excessive epicardial adipose tissue (EAT) is associated with worse exercise capacity and is thought to play a role in the pathophysiology of heart failure with preserved ejection fraction. Few studies have explored the relationship between EAT, cardiorespiratory fitness in men and women without cardiovascular disease. Purpose To investigate the association between EAT, cardiorespiratory fitness, and physical activity levels in asymptomatic men and women of variable degree of adiposity. Methods A total of 239 participants (43% women) free from cardiovascular disease who underwent concurrent quantification of EAT volume assessed by cardiac magnetic resonance and a cardiopulmonary exercise testing (CPET) (VO2peak [ml/kg/min]) were studied. Physical activity levels/intensity were measured by questionnaire and using pedometer. Participants were categorized into low-EAT, moderate-EAT, and high-EAT groups on the basis of EAT volume. Results Mean age of participants was 49.8 ± 8.3 years, BMI 26.0 ± 3.7 kg/m2 (15% with obesity), waist circumference 89 ± 11 cm, visceral adipose tissue volume 91.3 ± 51.3 cm3, and EAT volume 9.8 ± 3.1 cm3. EAT volume decreased with increment in cardiorespiratory fitness in men and women of variable adiposity (p&amp;lt;0.05). Men and women with high-EAT had worse cardiometabolic profile (visceral adiposity, insulin resistance, high blood pressure, dysglycemia, atherogenic dyslipidemia), and lower cardiorespiratory fitness (VO2peak) than those with low-EAT (all p&amp;lt;0.05). Physical activity levels were comparable across EAT tertiles (p=NS). The association between EAT and cardiorespiratory fitness was no longer significant after controlling for visceral adiposity. Conclusions In men and women of variable degree of adiposity, excessive EAT accumulation is associated with visceral adiposity and worse cardiorespiratory fitness. Further longitudinal studies are needed to understand the interplay between EAT and cardiorespiratory fitness, and the development of obesity-related heart failure features.

Additional effects of exercise to hypocaloric diet on body weight, body composition, glycaemic control and cardio-respiratory fitness in adults with overweight or obesity and type 2 diabetes: A systematic review and meta-analysis.

This systematic review and meta-analysis evaluates the additional effect of exercise to hypocaloric diet on body weight, body composition, glycaemic control and cardio-respiratory fitness in adults with overweight or obesity and type 2 diabetes. Embase, Medline, Web of Science and Cochrane Central databases were evaluated, and 11 studies were included. Random-effects meta-analysis was performed on body weight and measures of body composition and glycaemic control, to compare the effect of hypocaloric diet plus exercise with hypocaloric diet alone. Exercise interventions consisted of walking or jogging, cycle ergometer training, football training or resistance training and duration varied from 2 to 52 weeks. Body weight and measures of body composition and glycaemic control decreased during both the combined intervention and hypocaloric diet alone. Mean difference in change of body weight (-0.77 kg [95% CI: -2.03; 0.50]), BMI (-0.34 kg/m2 [95% CI: -0.73; 0.05]), waist circumference (-1.42 cm [95% CI: -3.84; 1.00]), fat-free mass (-0.18 kg [95% CI: -0.52; 0.17]), fat mass (-1.61 kg [95% CI: -4.42; 1.19]), fasting glucose (+0.14 mmol/L [95% CI: -0.02; 0.30]), HbA1c (-1 mmol/mol [95% CI: -3; 1], -0.1% [95% CI: -0.2; 0.1]) and HOMA-IR (+0.01 [95% CI: -0.40; 0.42]) was not statistically different between the combined intervention and hypocaloric diet alone. Two studies reported VO2max and showed significant increases upon the addition of exercise to hypocaloric diet. Based on limited data, we did not find additional effects of exercise to hypocaloric diet in adults with overweight or obesity and type 2 diabetes on body weight, body composition or glycaemic control, while cardio-respiratory fitness improved.

Criterion-related validity and reliability of the 2-km walk test and the 20-m shuttle run test in adults: The role of sex, age and physical activity level.

To analyze the criterion-related validity and the reliability of fitness field tests for evaluating cardiorespiratory fitness in adults, by sex, age, and physical activity level. Cross-sectional. During 3 weeks, sociodemographic, anthropometric measurements, a treadmill maximal test, the 2-km walk test, and the 20-m SRT were performed in 410 adults aged 18-64 years. Measured and estimated VO2max (by Oja's and Leger's equations) were analyzed. Measured VO2max was associated with estimated VO2max by the 2-km walk test and 20-m SRT (r = 0.784 and r = 0.875, respectively; both p < 0.01). Bland-Altman analysis showed a mean difference of -0.30 ml* kg-1 * min-1 (p < 0.001, d = -0.141) in the 2-km walk test, and 0.86 ml* kg-1 * min-1 (p = 0.051) in the 20-m SRT. Significant mean differences between test and retest were found in the time to complete the 2-km walk test (-1.48 ± 0.51 s, p = 0.004, d = -0.014) and in the final stage reached in the 20-m SRT (0.04 ± 0.01, p = 0.002, d = 0.015). Non-significant differences were found between test and retest in the estimated VO2max by Oja's (-0.29 ± 0.20 ml* kg-1 * min-1, p > 0.05) and Leger's eqs. (0.03 ± 0.04 ml* kg-1 * min-1, p > 0.05). Moreover, both test results and estimated VO2max equations showed a high test-retest reliability. Both tests were valid and reliable for evaluating cardiorespiratory fitness in adults aged 18-64 years, regardless of sex, age, and physical activity level.

Cardiorespiratory Fitness in the Prevention and Management of Cardiovascular Disease.

Cardiovascular disease (CVD) is the leading cause of death among adults in the U.S. and elsewhere. Variation in the presence, severity, and control of major modifiable risk factors accounts for much of the variation in CVD rates worldwide. Cardiorespiratory fitness (CRF) reflects the integration of ventilation, circulation, and metabolism for the delivery and utilization of oxygen in support of dynamic aerobic physical activity. The gold standard measure of CRF is maximal oxygen uptake. Because the primary factor underlying differences in this measure between individuals is maximal cardiac output, it can serve as a clinical indicator of cardiac function. Higher CRF is associated with favorable levels of major CVD risk factors, lower prevalence and severity of subclinical atherosclerosis, and lower risks of developing both primary and secondary clinical CVD events. The beneficial associations between CRF and CVD are seen in women and men, older and younger adults, in those with multiple coexisting risk factors or prior diagnosis of CVD. Exercise training and regular physical activity of at least moderate intensities and volumes improves CRF in adults, and improvements in CRF are associated with lower risks of subsequent CVD and mortality. Routine assessment of CRF in primary care settings could enhance individual-level CVD risk assessment and thereby guide implementation of appropriate measures to prevent future clinical events.

Cardiorespiratory Fitness in Adults Aged 18 to 34 Years and Long-Term Pericardial Adipose Tissue (from the Coronary Artery Risk Development in Young Adults Study)

Pericardial adipose tissue (PAT), an ectopic adipose depot surrounding the coronary arteries, is a pathogenic risk marker for cardiometabolic disease; however, the association between cardiorespiratory fitness (CRF) and PAT is unclear. Young adults (n=2,614, mean age 25.1 years, 55.8% women, and 43.8% Black at baseline [1985 to 1986]) from the Coronary Artery Risk Development in Young Adults study were included. Maximal CRF was estimated at baseline, examination year 7 (1992 to 1993) and year 20 (2005 to 2006), using a symptom-limited maximal treadmill exercise test (duration in minutes) among those achieving ≥85% of age-predicted maximal heart rate. PAT volume (ml) was quantified at examination year 15 (2000 to 2001) and year 25 (2010 to 2011) using computed tomography. Multivariable linear and linear mixed regressions with covariates (sociodemographics, cardiovascular disease risk factors, inflammation, waist circumference) from baseline, year 7, and/or year 20 were used. Separate multivariable regression models revealed inverse associations of CRF at baseline, year 7, or year 20 with PAT at year 25 in fully adjusted models (all p <0.001). The linear mixed model showed that a 1-minute increase in treadmill exercise test duration over 20 years was associated with 1.49 ml lower subsequent PAT volume (p <0.001). In conclusion, findings suggest that higher CRF is inversely associated with subsequent PAT volume. Strategies to optimize CRF may be preventive against excessive PAT accumulation with age.

Childhood cardiorespiratory fitness and the early markers of kidney disease in middle age: A population-based cohort study

ObjectivesTo investigate the relationship of childhood cardiorespiratory fitness with early markers of chronic kidney disease, glomerular hyperfiltration and albuminuria, in midlife. DesignProspective cohort study. MethodsThis study included 1371 participants aged 36–49 years who participated in the 1985 Australian Schools Health and Fitness Survey when they were 7–15 years of age. Childhood cardiorespiratory fitness was estimated by the time taken to complete a 1.6- km run. Blood and urine samples were collected at follow-up. Log-binomial regression was used to determine the associations of childhood cardiorespiratory fitness with glomerular hyperfiltration [estimated glomerular filtration rate (mL/min/1.73 m2) > 95th percentile standardized for age and sex] and albuminuria (urine albumin-to-creatinine ratio ≥ 2.5 mg/mmol in males or ≥3.5 mg/mmol in females) in midlife. ResultsCompared with women with high childhood cardiorespiratory fitness, those with lower childhood cardiorespiratory fitness had a higher risk of glomerular hyperfiltration in midlife after adjusting for childhood age, the duration of follow-up, and midlife smoking status [adjusted relative risk = 2.86, 95% confidence interval, 1.04–7.86 for individuals with moderate childhood cardiorespiratory fitness (P = 0.04), and adjusted relative risk = 3.38, 95% confidence interval, 1.13–10.14 for individuals with low childhood cardiorespiratory fitness (P = 0.03)]. Further adjustment for childhood and midlife body mass index resulted in a slightly attenuated and statistically non-significant association. No significant associations were found with glomerular hyperfiltration in males or albuminuria in either males or females. ConclusionsLow cardiorespiratory fitness in childhood may increase the risk of glomerular hyperfiltration in midlife in females, possibly via a path through adult cardiorespiratory fitness.

Comparison of time-matched aerobic, resistance or combined exercise training in women living with obesity: a protocol for a pilot randomised controlled trial\u2014the EXOFFIT (Exercise for Obesity in Females to increase Fitness) study

IntroductionObesity in women has more than doubled in the past thirty years. Increasing research suggests that increased cardiorespiratory fitness (CRF) can largely attenuate the negative health risks associated with obesity. Though previous literature suggests that combined training may be the most effective for improving CRF in adults with obesity, there is minimal research investigating the efficacy of combined and resistance programmes in women with obesity. This article outlines a protocol for a parallel pilot study which aims to evaluate the feasibility and efficacy of three exercise modalities in women with obesity for increasing CRF and strength and improving body composition and other health outcomes (i.e. quality of life).Methods and analysisSixty women (aged 18–50) with obesity (body mass index [BMI] ≥ 30 and/or waist circumference ≥ 88 cm) who are physically inactive, have no unstable health conditions and are safe to exercise will be recruited from September 2021 to December 2022. The main outcome will be feasibility and acceptability of the intervention and procedures. Trial feasibility outcomes will be evaluated to determine if a definitive trial should be undertaken. Trial acceptability will be explored through follow-up qualitative interviews with participants. Secondary outcomes will include CRF (predicted VO2 max), anthropometrics (i.e. BMI), strength (5RM bench press, leg dynamometry, grip strength) and other health outcomes (i.e., pain). Participants will be block randomised into one of four trial arms (aerobic exercise, resistance training and combined training groups, non-active control group) and measurements will be completed pre- and post-intervention. The exercise groups will receive an individualised supervised exercise programme for 3× sessions/week for 12 weeks. The change in mean values before and after intervention will be calculated for primary and secondary outcomes. ANOVA and t-tests will be applied to evaluate within-group and between-group differences. If sufficient participants are recruited, the data will be analysed using ANCOVA with the age and BMI as covariates.DiscussionThis pilot will provide data on the feasibility and acceptability of trial procedures and of the programmes’ three progressive time-matched exercise interventions (aerobic, resistance and combined) for women living with obesity, which will help inform future research and the potential development of a full-scale randomised clinical trial.Trial registrationISRCTN, ISRCTN13517067. Registered 16 November 2021—retrospectively registered.

A systematic review and meta-analysis of the effects of aerobic exercise interventions on cardiorespiratory fitness in adults with intellectual disability.

Adults with an intellectual disability (ID) have low cardiorespiratory fitness (CRF). Low CRF has been associated with a high risk of cardiovascular disease and all-cause mortality. Participation in regular exercise can help adults with ID increase their CRF. To perform a systematic review and meta-analysis of published, peer-reviewed clinical trials that evaluated the effects of aerobic exercise (AE) interventions on CRF in adults with ID, ages 18-65 years. English-language articles were searched up to June 2021 from 11 electronic databases. Data were extracted using an author-developed form. Two independent authors assessed the risk of bias using the Tool for the Assessment of Study Quality and reporting in Exercise (TESTEX). Meta-analysis was performed using the RevMan 5.3. Of the 1870 article titles and abstracts screened, 16 articles were included. The average TESTEX score (out of 15) was 8.1 (SD=3.5, range 2-14). The pooled effect was statistically significant (SMD=0.41, 95% CI: 0.19 to 0.63, z=3.59; p=.000) with moderate heterogeneity (I2=35%, p=.000). Both types of intervention produced statistically significant CRF gains, with interventions that combined AE with resistance, balance, and/or flexibility exercises being slightly more effective (SMD=0.40, 95% CI: 0.11 to 0.70, p=.007) than non-combined interventions (SMD=0.42, 95% CI: 0.05 to 0.79, p=.02). Heterogeneity was moderate but non-significant for both types of intervention. The review supports the use of AE interventions in promoting CRF in adults with ID. The interpretation is limited by the quality of evidence and by poorly described and/or executed familiarization and measurement protocols.

P.0821 Association between modified shuttle walk test and cardiorespiratory fitness in adults with schizophrenia: CORTEX-SP study

P.0821 Association between modified shuttle walk test and cardiorespiratory fitness in adults with schizophrenia: CORTEX-SP study