SUMMARYACSM Position Stand on The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Adults. Med. Sci. Sports Exerc., Vol. 30, No. 6, pp. 975-991, 1998. The combination of frequency, intensity, and duration of chr

http://myweb.facstaff.wwu.edu/chalmers/pdfs/acsm position stand - quantity and quality of exercise.pdf

ACSM Position Stand: The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults

Kubios HRV - Heart rate variability analysis software

Skeletal muscle has recently been identified as an endocrine organ. It has, therefore, been suggested that cytokines and other peptides that are produced, expressed, and released by muscle fibers and exert paracrine, autocrine, or endocrine effects should be classified as "myokines." Recent research demonstrates that skeletal muscles can produce and express cytokines belonging to distinctly different families. However, the first identified and most studied myokine is the gp130 receptor cytokine interleukin-6 (IL-6). IL-6 was discovered as a myokine because of the observation that it increases up to 100-fold in the circulation during physical exercise. Identification of IL-6 production by skeletal muscle during physical activity generated renewed interest in the metabolic role of IL-6 because it created a paradox. On one hand, IL-6 is markedly produced and released in the postexercise period when insulin action is enhanced but, on the other hand, IL-6 has been associated with obesity and reduced insulin action. This review focuses on the myokine IL-6, its regulation by exercise, its signaling pathways in skeletal muscle, and its role in metabolism in both health and disease.

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Muscle as an endocrine organ: focus on muscle-derived interleukin-6.

Chronic diseases are major killers in the modern era. Physical inactivity is a primary cause of most chronic diseases. The initial third of the article considers: activity and prevention definitions; historical evidence showing physical inactivity is detrimental to health and normal organ functional capacities; cause vs. treatment; physical activity and inactivity mechanisms differ; gene-environment interaction [including aerobic training adaptations, personalized medicine, and co-twin physical activity]; and specificity of adaptations to type of training. Next, physical activity/exercise is examined as primary prevention against 35 chronic conditions [Accelerated biological aging/premature death, low cardiorespiratory fitness (VO2max), sarcopenia, metabolic syndrome, obesity, insulin resistance, prediabetes, type 2 diabetes, non-alcoholic fatty liver disease, coronary heart disease, peripheral artery disease, hypertension, stroke, congestive heart failure, endothelial dysfunction, arterial dyslipidemia, hemostasis, deep vein thrombosis, cognitive dysfunction, depression and anxiety, osteoporosis, osteoarthritis, balance, bone fracture/falls, rheumatoid arthritis, colon cancer, breast cancer, endometrial cancer, gestational diabetes, preeclampsia, polycystic ovary syndrome, erectile dysfunction, pain, diverticulitis, constipation, and gallbladder diseases]. The article ends with consideration of deterioration of risk factors in longer-term sedentary groups; clinical consequences of inactive childhood/adolescence; and public policy. In summary, the body rapidly maladapts to insufficient physical activity, and if continued, results in substantial decreases in both total and quality years of life. Taken together, conclusive evidence exists that physical inactivity is one important cause of most chronic diseases. In addition, physical activity primarily prevents, or delays, chronic diseases, implying that chronic disease need not be an inevitable outcome during life.

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Lack of exercise is a major cause of chronic diseases

Regular exercise reduces the risk of chronic metabolic and cardiorespiratory diseases, in part because exercise exerts anti-inflammatory effects. However, these effects are also likely to be responsible for the suppressed immunity that makes elite athletes more susceptible to infections. The anti-inflammatory effects of regular exercise may be mediated via both a reduction in visceral fat mass (with a subsequent decreased release of adipokines) and the induction of an anti-inflammatory environment with each bout of exercise. In this Review, we focus on the known mechanisms by which exercise — both acute and chronic — exerts its anti-inflammatory effects, and we discuss the implications of these effects for the prevention and treatment of disease.

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The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease

Over the last 20 years, heart rate monitors (HRMs) have become a widely used training aid for a variety of sports. The development of new HRMs has also evolved rapidly during the last two decades. In addition to heart rate (HR) responses to exercise, research has recently focused more on heart rate variability (HRV). Increased HRV has been associated with lower mortality rate and is affected by both age and sex. During graded exercise, the majority of studies show that HRV decreases progressively up to moderate intensities, after which it stabilises. There is abundant evidence from cross-sectional studies that trained individuals have higher HRV than untrained individuals. The results from longitudinal studies are equivocal, with some showing increased HRV after training but an equal number of studies showing no differences. The duration of the training programmes might be one of the factors responsible for the versatility of the results. HRMs are mainly used to determine the exercise intensity of a training session or race. Compared with other indications of exercise intensity, HR is easy to monitor, is relatively cheap and can be used in most situations. In addition, HR and HRV could potentially play a role in the prevention and detection of overtraining. The effects of overreaching on submaximal HR are controversial, with some studies showing decreased rates and others no difference. Maximal HR appears to be decreased in almost all ‘overreaching’ studies. So far, only few studies have investigated HRV changes after a period of intensified training and no firm conclusions can be drawn from these results. The relationship between HR and oxygen uptake (VO2) has been used to predict maximal oxygen uptake (VO2max). This method relies upon several assumptions and it has been shown that the results can deviate up to 20% from the true value. The HR-VO2 relationship is also used to estimate energy expenditure during field conditions. There appears to be general consensus that this method provides a satisfactory estimate of energy expenditure on a group level, but is not very accurate for individual estimations. The relationship between HR and other parameters used to predict and monitor an individual’s training status can be influenced by numerous factors. There appears to be a small day-to-day variability in HR and a steady increase during exercise has been observed in most studies. Furthermore, factors such as dehydration and ambient temperature can have a profound effect on the HR-VO2 relationship.

Heart rate monitoring: applications and limitations.

An athlete’s carbohydrate intake can be judged by whether total daily intake and the timing of consumption in relation to exercise maintain adequate carbohydrate substrate for the muscle and central nervous system (‘‘high carbohydrate availability’’) or whether carbohydrate fuel sources are limiting for the daily exercise programme (‘‘low carbohydrate availability’’). Carbohydrate availability is increased by consuming carbohydrate in the hours or days prior to the session, intake during exercise, and refuelling during recovery between sessions. This is important for the competition setting or for high-intensity training where optimal performance is desired. Carbohydrate intake during exercise should be scaled according to the characteristics of the event. During sustained high-intensity sports lasting *1 h, small amounts of carbohydrate, including even mouth-rinsing, enhance performance via central nervous system effects. While 30–60 g h 71 is an appropriate target for sports of longer duration, events42.5 h may benefit from higher intakes of up to 90 g h 71 . Products containing special blends of different carbohydrates may maximize absorption of carbohydrate at such high rates. In real life, athletes undertake training sessions with varying carbohydrate availability. Whether implementing additional ‘‘train-low’’ strategies to increase the training adaptation leads to enhanced performance in well-trained individuals is unclear.

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Carbohydrates for training and competition.

Measures of substrate oxidation have traditionally been calculated from indirect calorimetry measurements using stoichiometric equations. Although this has proven to be a solid technique and it has become one of the standard techniques to measure whole body substrate metabolism, there are also several limitations that have to be considered. When indirect calorimetry is used during exercise most of the assumptions on which the method is based hold true although changes in the size of the bicarbonate pool at higher exercise intensities may invalidate the calculations of carbohydrate and fat oxidation. Most of the existing equations are based on stoichiometric equations of glucose oxidation and the oxidation of a triacylglycerol that is representative of human adipose tissue. However, in many exercise conditions, glycogen and not glucose is the predominant carbohydrate substrate. Therefore we propose slightly modified equations for the calculation of carbohydrate and fat oxidation for use during low to high intensity exercise. Studies that investigated fat oxidation over a wide range of intensities and that determined the exercise intensity at which fat oxidation is maximal have provided useful insights in the variation in fat oxidation between individuals and in the factors that affect fat oxidation. Fat oxidation during exercise can be influenced by exercise intensity and duration, diet, exercise training, exercise mode and gender. Although a number of important factors regulating fat oxidation have been identified, it is apparent that a considerable degree of inter-subject variability in substrate utilization persists and cannot be explained by the aforementioned factors. Future research should investigate the causes of the large inter-individual differences in fat metabolism between individuals and their links with various disease states.

Measurement of substrate oxidation during exercise by means of gas exchange measurements.

Performance testing is one of the most common and important measures used in sports science and physiology. Performance tests allow for a controlled simulation of sports and exercise performance for research or applied science purposes. There are three factors that contribute to a good performance test: (i) validity; (ii) reliability; and (iii) sensitivity. A valid protocol is one that resembles the performance that is being simulated as closely as possible. When investigating race-type events, the two most common protocols are time to exhaustion and time trials. Time trials have greater validity than time to exhaustion because they provide a good physiological simulation of actual performance and correlate with actual performance. Sports such as soccer are more difficult to simulate. While shuttle-running protocols such as the Loughborough Intermittent Shuttle Test may simulate physiology of soccer using time to exhaustion or distance covered, it is not a valid measure of soccer performance. There is a need to include measures of skill in such protocols. Reliability is the variation of a protocol. Research has shown that time-to-exhaustion protocols have a coefficient of variation (CV) of >10%, whereas time trials are more reliable as they have been shown to have a CV of <5%. A sensitive protocol is one that is able to detect small, but important, changes in performance. The difference between finishing first and second in a sporting event is <1%. Therefore, it is important to be able to detect small changes with performance protocols. A quantitative value of sensitivity may be accomplished through the signal : noise ratio, where the signal is the percentage improvement in performance and the noise is the CV.

Validity, Reliability and Sensitivity of Measures of Sporting Performance

The extensive use of performance tests in diet intervention studies mirrors the importance of such a measurement. Although many different endurance performance tests have been used in the past, the majority of these different protocols has never been validated. In this study reproducibility of three different endurance performance tests was evaluated. Thirty well-trained subjects were matched on age, weight, and Wmax and divided into three subgroups. Each group of subjects performed one of three exercise protocols: protocol (A) consisted of cycling at 75% Wmax until exhaustion. In (B) subjects received a preload of 45 min 70% Wmax and then performed as much work as possible in 15 min. (C) consisted of a time trial, in which subjects had to complete a preset amount of work as fast as possible. Each subject performed one of the trials six times. Coefficient of variation (CV) was calculated for each protocol. CV(A) was 26.6%, CV(B) 3.49%, and CV(C) 3.35%. It was concluded that reproducibility of a test at 75% Wmax until exhaustion is poor and these tests are not reliable. Time trial protocols may result in better performance evaluation.

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Asker E. Jeukendrup

Papers

Heart rate monitoring: applications and limitations.

Carbohydrates for training and competition.

Measurement of substrate oxidation during exercise by means of gas exchange measurements.

Validity, Reliability and Sensitivity of Measures of Sporting Performance

A new validated endurance performance test.