Examining the impact of 45 minutes of daily physical education on cognitive ability, fitness performance, and body composition of African American youth. Methods of the NSW Schools Fitness and Physical Activity Survey, 1997. Tracking of muscular strength and power from youth to young adulthood: Longitudinal findings from the Childhood Determinants of Adult Health Study. The effect of a multidisciplinary intervention program on hepatic adiposity in overweight-obese children: protocol of the EFIGRO study. Daughters and mothers exercising together: effects of home- and community-based programs. Intensive aerobic and muscle endurance exercise in patients with systemic sclerosis: a pilot study Structured exercise in older adults with limited functional ability. Improvement in balance, strength, and flexibility after 12 weeks of Tai chi exercise in ethnic Chinese adults with cardiovascular disease risk factors. Healthy Eating, Aerobic and Resistance Training in Youth (HEARTY): study rationale, design and methods. Two years of school-based intervention program could improve the physical fitness among Ecuadorian adolescents at health risk: subgroups analysis from a cluster-randomized trial The effect of diet and strength training on obese children's physical self-concept. Emotional Health Predicts Changes in Body Mass Index (BMI-z) Among Black and Latino Youth Muscle strength in youth and cardiovascular risk in young adulthood (the European Youth Heart Study) Predictors of low back pain in physically active conscripts with special emphasis on muscular fitness. Comparative effectiveness of aerobic, resistance, and combined training on cardiovascular disease risk factors: A randomized controlled trial Adiposity, aerobic fitness, muscle fitness, and markers of inflammation in children. Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews Exercise training normalizes vascular dysfunction and improves central adiposity in obese adolescents. Aerobic and resistance exercise training effects on body composition, muscular strength, and cardiovascular fitness in an hiv—1 population Benefits of Strength and Skill-based Training During Primary School Physical Education Improvements in fitness reduce the risk of becoming overweight across puberty. Effects of aerobic or aerobic and resistance training on cardiorespiratory and skeletal muscle function in heart failure: a randomized controlled pilot trial Exercise programs for older men: mode and intensity to induce the highest possible health-related benefits. Do sugar-sweetened beverages cause adverse health outcomes in children? A systematic review protocol Effects of Combined Aerobic-Strength Training vs Fitness Education Program in COPD Patients. Heart rate dynamics after combined endurance and strength training in older men. Effects of fitness training on physical fitness parameters and quality of life in human immunodeficiency virus-positive Indian females Physiological adaptations to a weight-loss dietary regimen and exercise programs in women. Dietary weight loss and exercise interventions effects on quality of life in overweight/obese postmenopausal women: a randomized controlled trial
OBJECT Increased importance on academic achievement has result ed in many school districts focusing on improved academic performance leading to reductions in physical education time . The purpose was to examine the effects of 45 minutes of daily physical education on the cognitive ability , fitness performance and body composition of African American elementary and middle school youth . METHODS Participants completing the informed consent in grade s 2nd to 8th were included in the study . A pre/posttest design was used with repeated measures analysis of variance . Experimental and control school participants were pretested on the  cognitive measures ( ie , Fluid Intelligence and Perceptual Speed ) and Fitnessgram ® physical fitness test items ( eg , aerobic capacity , muscular strength and muscular endurance , body composition ) in September 2009 and posttested in May 2010 . RESULTS Experimental elementary and middle school participants observed significantly greater improvements compared with control elementary and middle school participants on 7 of 16 fitness and body composition measures and on 8 of 26 cognitive measures . These fitness , body composition , and cognitive improvement differences were more noticeable among elementary and middle school females . CONCLUSIONS Providing 45 minutes of daily physical education can perhaps increase cognitive ability while increasing fitness and decreasing the prevalence of overweight and obese youth Physical fitness , participation in physical activity , fundamental motor skills and body composition are important contributors to the health and the development of a healthy lifestyle among children and youth . The New South Wales Schools  Fitness and Physical Activity Survey , 1997 , was conducted to fill some of the gaps in our knowledge of these aspects of the lives of young people in New South Wales . The survey was conducted in February and March , 1997 and collected data on a r and omly-selected sample of students ( n = 5518 ) in Years 2 , 4 , 6 , 8 and 10 . Measures were taken on body composition ( height and weight , waist and hip girths , skinfolds ) , health-related fitness ( aerobic capacity , muscular strength , muscular endurance , flexibility ) , fundamental motor skills ( run , vertical jump , catch , overh and throw , foreh and strike and kick ) , self-reported physical activity , time spent in sedentary recreation , and physical education ( PE ) classes . The methods are described to assist in the development of surveys of other population s and to provoke debate relevant to the development and dissemination of st and ard approaches to monitoring the fitness , physical activity habits and body composition of Australian children and youth . Finally , we offer comments on some of the strengths and limitations of the methods employed OBJECTIVES Low muscular fitness levels have previously been reported as an independent risk factor for chronic disease outcomes . Muscular fitness tracking , the ability to maintain levels measured at one point in time to another point in time , was assessed from youth to adulthood to provide insight into whether early identification of low muscular fitness in youth is possible . DESIGN Prospect i ve longitudinal study . METHODS Study including 623 participants who had muscular fitness measures in 1985 ( aged 9 , 12 or 15 years ) and again 20 years later in young adulthood . Measures of muscular fitness were strength ( right and left grip , leg , shoulder extension and flexion measured by dynamometer , and a combined strength score ) and power ( st and ing long jump distance ) . RESULTS Strength and power were relatively stable between youth and adulthood ; the strongest tracking correlations were observed for the combined strength score ( r=0.47 , p≤0.001 ) , right grip strength ( r=0.43 , p≤0.001 ) and st and ing long jump ( r=0.43 , p≤0.001 ) . Youth in the lowest third of muscular fitness had an increased risk of remaining in the lowest third of muscular fitness in adulthood ( strength : relative risk (RR)=4.70 , 95 % confidence interval ( CI ) ( 3.19 , 6.92 ) ; power : RR=4.06 ( 2.79 , 5.90 ) ) . CONCLUSIONS Youth with low muscular fitness are at increased risk of maintaining a low muscular fitness level into adulthood . These findings warrant investigation into the long term effects of early interventions that focus on improving low muscular fitness levels in youth which could potentially improve adult muscular fitness and reduce future chronic disease outcomes BACKGROUND Non-alcoholic fatty liver disease is the most frequent liver abnormality observed in overweight or obese children and is strongly associated with metabolic syndrome and insulin resistance . OBJECTIVES ( i ) To evaluate the effect of a 22-week multidisciplinary intervention program on hepatic fat fraction in overweight or obese children and ( ii ) to examine the effect of the intervention on cardiometabolic risk factors , self-esteem and well-being . METHODS A total of 160 children , 9 - 11 years , will be recruited by pediatricians and r and omly assigned to control ( N = 80 ) or intervention ( N = 80 ) groups . The control group will receive a family-based lifestyle and psycho-educational program ( 2 days/month ) , while the intervention group will attend the same lifestyle education and psycho-educational program plus the exercise program ( 3 days/week ) . The duration of training sessions will be 90 min of exercise , including warm-up , moderate to vigorous aerobic activities , and strength exercises . The primary outcome is the change in hepatic fat fraction ( magnetic resonance imaging , MRI ) . Secondary outcomes include cardiometabolic risk factors such as total adiposity ( dual Xray absorptiometry ) , visceral adiposity ( MRI ) , functional peak aerobic capacity ( cardiopulmonary exercise testing ) , blood pressure , muscular fitness , speed – agility , and fasting blood insulin , glucose , C-reactive protein , alanine aminotransferase , aspartate aminotransferase , gamma glutamyltransferase , lipid profile and psychological measurements ( question naires ) . All the measurements will be evaluated at baseline prior to r and omization and after the intervention . DISCUSSION This study will provide insight in the efficacy of a multidisciplinary intervention program including healthy lifestyle education , psycho-education and supervised exercise to reduce hepatic fat and cardiometabolic risk in overweight children PURPOSE This pilot study compares the effectiveness of home- and community-based physical activity interventions that target mothers and daughters to increase physical activity and improve health-related fitness . METHODS Mothers ( 45.18 + /- 7.49 yr ) and daughters ( 15.41 + /- 1.33 yr ) were r and omly assigned to a community-based ( CB ) ( N = 20 participants ) or home-based ( HB ) ( N = 14 participants ) program . CB participants attended three instructor-led sessions per week for 12 wk . HB participants were asked to participate in 3 sessions per week for 12 wk in a program similar to the CB program . The main difference between the programs was that CB activities were completed at a fitness facility within a university and HB activities were completed in or near the home . Before and after the intervention , changes in health-related fitness and physical activity were assessed . A series of 2 ( group assignment ) x 2 ( time ) ANOVAs were conducted to assess changes separately for mothers and daughters . RESULTS CB participants attended 77 % of the sessions , and none of the pairs dropped out . HB participants completed 70 % of the recommended sessions , and three pairs dropped out . Mothers and daughters in both groups significantly increased their participation in aerobic , muscular strength , and flexibility activities ( P = 0.02 to 0.000 ) . Daughters in both groups significantly improved their muscular endurance ( sit-ups , P = 0.000 ) . Mothers in both groups improved their muscular strength ( push-ups , P = 0.003 ) , muscular endurance ( sit-ups , P = 0.000 ) , flexibility ( sit- and -reach , P = 0.008 ) , and aerobic capacity ( 1-mile walk , P = 0.002 ) . Positive changes in diastolic blood pressure also occurred ( P = 0.008 ) . CONCLUSION Mothers and daughters responded positively to CB and HB physical activity programs . Home-based physical activity programming is a cost-effective means to increase physical activity and improve health-related fitness in these groups Background No previous studies have examined the effect of intensive exercise in systemic sclerosis patients with pulmonary impairment . The objective of this study was to examine the effect of an eight-week intensive aerobic exercise and muscle endurance training program for patients with systemic sclerosis with 50–100 % of forced vital capacity . Methods A single-subject experimental design with repeated systematic measures during a six week A-phase ( non-interventional baseline period ) and an eight week B-phase ( exercise intervention period ) was used . Three women and one man with median age 66 years and median disease duration of 3.5 years completed aerobic exercise corresponding to 15 on the Borg RPE scale ( strenuous ) and muscular endurance training three times/week . Physical capacity ( six-minute walk test ) , aerobic capacity ( submaximal treadmill test ) and muscle endurance in shoulder and hip flexion ( Functional Index 2 ) were assessed every other week throughout the 14-week study . Activity limitation ( Health Assessment Question naire ) , quality of life ( Short Form 36 ) , Raynaud , Fatigue and Global Health during the recent week ( Visual Analogue Scales ) were assessed at weeks 0 , 6 , 14 . Results Three participants improved significantly in muscular endurance , and two participants improved significantly or clinical ly relevant in aerobic capacity . All other variables remained unchanged , except for a trend towards reduced fatigue . Conclusions This eight week exercise program was largely successful with positive effects on aerobic capacity and muscle endurance . Trial registration Clinical trials.gov Identifier : The authors of this study examined the effects of a 16-week exercise program design ed to increase aerobic capacity , muscular strength , and muscular endurance in older adults who reported and exhibited limited functional ability . Participants were r and omly assigned to either an  exercise ( n=39 ) or a  control ( n=34 ) group . Dependent variables tested included measures of fitness ( aerobic exercise capacity and isokinetic strength testing of the legs and arms ) and measures of functional capacity ( time to and off the floor , stair test , chair st and , and bicep curl ) . At the end of the program , there were significant differences between the exercise and control groups in arm strength , chair st and , and biceps curl . The results of this study indicate functionally limited older adults who maintain a structured exercise program for 16 weeks exhibit increased functional ability CONTEXT Declines in physical performance are associated with aging and chronic health conditions . Appropriate physical activity interventions can reverse functional limitations and help maintain independent living . Tai chi is a popular form of exercise in China among older adults . OBJECTIVE To determine whether tai chi improves balance , muscular strength and endurance , and flexibility over time . DESIGN Repeated measures intervention ; data collected at baseline , 6 weeks , and 12 weeks . SETTING Community center in the San Francisco Bay Area . PARTICIPANTS Thirty-nine Chinese adults with at least 1 cardiovascular disease ( CVD ) risk factor . INTERVENTIONS A 60-minute tai chi exercise class 3 times per week for 12 weeks . MAIN OUTCOME MEASURES A battery of physical fitness measures specifically developed for older adults assessed balance , muscular strength and endurance , and flexibility . RESULTS Subjects were 65.7 ( + /- 8.3 ) years old , Cantonese-speaking ( 97 % ) immigrants , with 12 years or less of formal education ( 87 % ) and very low income ( 67 % ) . Reported CVD risk factors were hypertension ( 92 % ) , hypercholesteremia ( 49 % ) , diabetes ( 21 % ) , and 1 current smoker . Subjects were below the 50th percentile of fitness at baseline compared to age- and gender-specific normative US data . Statistically significant improvements were observed in all balance , muscular strength and endurance , and flexibility measures after 6 weeks , and they increased further after 12 weeks . CONCLUSIONS Tai chi is a potent intervention that improved balance , upper- and lower-body muscular strength and endurance , and upper- and lower-body flexibility in these older Chinese adults . These findings provide important information for future community-based tai chi exercise programs and support current public health initiatives to reduce disability from chronic health conditions and enhance physical function in older adults PURPOSE The objective of the Healthy Eating Aerobic and Resistance Training in Youth ( HEARTY ) trial ( Clinical Trials . Gov # NCT00195858 ) was to examine the effects of resistance training , with and without aerobic training , on percent body fat in sedentary , post-pubertal overweight or obese adolescents aged 14 - 18 years . This paper describes the HEARTY study rationale , design and methods . METHODS After a 4-week supervised low-intensity exercise run-in period , 304 overweight or obese adolescents with a body mass index≥85th percentile for age and sex were r and omized to 4 groups for 22 weeks ( 5 months ) : diet+aerobic exercise , diet+resistance exercise , diet+combined aerobic and resistance exercise , or a diet only waiting-list control . All participants received dietary counseling design ed to promote healthy eating with a maximum daily energy deficit of -250 kcal . OUTCOMES The primary outcome is percent body fat measured by Magnetic Resonance Imaging . Secondary outcomes include changes in anthropometry , regional body composition , resting energy expenditure , cardiorespiratory fitness , musculoskeletal fitness , cardiometabolic risk markers , and psychological health . SUMMARY To our knowledge , HEARTY is the largest clinical trial examining effects of aerobic training , resistance training , and combined aerobic and resistance training on changes in adiposity and cardiometabolic risk markers in overweight and obese adolescents . The findings will have important clinical implication s regarding the role that resistance training should play in the management of adolescent obesity and its co-morbidities Background Adolescents with overweight and poor physical fitness have an increased likelihood of developing cardiovascular diseases during adulthood . In Ecuador , a health promotion program improved the muscular strength and speed-agility , and reduced the decline of the moderate-to-vigorous physical activity of adolescents after 28 months . We performed a sub-group analysis to assess the differential effect of this intervention in overweight and low-fit adolescents . Methods We performed a cluster-r and omized pair matched trial in schools located in Cuenca – Ecuador . In total 20 schools ( clusters ) were pair matched , and 1440 adolescents of grade 8 and 9 ( mean age of 12.3 and 13.3 years respectively ) participated in the trial . For the purpose s of the subgroup analysis , the adolescents were classified into groups according to their weight status ( body mass index ) and aerobic capacity ( scores in the 20 m shuttle run and FITNESSGRAM st and ards ) at baseline . Primary outcomes included physical fitness ( vertical jump , speed shuttle run ) and physical activity ( proportion of students achieving over 60 min of moderate – to-vigorous physical activity/day ) . For these primary outcomes , we stratified analysis by weight ( underweight , normal BMI and overweight/obese ) and fitness ( fit and low fitness ) groups . Mixed linear regression models were used to assess the intervention effect . Results The prevalence of overweight/obesity , underweight and poor  physical  fitness  was 20.3 % , 5.8 % and 84.8 % respectively . A higher intervention effect was observed for speed shuttle run in overweight ( β = −1.85 s , P = 0.04 ) adolescents compared to underweight ( β = −1.66 s , P = 0.5 ) or normal weight ( β = −0.35 s , P = 0.6 ) peers . The intervention effect on vertical jump was higher in adolescents with poor physical fitness ( β = 3.71 cm , P = 0.005 ) compared to their fit peers ( β = 1.28 cm , P = 0.4 ) . The proportion of students achieving over 60 min of moderate-to-vigorous physical activity/day was not significantly different according to weight or fitness status . Conclusion Comprehensive school-based interventions that aim to improve diet and physical activity could improve speed and strength aspects of physical fitness in low-fit and overweight/obese adolescents . Trial registration Clinical trials.gov identifier NCT01004367 . Registered October 28 , 2009 AIM The aim of this study was to examine the effects of a 6-week diet and exercise program , with emphasis on strength training , on the physical self-concept , body composition , and physical fitness of young overweight and obese children . METHODS Eighty-two overweight and obese children aged 8 - 11 years were r and omized into a  diet-only or a diet- and -strength training group .  Self-concept , body composition and physical fitness were measured before and after the 6-week study period using the Physical Self Description Question naires ( PSDQ ) , dual-energy X-ray absorptiometry ( DXA ) , and st and ard fitness tests .  Dietary intake was assessed with a food frequency question naire . Total daily energy intake was significantly reduced in both groups with a trend of more reduction in the diet-only group . RESULTS Both groups developed greater confidence in strength . Those in the diet- and -strength training group also improved their endurance self-concept . Body Mass Index ( BMI ) decreased significantly in both groups . Lean mass increased significantly in both groups but significantly more in the diet- and -strength training group ( + 0.8 kg vs + 0.3 kg , P<0.05 ) . H and grip , shuttle run , sit-up , and push-up were significantly improved in both groups , to a significantly greater extent in the diet- and -strength training group . CONCLUSION These findings confirm the 6-week program of either diet-only or diet- and -strength training  improved overweight/obese children 's  self-perception of muscular strength and body composition . With the diet- and -strength training program , self-concept in endurance also improved and the gain in lean body mass was more than double that of the diet only group Childhood obesity is a complex and multifaceted health problem linked to elevated risk for chronic diseases , such as diabetes , cancer , hypertension , and cardiovascular disease.1,2 Although research has increased dramatically in the past 2 decades , questions regarding factors driving overweight and obesity remain , particularly among youth of color who experience disproportionate rates of obesity and comorbid health conditions.3 Adolescence is a critical period in the developmental trajectory,4 in part because overweight and obese adolescents are more likely to remain overweight and /or obese in adulthood.3 Overweight and obesity have been associated with adverse symptoms and intra- and interpersonal psychological , social , and emotional issues that continue into adulthood , including depression and anxiety , social withdrawal , feeling worthless , lower self-esteem , and behavioral problems.5–7 Poor mental health may lead to increases in weight due to fluctuations in appetite , obesogenic behaviors ( eg , overeating ) to cope with negative mood , sedentary behavior , and increased isolation.8 Chronic stress or experiences of discrimination may also influence physiology and behaviors that affect weight gain.9 On the other h and , increased body mass index ( BMI ) could result in adverse emotional outcomes over time due to weight-based stigma , bullying , or poor self-esteem.5,6 The few longitudinal studies that have examined the association between emotional health and physical health outcomes have primarily taken a narrow focus of mental health symptoms ( e.g. , only examining depression)10 or behavioral concerns ( e.g. , conduct).11 Physical outcomes , including BMI , were often collected by self-report12 and /or retrospectively.13 Furthermore , they have been limited to predominantly White sample s of older adolescents or adults.12,13 Persistent racial and ethnic disparities in overweight and obesity further complicate research as well as clinical prevention and intervention efforts . Black and Latino youth experience disproportionate levels of overweight and obesity beginning as early as preschool and are more likely to remain obese as adults compared with Whites.14 Blacks and Latinos also are at disproportionate risk for multiple negative health conditions associated with overweight and obesity , such as diabetes.14,15 Reasons for such disparities remain poorly understood and understudied . Although emotional health has been associated with weight in both adults and youth,16 prior research has been limited to cross-sectional studies .17 Longitudinal , prospect i ve design s are critical to explicate the association between emotional health and BMI among Black and Latino youth . The primary objective of this study is to examine whether negative emotional symptoms prospect ively predict increases in BMI z-scores ( BMI -z ) across 2 years among a sample of predominantly Black and Latino , urban youth . We hypothesize that more negative emotional symptoms measured at baseline ( grade s 5 and 6 ) would predict increases in BMI -z scores 2 years later . Results can inform programs and interventions aim ed at reducing obesity in youth of color Background Whether muscle strength in youth is related to cardiovascular risk later in life independent of cardiorespiratory fitness is unclear . Methods We examined the independent association of isometric muscle strength in youth with cardiovascular risk factors in young adulthood using data from the Danish European Youth Heart Study ; a population -based prospect i ve cohort study among boys and girls ( n=332 ) followed for up to 12 years . In youth maximal voluntary contractions during isometric back extension and abdominal flexion were determined using a strain-gauge dynamometer and cardiorespiratory fitness was obtained from a maximal cycle ergometer test . Cardiovascular risk factors were obtained in youth and in young adulthood . Associations were examined using multivariable-adjusted regression models including major confounding factors . Results Each 1 SD difference in isometric muscle strength in youth ( 0.17 N/kg ) was inversely associated with body mass index ( BMI ; −0.60 kg/m2 , 95 % CI −0.97 to −0.22 ) , triglyceride ( −0.09 mmol/l , 95 % CI −0.16 to −0.02 ) , diastolic blood pressure ( BP ) ( −1.22 mm Hg , 95 % CI −2.15 to −0.29 ) and a composite cardiovascular risk factor score ( −0.61 SD , 95 % CI −1.03 to −0.20 ) in young adulthood in multivariable-adjusted analyses including fitness . Associations to triglyceride , diastolic BP and the cardiovascular risk factor score remained with additional adjustment for waist circumference or BMI . Each 1 SD difference in isometric muscle strength in youth was significantly associated with 0.59 ( 95 % CI 0.40 to 0.87 ) lower odds of general overweight/obesity in young adulthood ( p=0.007 ) and was marginally associated with incident raised BP , raised triglyceride and low high-density lipoprotein cholesterol . Conclusions This study suggests that greater isometric muscle strength in youth is associated with lower levels of cardiovascular risk factors in young adulthood independent of fitness , adiposity and other confounding factors BACKGROUND CONTEXT Association between low physical fitness and  low back pain ( LBP ) is contradictory in previous studies . PURPOSE The objective of the present prospect i ve cohort study was to investigate the predictive associations of various intrinsic risk factors in young conscripts for LBP , with special attention to physical fitness . STUDY DESIGN A prospect i ve cohort study . PATIENT SAMPLE A representative sample of Finnish male conscripts . In Finl and , military service is compulsory for male citizens and 90 % of young men enter into the service . OUTCOME MEASURES Incidence of LBP and recurrent LBP prompting a visit at the garrison health clinic during 6-month military training . METHODS Four successive cohorts of 18- to 28-year-old male conscripts ( N=982 ) were followed for 6 months . Conscripts with incidence of LBP were identified and treated at the garrison clinic . Predictive associations between intrinsic risk factors and LBP were examined using multivariate Cox proportional hazard models . RESULTS The cumulative incidence of LBP was 16 % , the incidence rate being 1.2 ( 95 % confidence interval [ CI ] , 1.0 - 1.4 ) per 1,000 person-days . Conscripts with low educational level had increased risk for incidence of LBP ( hazard ratio [ HR ] , 1.6 ; 95 % CI , 1.1 - 2.3 ) . Conscripts with low dynamic trunk muscle endurance and low aerobic endurance simultaneously ( ie , having coimpairment ) at baseline also had an increased risk for incidence of LBP . The strongest risk factor was coimpairment of trunk muscular endurance in tests of back lift and push-up ( HR , 2.8 ; 95 % CI , 1.4 - 5.9 ) . CONCLUSIONS The increased risk for LBP was observed among young men who had a low educational level and poor fitness level in both muscular and aerobic performance Although exercise has well-documented health benefits on cardiovascular disease ( CVD ) , the benefit of combination exercise on CVD risk factors in individuals with elevated risk has not been fully eluci date d. We compared the effects of aerobic , resistance , and a combination of both aerobic and resistance training on CVD risk factors including peripheral and central BP , cardiorespiratory fitness ( CRF ) , muscular strength , body composition , blood glucose and lipids .  Sixty-nine adults ( 58±7 years ) with an elevated blood pressure or hypertension , overweight/obesity , and sedentary lifestyle were r and omized to one of the three 8-week exercise programs or a non-exercise control group . Participants in all three exercise groups had an equal total exercise time , 3 days/week ( aerobic : 60 minutes/session vs. resistance : 60 minutes/session vs. combination : aerobic 30 minutes/session plus resistance 30 minutes/session ) . Combined training provided significant reductions in peripheral ( -4 mmHg ) and central diastolic BP ( -4 mmHg ) , increase in CRF ( 4.9 ml/kg/min ) , increase in upper ( 4 kg ) and lower ( 11 kg ) body strength , and increase in lean body mass ( 0.8 kg ) ( p < 0.05 ) . Aerobic training only increased CRF ( 7.7 ml/kg/min ) , and reduced body weight ( -1.0 kg ) and fat mass ( -0.9 kg ) ( p < 0.05 ) . Resistance training only increased lower body strength ( 13 kg ) and reduced waist circumference ( -1.7 cm ) ( p < 0.05 ) . However , neither aerobic or resistance training alone showed significant reductions in BP ( p>0.05 ) . Furthermore , a composite score of CVD risk factors indicated a greater reduction with combination training compared to the control group . In conclusion , among individuals at an increased risk for CVD , as little as 8-weeks of combined training may provide more comprehensive CVD benefits compared to time-matched aerobic or resistance training alone PURPOSE The purpose of this study was to describe levels of inflammation markers in Norwegian children and to examine the associations of adiposity , aerobic fitness , and muscle fitness with markers of inflammation . METHODS In 2005 - 2006 , 1467 nine-year-olds were r and omly selected from all regions in Norway . The participation rate was 89 % . The inflammatory markers evaluated included C-reactive protein ( CRP ) , leptin , adiponectin , plasminogen activator inhibitor-1 , tumor necrosis factor-α , hepatocyte growth factor , resistin , and interleukin-6 . We assessed muscular strength by measuring  explosive , isometric , and endurance strength . Aerobic fitness was measured directly during a maximal cycle ergometer test .  Adiposity was expressed as waist circumference ( WC ) . RESULTS The girls had significantly higher levels of CRP , leptin , adiponectin , and resistin and lower levels of tumor necrosis factor-α compared with the boys . We observed a grade d association of CRP and leptin levels across quintiles of WC , aerobic fitness , and muscle fitness ( P ≤ 0.001 for all participants ) . The regression analyses revealed that WC , aerobic fitness , and muscle fitness were independently associated with the CRP ( WC β = 0.158 , P < 0.001 ; aerobic fitness β = -0.190 , P < 0.001 ; muscle fitness β = -0.122 , P < 0.002 ) after adjustments for sex , age , Tanner pubertal stage , and the other independent variables . The same pattern was observed for leptin levels ( WC β = 0.406 , P < 0.001 ; aerobic fitness β = -0.298 , P < 0.001 ; muscle fitness β = -0.064 , P < 0.036 ) . CONCLUSIONS These data represent a reference material with respect to inflammatory markers . Our results show that adiposity , aerobic fitness , and muscle fitness were independently associated with the CRP and leptin levels Objectives : This umbrella review aim ed to determine the effectiveness of exercise interventions , alone or in combination with other interventions , in improving physical function in community-dwelling older people identified as pre-frail or frail . Introduction : Exercise is said to have a positive impact on muscle mass and strength which improves physical function and hence is beneficial for the treatment of frailty . Several systematic review s discuss the effects of exercise interventions on physical function parameters , such as strength , mobility , gait , balance and physical performance , and indicate that multi-component exercise , including resistance , aerobic , balance and flexibility training , appears to be the best way in which to improve physical function parameters in frail older people . However , there is still uncertainty as to which exercise characteristics ( type , frequency , intensity , duration and combinations ) are the most effective and sustainable over the long-term . Inclusion criteria : Participants were adults , 60 years or over , living in the community and identified as pre-frail or frail . Quantitative systematic review s , with or without meta- analysis that examined the effectiveness of exercise interventions of any form , duration , frequency and intensity , alone or in combination with other interventions design ed to alter physical function parameters in frail older people , were considered . The quantitative outcome measures were physical function , including muscular strength , gait , balance , mobility and physical performance . Methods : An iterative search strategy for ten bibliometric data bases and gray literature was developed . Critical appraisal of seven systematic review s was conducted independently by two review ers using a st and ard Joanna Briggs Institute tool . Data was extracted independently by two review ers using a st and ard Joanna Briggs Institute data extraction tool and summarized using a narrative synthesis approach . Results : Seven systematic review s were included in this umbrella review , with a total of 58 relevant r and omized controlled trials and 6927 participants . Five systematic review s examined the effects of exercise only , while two systematic review s reported on exercise in combination with a nutritional approach , including protein supplementations , as well as fruit and dairy products . The average  exercise frequency was 2–3 times per week ( mean 3.0 ± 1.5 times per week ; range 1–7 weekly ) for 10–90 minutes per session ( mean of 52.0 ± 16.5 mins ) and a total duration of 5–72 weeks with the majority lasting a minimum of 2.5 months ( mean 22.7 ± 17.7 weeks ) . Multi-component exercise interventions can currently be recommended for pre-frail and frail older adults to improve muscular strength , gait speed , balance and physical performance , including resistance , aerobic , balance and flexibility tasks . Resistance training alone also appeared to be beneficial , in particular for improving muscular strength , gait speed and physical performance . Other types of exercise were not sufficiently studied and their effectiveness is yet to be established . Conclusions : Interventions for pre-frail and frail older adults should include multi-component exercises , including in particular resistance training , as well as aerobic , balance and flexibility tasks . Future research should adopt a consistent definition of frailty and investigate the effects of other types of exercise alone or in combination with nutritional interventions so that more specific recommendations can be made OBJECTIVES We sought to characterize the impact of obesity on vascular function in adolescents and to determine whether an exercise program reverses abnormalities in endothelial function . BACKGROUND Obesity , a major modifiable risk factor for cardiovascular disease , is epidemic in Western societies , with rapid rates of increase in the young . Atherosclerosis begins in childhood , and endothelial dysfunction is its earliest detectable manifestation . METHODS The influence of eight weeks of circuit training ( CT ) was examined in 19 obese subjects ( 14.3 + /- 1.5 years ) , using a r and omized , crossover protocol . Functional capacity and muscular strength were assessed by st and ard techniques .  Body composition was examined using anthropometric measures and dual-energy X-ray absorptiometry .  Conduit vessel endothelial function was assessed using high-resolution ultrasound and flow-mediated dilation ( FMD ) of the brachial artery . RESULTS Circuit training decreased abdominal and trunk fat and significantly improved fitness and muscular strength ( p < 0.05 ) . In the obese group , FMD was significantly impaired relative to control subjects ( n = 20 ) at entry ( 5.3 + /- 0.9 % vs. 8.9 + /- 1.5 % , p < 0.05 ) and was normalized after CT ( 8.8 + /- 0.8 % , p < 0.05 ) . CONCLUSIONS Circuit training improved functional capacity , muscular strength , and body composition in obese adolescents . Furthermore , conduit vessel function was normalized after exercise training . If vascular dysfunction is an integral component of the pathogenesis of vascular disease , this study supports the value of an exercise program in the management of obese adolescents Although HIV-I infection rates peaked in the 1980s in the United States , advanced stage HIV disease will grow by about 40 % in the next 40 years . This fact has signaled the need for intervention strategies that go beyond primary prevention and into treatment of the complications associated with this chronic disease . Recently , the role of exercise in reversing the wasting process experienced by individuals with HIV-1 has received much needed attention . The purpose of this study was to examine the independent contributions of a 12-week aerobic or resistance weight training exercise regimen in improving body composition , muscle strength , and cardiovascular fitness in an HT V-l population . Participants for this study ( N = 33 ) were r and omly assigned to an aerobic exercise training group , a resistance weight training group , or a stretching/flexibility control group .  Measures of body composition , muscular strength , and cardiovascular fitness were assessed both prior to and following completion of the intervention . In general , the results revealed significant improvements in the amount of lean muscle tissue , upper and lower body muscular strength , and predicted V02max for exercise participants , whereas control participants experienced declines in all physiological measures . Based on these findings , it is suggested that exercise may be one complimentary therapeutic modality capable of combating the wasting process associated with advanced HIV-1 infection Abstract Faigenbaum , AD , Bush , JA , McLoone , RP , Kreckel , MC , Farrell , A , Ratamess , NA , and Kang , J. Benefits of strength and skill-based training during primary school physical education . J Strength Cond Res 29(5 ) : 1255–1262 , 2015—Physical education ( PE ) programs are evolving from a traditional skill-centered model to a health-centered model that focuses on time engaged in moderate to vigorous physical activity ( MVPA ) . However , improvements in muscular fitness and fundamental movement skills are prerequisites for continuous participation in MVPA . The purpose of this study was to examine the effects of integrative strength and skill-based training on measures of physical fitness in children during primary school PE . Children from two fourth grade PE classes were cluster r and omized into either a fundamental integrative training ( FIT ) group ( n = 20 ) or a control ( CON ) group ( n = 21 ) . The 8-week FIT program was performed twice per week during the first ∼15 minutes of each PE class and consisted of a circuit of strength and skill-based exercises . All participants were assessed for health- and skill-related fitness before and after the intervention . The outcome variables were analyzed via 2 × 2 repeated measures analysis of variance with post hoc analysis . A significant ( p ⩽ 0.05 ) interaction of group by time was observed in FIT participants with improvements in aerobic capacity , push-ups , sit and reach flexibility , and single-leg hop . There were no groups by time effects for the sit-up and long jump tests . No injuries were reported . These findings highlight the potential benefits of integrating both health- and skill-related fitness components into primary school PE as evidence d by improvements in measures of aerobic capacity and muscular fitness in children PURPOSE Information about factors related to overweight development in early stages of life is needed for design ing useful strategies to prevent overweight and related diseases . Longitudinal studies can contribute to this goal . The present study aim ed to identify factors in childhood that determine the development of overweight/obesity in adolescence . METHODS A prospect i ve study in 598 normal-weight Estonian and Swedish children age 9.5 ± 0.4 yr from the European Youth Heart Study , who were followed during 6 yr , was conducted . Weight and height were measured at baseline and follow-up , and weight status was ascertained according to the international criteria for body mass index . Cardiorespiratory fitness  ( expressed as  VO(2max ) ( mL·kg(-1)·min(-1 ) ) ) was assessed by a maximal bike test . Parents reported their weight , height , and educational level . RESULTS Being male ( vs female ) and Estonian ( vs Swedish ) was related to higher risk for incident overweight/obesity . Change in fitness was a stronger predictor of incident overweight/obesity than childhood fitness , parental overweight , or parental education . The risk of developing overweight/obesity was reduced 10 % every 1 mL·kg(-1)·min(-1 ) of VO(2max ) increase ( odds ratio = 0.90 and 95 % confidence interval = 0.84 - 0.95 ) after adjustment for a set of confounders including baseline body mass index and without differences by gender . CONCLUSIONS Our results suggest that improvements in fitness from childhood to adolescence are associated with a lower risk of becoming overweight/obese in adolescence . The current findings highlight the importance of promoting fitness through physical exercise from early stages in life , as a promising strategy to fight against overweight and obesity . Gender and country differences observed in this study require social and political attention Objective : To examined the effects of different training modalities on exercise capacity ( Vo 2peak ) , systolic function , muscular strength and endurance and quality of life in heart failure patients . Design : R and omized controlled trial . Setting : Cardiac rehabilitation centre in Canada . Subjects : Forty-two individuals with heart failure ( 62 ± 12 years ; New York Heart Association ( NYHA ) classes I — III ) . Interventions : Aerobic training ( n = 14 ) , combined aerobic and resistance training ( n = 15 ) or usual care ( n = 13 ) three times per week for 12 weeks . Main measures : ( 1 ) Vo 2peak measured by symptom-limited grade d exercise test on cycle ergometer ; ( 2 ) systolic function assessed by two-dimensional echocardiography ; ( 3 ) muscular strength and muscular endurance measured by one-repetition maximum procedure ; and ( 4 ) quality of life assessed by question naires . Results : In the intention-to-treat analysis , neither aerobic nor combined aerobic and resistance training significantly improved Vo2peak , systolic function or quality of life compared with usual care . However , combined aerobic and resistance training significantly improved upper extremity strength ( 40.7 (14.0)—48.5 ( 16.0 ) kg , P<0.05 ) and muscular endurance ( 5.7 (2.7)—11.6 ( 7.6 ) reps , P<0.05 ) compared with aerobic training or usual care . In compliant participants ( exercise adherence 80 % ) , Vo2peak increased in the aerobic group ( 16.9 (6.0)—19.0 ( 6.8 ) , P= 0.026 ) and tended to increase in the combined training group ( 15.9 (5.0)—17.6 ( 5.6 ) , P= 0.058 ) compared with usual care . Quality of life was improved in the aerobic group only . Conclusions : Both aerobic and combined aerobic and resistance training are effective interventions to improve Vo2peak in compliant heart failure patients . Combined training may be more effective in improving muscle strength and endurance BACKGROUND Although health-related benefits of fitness training in older men are well established , it is not clear yet which mode and intensity of a exercise program is most effective . This study addresses whether the combination of endurance ( ED ) and resistance training in older men have supplementary health-related benefits in addition to profits attained through endurance training alone . Additionally , effects of moderate- and low-intensity resistance training are compared . METHODS Men , 55 - 75 years of age , were r and omly assigned to a  control group ( N = 13 ) or one of three exercise groups ( 20 weeks , two to three times per week ) : endurance plus moderate resistance ( MR ) training ( N = 22 ) , endurance plus low resistance ( LR ) training ( N = 22 ) and endurance training only ( N = 22 ) . Cardiovascular ( CV ) risk factors , muscular fitness and postural control were assessed before and after training . RESULTS All exercise groups revealed significant ( P < 0.05 ) improvements in resting heart rate , work capacity and recovery , waist girth , insulin response and knee-extensor strength with no differences among groups . Body composition , resting metabolic rate ( RMR ) , VO2peak and postural control did not change in exercise groups . CONCLUSION In older men , a fitness program consisting of 20 weeks endurance training combined with resistance training is equally effective as endurance training alone . Moderate vs. low resistance training added to endurance training yields similar health-related benefits Background Cardiovascular disease and type 2 diabetes are examples of chronic diseases that impose significant morbidity and mortality in the general population worldwide . Most chronic diseases are associated with underlying preventable risk factors , such as elevated blood pressure , high blood glucose or glucose intolerance , high lipid levels , physical inactivity , excessive sedentary behaviours , and overweight/obesity . The occurrence of intermediate outcomes during childhood increases the risk of disease in adulthood . Sugar-sweetened beverages are known to be significant sources of additional caloric intake , and given recent attention to their contribution in the development of chronic diseases , a systematic review is warranted . We will assess whether the consumption of sugar-sweetened beverages in children is associated with adverse health outcomes and what the potential moderating factors are . Methods / Design Of interest are studies addressing sugar-sweetened beverage consumption , taking a broad perspective . Both direct consumption studies as well as those evaluating interventions that influence consumption ( e.g. school policy , educational ) will be relevant . Non-specific or multi-faceted behavioural , educational , or policy interventions may also be included subject to the level of evidence that exists for the other interventions /exposures . Comparisons of interest and endpoints of interest are pre-specified . We will include r and omized controlled trials , controlled clinical trials , interrupted time series studies , controlled before-after studies , prospect i ve and retrospective comparative cohort studies , case – control studies , and nested case – control design s. The MEDLINE ® , Embase , The Cochrane Library , CINAHL , ERIC , and PsycINFO ® data bases and grey literature sources will be search ed . The processes for selecting studies , abstract ing data , and resolving conflicts are described . We will assess risk of bias using design -specific tools . To determine sets of confounding variables that should be adjusted for , we have developed causal directed acyclic graphs and will use those to inform our risk of bias assessment s. Meta- analysis will be conducted where appropriate ; parameters for exploring statistical heterogeneity and effect modifiers are pre-specified . The Grading of Recommendations Assessment , Development and Evaluation ( GRADE ) approach will be used to determine the quality of evidence for outcomes . Systematic review registration PROSPERO CRD42014009641 We compared the effects of a new physical activity education program approach ( EDU ) , based on a periodically supervised protocol of different exercise modalities vs traditionally supervised combined strength-endurance training ( CT ) on health-related factors in patients with stable chronic obstructive pulmonary disease ( COPD ) . Twenty-eight COPD patients without comorbidities were r and omly assigned to receive either EDU or CT . CT was continuously supervised to combine strength-endurance training ; EDU was taught to progressively increase the rate of autonomous physical activity , through different training modalities such as Nordic walking , group classes and circuit training .  Body composition , walking capacity , muscle strength , flexibility and balance , total daily energy expenditure and quality of life were evaluated at baseline , after 28 weeks training period ( 3d/week ) and after a 14-week follow-up . No adverse events occurred during the interventions . After training , CT and EDU similarly improved walking capacity , body composition and quality of life . However , after 14 weeks of follow-up , such improvements were not maintained . Only in CT , muscle strength and flexibility improved after training but returned to baseline after follow-up . EDU , similar to CT , can effectively and safely improve health-related parameters in COPD patients . EDU could be an attractive alternative to traditional supervised training for improving quality of life in COPD patients PURPOSE Aging alters cardiac autonomic function , which may contribute to a higher risk of cardiac events . Spectral measures of HR variability ( HRV ) and fractal-like behavior of HR are considered as markers of a healthy heart . The present study examined the effects of combining endurance and strength training compared with endurance or strength training alone on HR dynamics and physical fitness in older previously untrained men aged 40 - 67 yr . METHODS Subjects were r and omized into endurance training ( E , n = 23 ) , strength training ( S , n = 25 ) , combined endurance and strength training ( ES , n = 29 ) , or control group ( C , n = 16 ) . Short-term fractal scaling exponent ( alpha1 ) and spectral HRV were analyzed from maximal aerobic cycling tests and during supine rest , and leg extension one repetition maximum strength was measured . RESULTS Aerobic capacity and maximal strength increased in the training groups performing endurance and /or strength training , respectively . Only ES showed a decrease after training in fractal HR behavior during exercise , and the difference was significant between groups ( P = 0.019 ) . During supine rest , alpha1 only decreased significantly ( P = 0.039 ) in ES from 1.18 ( SD = 0.20 ) to 1.11 ( SD = 0.21 ) . The decrease in alpha1 at rest from 1.21 ( SD = 0.19 ) to 1.11 ( SD = 0.22 ) also approached significance ( P = 0.061 ) in E. Changes in spectral measures of HRV were minor during the study period and only occurred during exercise . CONCLUSION Fractal HR dynamics were improved more by combining strength training with endurance training in our older men compared with endurance training alone , although strength training alone produced no changes in fractal HR behavior . The synergistic effect in fractal HR behavior occurred regardless of changes in aerobic capacity Purpose : Highly active antiretroviral therapy has significantly extended survival of human immunodeficiency virus ( HIV ) infected patients . These drugs suppress replication of HIV but at the same time , have many physical and mental side effects which may affect daily activities of the patients . The present study assessed if moderate intensity exercise program helped in enhancing the physical fitness and quality of life ( QoL ) in HIV positive females which may reduce the comorbidities associated with the disease and medications . Aim and Objectives : The aim of this study is to study the effects of moderate intensity physical training on physical fitness parameters and QoL in HIV positive females . Methodology : Post IEC approval , a r and omized control , single-blinded , parallel group trial was conducted on 55 females ( 20 experimental HIV , 20 control HIV , 15 control normal ) matching the selection criteria . Post informed consent , their muscular endurance , flexibility , aerobic capacity , and QoL was assessed . Moderate intensity physical exercises were given to experimental HIV and control normal 5 days/week for 8 weeks and subjects were reassessed for above parameters . Intragroup analysis was performed using paired t-test while inter-group was by one-way ANOVA with alpha set at ≤0.05 . Results : Moderate-intensity exercises  improved muscular endurance ( P < 0.05 ) , flexibility ( P < 0.05 ) , and aerobic capacity ( P < 0.05)in experimental HIV and control normal group as compared to control HIV group . QoL in experimental HIV showed improvement in all the domains . Conclusion : Moderate-intensity exercises help improve the physical fitness as well as enhance the QoL in HIV positive females Thirty-one women ( mean age 35.4 + /- 8.5 yr ) who were overweight were matched and r and omly placed into either a control group ( Con ; n = 6 ) , a diet-only group ( D ; n = 8) , a diet+aerobic endurance exercise training group ( DE ; n = 9 ) , or a diet+aerobic endurance exercise training+strength training group ( DES ; n = 8) . After 12 wk , the three dietary groups demonstrated a significant ( P < /= 0.05 ) reduction in body mass , % body fat , and fat mass . No differences were observed in the magnitude of loss among groups , in fat-free mass , or in resting metabolic rate . The DE and DES groups increased maximal oxygen consumption , and the DES group demonstrated increases in maximal strength . Weight loss result ed in a similar reduction in total serum cholesterol , low-density lipoprotein cholesterol , and high-density lipoprotein cholesterol among dietary groups . These data indicate that weight loss during moderate caloric restriction is not altered by inclusion of aerobic or aerobic+resistance exercise , but diet in conjunction with training can induce remarkable adaptations in aerobic capacity and muscular strength despite significant reductions in body mass Background Although lifestyle interventions targeting multiple lifestyle behaviors are more effective in preventing unhealthy weight gain and chronic diseases than intervening on a single behavior , few studies have compared individual and combined effects of diet and /or exercise interventions on health-related quality of life ( HRQOL ) . In addition , the mechanisms of how these lifestyle interventions affect HRQOL are unknown . The primary aim of this study was to examine the individual and combined effects of dietary weight loss and /or exercise interventions on HRQOL and psychosocial factors ( depression , anxiety , stress , social support ) . The secondary aim was to investigate predictors of changes in HRQOL . Methods This study was a r and omized controlled trial . Overweight/obese postmenopausal women were r and omly assigned to 12 months of dietary weight loss ( n = 118 ) , moderate-to-vigorous aerobic exercise ( 225 minutes/week , n = 117 ) , combined diet and exercise ( n = 117 ) , or control ( n = 87 ) . Demographic , health and anthropometric information , aerobic fitness , HRQOL ( SF-36 ) , stress ( Perceived Stress Scale ) , depression [ Brief Symptom Inventory (BSI)-18 ] , anxiety ( BSI-18 ) and social support ( Medical Outcome Study Social Support Survey ) were assessed at baseline and 12 months . The 12-month changes in HRQOL and psychosocial factors were compared using analysis of covariance , adjusting for baseline scores . Multiple regression was used to assess predictors of changes in HRQOL . Results Twelve-month changes in HRQOL and psychosocial factors differed by intervention group . The combined diet + exercise group improved 4 aspects of HRQOL ( physical functioning , role-physical , vitality , and mental health ) , and stress ( p ≤ 0.01 vs. controls ) . The diet group increased vitality score ( p < 0.01 vs. control ) , while HRQOL did not change differently in the exercise group compared with controls . However , regardless of intervention group , weight loss predicted increased physical functioning , role-physical , vitality , and mental health , while increased aerobic fitness predicted improved physical functioning . Positive changes in depression , stress , and social support were independently associated with increased HRQOL , after adjusting for changes in weight and aerobic fitness . Conclusions A combined diet and exercise intervention has positive effects on HRQOL and psychological health , which may be greater than that from exercise or diet alone . Improvements in weight , aerobic fitness and psychosocial factors may mediate intervention effects on HRQOL.Trial Registration Clinical Trials , Clinical Trials.gov register ,
In conclusion , overweight and obese youth can improve physical fitness across a variety of test measures .
When fitness improves , beneficial health effects are observed in some , but not all chronic disease risk factors
A systematic review of literature was conducted to examine the association between changes in health-related fitness ( e.g. aerobic capacity and muscular strength /endurance ) and chronic disease risk factors in overweight and /or obese youth .