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Dino G. Costanzo, David M. Rustico, and Linda S. Pescatello

The preparedness of community facilities offering exercise programs to older adults is unknown. On-site evaluations were conducted by trained professionals to assess compliance of community older adult exercise programs with fitness-industry standards. Fourteen facilities were evaluated whose clientele (N = 2,172) were predominantly White (98%) women (87%) over 75 years of age (66%). Few of the 14 facilities required exercise participants to complete preactivity health questionnaires (n = 5), 3 administered informed consents, and none adhered to a medical-clearance policy. Only 2 facilities had defined emergency policies, and none conducted emergency drills. One site conducted exercise programs with instructors trained in cardiopulmonary resuscitation. Professionally certified exercise instructors leading all exercise programs were observed in 1 facility. Most facilities evaluated were noncompliant with existing professional health and fitness standards. The practicality of imposing such standards on community exercise programs for older adult requires further examination.

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Linda S. Pescatello, Loretta DiPietro, Ann E. Fargo, Adrian M. Ostfeld, and Ethan R. Nadel

The cross-sectional relationship between physical activity, physical fitness, and measures of resting hemodynamic function and adiposity was examined in 11 women and 14 men, all of whom were in good health (M age = 69.3 yrs). Resting diastolic blood pressure (DBP) differed significantly by quartiles of both weekly energy expenditure and estimated VO2max. Subjects whose energy expenditure was above the 50th percentile had significantly lower DBP than less active subjects, independent of age, gender, and VO2max, whereas those above the 75th percentile of VO2max had lower DBP and mean arterial pressure compared to less fit subjects, independent of age, gender, and weekly energy expenditure. There were no significant differences in the body mass index or percent body fat by quartile of weekly energy expenditure or estimated VO2max in the multivariable analysis. Mean waist-to-hip ratio (WHR) differed by level of weekly energy expenditure, independent of age, gender, and VO2max; individuals who reported a threshold of energy expenditure ≥6,099 kcal/wk had less relative abdominal fat than those reporting less activity. There were no significant independent differences in mean WHR or the central-to-peripheral skinfold ratio between quartiles of VO2max.

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Amanda Zaleski, Beth Taylor, Braden Armstrong, Michael Puglisi, Priscilla Clarkson, Stuart Chipkin, Charles Michael White, Paul D. Thompson, and Linda S. Pescatello

Insufficient 25-hydroxyvitamin D [25(OH)D] levels are associated with high resting blood pressure (BP). However, the relationship between 25(OH)D and the peak systolic BP (SBP) response to exercise, a predictor of future hypertension, has yet to be investigated. We sought to examine the relationship among serum 25(OH)D and the peak SBP response to a graded exercise stress test (GEST) among a large sample (n = 417) of healthy men (49%) and women (51%) over a broad age range (20–76 years; mean age: 44.1 ± 0.8 years). We hypothesized that individuals with clinically insufficient 25(OH)D would have a greater peak SBP response to a GEST compared to individuals with sufficient 25(OH)D levels. Fasting serum 25(OH)D, anthropometrics, resting BP, and peak exercise SBP were obtained at the baseline visit of a larger clinical trial (STOMP; NCT01140308). Mean 25(OH)D levels were 36.1 ± 0.7 ng/ml, with ∼35% of individuals classified as insufficient (<30 ng/ml). Average resting BP was 119 ± 13 mmHg/75 ± 10 mmHg, with 52.3% considered to have normal BP, while 25.2% had elevated BP and 22.5% had established hypertension. The peak SBP response to a GEST was similar between individuals with sufficient (48 ± 19 mmHg) versus insufficient (48 ± 18 mmHg) 25(OH)D (p = 1.000). One unexpected finding emerged such that individuals with sufficient 25(OH)D had higher resting SBP (120 ± 14 mmHg vs. 117 ± 13 mmHg; p = .020) than individuals with insufficient 25(OH)D. In contrast to our hypothesis, 25(OH)D levels were not associated with the peak SBP response to a GEST. Baseline 25(OH)D levels were positively correlated with resting SBP; however, the magnitude of this effect is likely not clinically meaningful.

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Amanda L. Zaleski, Linda S. Pescatello, Kevin D. Ballard, Gregory A. Panza, William Adams, Yuri Hosokawa, Paul D. Thompson, and Beth A. Taylor

Context: Compression socks have become increasingly popular with athletes due to perceived enhancement of exercise performance and recovery. However, research examining the efficacy of compression socks to reduce exercise-associated muscle damage has been equivocal, with few direct measurements of markers of muscle damage. Objective: To examine the influence of compression socks worn during a marathon on creatine kinase (CK) levels. Design: A randomized controlled trial. Setting: 2013 Hartford Marathon, Hartford, CT. Participants: Adults (n = 20) randomized to control (CONTROL; n = 10) or compression sock (SOCK; n = 10) groups. Main Outcome Measures: Blood samples were collected 24 hours before, immediately after, and 24 hours following the marathon for the analysis of CK, a marker of muscle damage. Results: Baseline CK levels did not differ between CONTROL (89.3 [41.2] U/L) and SOCK (100.0 [56.2] U/L) (P = .63). Immediately following the marathon (≤1 h), CK increased 273% from baseline (P < .001 for time), with no difference in exercise-induced changes in CK from baseline between CONTROL (+293.9 [278.2] U/L) and SOCK (+233.1 [225.3] U/L; P = .60 for time × group). The day following the marathon (≤24 h), CK further increased 1094% from baseline (P < .001 for time), with no difference in changes in CK from baseline between CONTROL (+ 1191.9 [1194.8] U/L) and SOCK (+889.1 [760.2] U/L; P = .53 for time × group). These similar trends persisted despite controlling for potential covariates such as age, body mass index, and race finishing time (Ps > .29). Conclusions: Compression socks worn during a marathon do not appear to mitigate objectively measured markers of muscle damage immediately following and 24 hours after a marathon.

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Linda S. Pescatello, Emily A. Hennessy, Peter T. Katzmarzyk, William E. Kraus, Anne F. Fish, Lynette L. Craft, and Blair T. Johnson

Background: Systematic reviews (SRs) and meta-analyses (MAs) have proliferated with a concomitant increase in reviews of SRs/MAs or “meta-reviews” (MRs). As uncovered by the 2018 US Physical Activity Guidelines Advisory Committee (PAGAC), there is a paucity of best practice guidance on MRs on physical activity health-related research. This manuscript aims to fill this gap. Methods: In total, the PAGAC conducted 38 literature searches across 3 electronic databases and triaged 20,838 titles, 4913 abstracts, and 2139 full texts from which 1130 articles qualified for the PAGAC Scientific Report. Results: During the MR process, the following challenges were encountered: (1) if the SR/MA authors had limited experience in synthesis methodology, they likely did not account for risk of bias in the conclusions they reached; (2) many SRs/MAs reviewed the same primary-level studies; (3) many SRs/MAs failed to disclose effect modifier analyses; (4) source populations varied; (5) physical activity exposures were nonstandardized; and (6) dose–response effects or effect modification of the physical activity exposure could not be identified. Conclusions: Using examples from the PAGAC Scientific Report, we provide (1) a high-level introduction to MRs; (2) recommended steps in conducting a MR; (3) challenges that can be encountered; and (4) guidance in addressing these challenges.

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Joshua Lowndes, Robert F. Zoeller, George A. Kyriazis, Mary P. Miles, Richard L. Seip, Niall M. Moyna, Paul S. Visich, Linda S. Pescatello, Paul M. Gordon, Paul D. Thompson, and Theodore J. Angelopoulos

The purpose of this study was to examine whether leptin levels affect the response of leptin to exercise training (ET) and whether this is also affected by C-reactive protein (CRP) or the three common Apolipoprotein E genotypes (APOE). Ninety-seven (male = 45, female = 52) sedentary individuals underwent 6 months of supervised ET. Blood was sampled before the initiation of ET, and again 24 and 72 hr after completion of the final training session. ET resulted in a small reduction in body mass (80.47 ± 18.03 vs 79.42 ± 17.34 kg, p < .01). Leptin was reduced 24 hr after the final exercise session (p < .01), but returned to normal after 72 hr (p > .05)—Pre: 13.51 ± 12.27, 24hr: 12.14 ± 12.34, 72hr: 12.98 ± 11.40 ng/ml. The most hyperleptinemic individuals had a greater initial response, which was sustained through to 72 hr after the final session in the pooled study population (p < .01), and in both males (p < .05) and females (p < .05) separately. CRP was related to leptin independently of body weight and positively related to the reductions in leptin. APOE genotype was not related to leptin levels and did not affect the response to ET. Leptin levels may only be reduced by ET in those with hyperleptinemia. In addition, both the initial extent of hyperleptinemia and the subsequent reduction in leptin may be related to low grade chronic systemic inflammation.

Open access

Kenneth E. Powell, Abby C. King, David M. Buchner, Wayne W. Campbell, Loretta DiPietro, Kirk I. Erickson, Charles H. Hillman, John M. Jakicic, Kathleen F. Janz, Peter T. Katzmarzyk, William E. Kraus, Richard F. Macko, David X. Marquez, Anne McTiernan, Russell R. Pate, Linda S. Pescatello, and Melicia C. Whitt-Glover

Background: The 2018 Physical Activity Guidelines Advisory Committee Scientific Report provides the evidence base for the Physical Activity Guidelines for Americans, 2nd Edition. Methods: The 2018 Physical Activity Guidelines Advisory Committee addressed 38 questions and 104 subquestions selected for their public health relevance, potential to inform public policies and programs, maturity of the relevant science, and applicability to the general US population. Rigorous systematic literature searches and literature reviews were performed using standardized methods. Results: Newly described benefits of physical activity include reduced risk of excessive weight gain in children and adults, incidence of 6 types of cancer, and fall-related injuries in older people. Physical activity is associated with enhanced cognitive function and mental health across the life span, plus improved mental health and physical function. There is no threshold that must be exceeded before benefits begin to accrue; the accrual is most rapid for the least active individuals. Sedentary time is directly associated with elevated risk of all-cause and cardiovascular mortality, incident cardiovascular disease and type 2 diabetes, and selected cancer sites. A wide range of intervention strategies have demonstrated success in increasing physical activity. Conclusion: The 2018 Physical Activity Guidelines Advisory Committee Scientific Report provides compelling new evidence to inform physical activity recommendations, practice, and policy.