Resistance Training and High-intensity Interval Training Improve Cardiometabolic Health in High Risk Older Adults: A Systematic Review and Meta-anaylsis

Abstract

Progressive resistance training (PRT) and high-intensity interval training (HIIT) improve cardiometabolic health in older adults. Whether combination PRT+HIIT (COMB) provides similar or additional benefit is less clear. This systematic review with meta-analysis of controlled trials examined effects of PRT, HIIT and COMB compared to non-exercise control in older adults with high cardiometabolic risk. Databases were searched until January 2021, with study quality assessed using the PEDro scale. Risk factor data was extracted and analysed using RevMan V.5.3. We analysed 422 participants from nine studies (7 PRT, n=149, 1 HIIT, n=10, 1 COMB, n=60; control n=203; mean age 68.1±1.4 years). Compared to control, exercise improved body mass index (mean difference (MD) −0.33 [−0.47, −0.20], p≤0.0001), body fat% (standardised mean difference (SMD) −0.71 [−1.34, −0.08], p=0.03), aerobic capacity (SMD 0.41 [0.05, 0.78], p=0.03), low-density lipoprotein (SMD −0.27 [−0.52, −0.01], p=0.04), and blood glucose (SMD −0.31 [−0.58, −0.05], p=0.02). Therefore, PRT, HIIT and COMB can improve cardiometabolic health in older adults with cardiometabolic risk. Further research is warranted, particularly in HIIT and COMB, to identify the optimal exercise prescription, if any, for improving older adults cardiometabolic health. (PROSPERO: CRD42019128527).

Key words

aerobic fitness - ageing - muscular strength, HIIT

Publikationsverlauf

Eingereicht: 12. Mai 2021

Angenommen: 26. Juli 2021

Accepted Manuscript online:
28. Juli 2021

Artikel online veröffentlicht:
07. Oktober 2021

• References

• 1 Reaven GM. Banting lecture 1988: Role of insulin resistance in human disease. Nutrition 1997; 13: 64
• 2 Australian Bureau of Statistics. National Health Survey First Results, Australia 2017-18. In: Australian Bureau of Statistics,. 2018
• 3 International Diabetes Federation. IDF Diabetes Atlas Eighth edition. In: Eighth ed: International Diabetes Federation;. 2017
• 4 Virani SS, Alonso A, Benjamin EJ. et al. Heart disease and stroke statistics-2020 update: A report from the American Heart Association. Circulation 2020; 141: e139-e596
• 5 Arnett DK, Blumenthal RS, Albert MA. et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: Executive summary: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Circulation 2019; 140: e563-e595
• 6 Mann S, Beedie C, Jimenez A. Differential effects of aerobic exercise, resistance training and combined exercise modalities on cholesterol and the lipid profile: Review, synthesis and recommendations. Sports Med 2014; 44: 211-221
• 7 Sharman JE, Smart NA, Coombes JS. et al. Exercise and sport science australia position stand update on exercise and hypertension. J Hum Hypertens 2019; 33: 837-843
• 8 Liberman K, Forti LN, Beyer I. et al. The effects of exercise on muscle strength, body composition, physical functioning and the inflammatory profile of older adults: A systematic review. Curr Opin Clin Nutr Metab Care 2017; 20: 30-53
• 9 Buresh R. Exercise and glucose control. J Sports Med Phys Fitness 2014; 54: 373-382
• 10 Bauman A, Merom D, Bull FC. et al. Updating the evidence for physical activity: Summative reviews of the epidemiological evidence, Prevalence, and Interventions to Promote “Active Aging”. Gerontologist 2016; 56 Suppl 2: S268-S280
• 11 Harber MP, Kaminsky LA, Arena R. et al. Impact of cardiorespiratory fitness on all-cause and disease-specific mortality: Advances since 2009. Prog Cardiovasc Dis 2017; 60: 11-20
• 12 Imboden MT, Harber MP, Whaley MH. et al. Cardiorespiratory fitness and mortality in healthy men and women. J Am Coll Cardiol 2018; 72: 2283-2292
• 13 Kim Y, White T, Wijndaele K. et al. The combination of cardiorespiratory fitness and muscle strength, and mortality risk. Eur J Epidemiol 2018; 33: 953-964
• 14 Garcia-Hermoso A, Cavero-Redondo I, Ramirez-Velez R. et al. Muscular strength as a predictor of all-cause mortality in an apparently healthy population: A systematic review and meta-analysis of data from approximately 2 million men and women. Arch Phys Med Rehabil 2018; 99: 2100-2113.e5
• 15 Lin X, Zhang X, Guo J. et al. Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc 2015; 4: e002014
• 16 Hollings M, Mavros Y, Freeston J. et al. The effect of progressive resistance training on aerobic fitness and strength in adults with coronary heart disease: A systematic review and meta-analysis of randomised controlled trials. Eur J Prev Cardiol 2017; 24: 1242-1259
• 17 Liu CJ, Latham NK. Progressive resistance strength training for improving physical function in older adults. Cochrane Database Syst Rev 2009; 2009: CD002759
• 18 Weston KS, Wisloff U, Coombes JS. High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: A systematic review and meta-analysis. Br J Sports Med 2014; 48: 1227-1234
• 19 MacInnis MJ, Gibala MJ. Physiological adaptations to interval training and the role of exercise intensity. J Physiol 2017; 595: 2915-2930
• 20 Hannan AL, Hing W, Simas V. et al. High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation: A systematic review and meta-analysis. Open Access J Sports Med 2018; 9: 1-17
• 21 Moholdt TT, Amundsen BH, Rustad LA. et al. Aerobic interval training versus continuous moderate exercise after coronary artery bypass surgery: A randomized study of cardiovascular effects and quality of life. Am Heart J 2009; 158: 1031-1037
• 22 Fragala MS, Cadore EL, Dorgo S. et al. Resistance training for older adults: position statement from the national strength and conditioning association. J Strength Cond Res 2019; 33: 2019-2052
• 23 Ashton RE, Tew GA, Aning JJ. et al. Effects of short-term, medium-term and long-term resistance exercise training on cardiometabolic health outcomes in adults: Systematic review with meta-analysis. Br J Sports Med 2020; 54: 341-348
• 24 Moher D, Shamseer L, Clarke M. et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015; 4: 1
• 25 Harriss DJ, MacSween A, Atkinson G. Ethical standards in sport and exercise science research: 2020 update. Int J Sports Med 2019; 40: 813-817
• 26 American College of Sports M. Guidelines for Exercise Testing and Prescription. 9th Edition. Lippincott Williams & Wilkins; 2014
• 27 Jensen MD, Ryan DH, Apovian CM. et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation 2014; 129: S102-S138
• 28 Alberti KG, Zimmet P, Shaw J. Metabolic syndrome–a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med 2006; 23: 469-480
• 29 Alberti KG, Eckel RH, Grundy SM. et al. Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120: 1640-1645
• 30 American Diabetes Association. 6. Glycemic Targets: Standards of Medical Care in Diabetes-2018. Diabetes Care 2018; 41: S55-S64
• 31 Gutch M, Kumar S, Razi SM. et al. Assessment of Insulin sensitivity/Resistance. Indian J Endocrinol Metab 2015; 19: 160-164
• 32 Higgins JG, Cochrane S. Handbook for Systematic Reviews of Interventions. West Sussex England: John Wiley & Sons Ltd; 2008
• 33 Jakobsen JC, Gluud C, Wetterslev J. et al. When and how should multiple imputation be used for handling missing data in randomised clinical trials – a practical guide with flowcharts. BMC Med Res Methodol 2017; 17: 162
• 34 Drahota AB. E. Cochrane RevMan calculator. In. doi: https://training.cochrane.org/resource/revman-calculator
• 35 Cashin AG, McAuley JH. Clinimetrics: Physiotherapy Evidence Database (PEDro) Scale. J Physiother 2020; 66: 59
• 36 de Morton NA. The PEDro scale is a valid measure of the methodological quality of clinical trials: A demographic study. Aust J Physiother 2009; 55: 129-133
• 37 Egger M, Smith GD, Schneider M. et al. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629-634
• 38 Davidson LE, Hudson R, Kilpatrick K. et al. Effects of exercise modality on insulin resistance and functional limitation in older adults: A randomized controlled trial. Arch Intern Med 2009; 169: 122-131
• 39 Adamson S, Kavaliauskas M, Yamagishi T. et al. Extremely short duration sprint interval training improves vascular health in older adults. Sport Sci Health 2018; 15: 123-131
• 40 Balkau B, Picard P, Vol S. et al. Consequences of change in waist circumference on cardiometabolic risk factors over 9 years: Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR). Diabetes Care 2007; 30: 1901-1903
• 41 Swank AM, Horton J, Fleg JL. et al. Modest increase in peak VO2 is related to better clinical outcomes in chronic heart failure patients: Results from heart failure and a controlled trial to investigate outcomes of exercise training. Circ Heart Fail 2012; 5: 579-585
• 42 Wong GW, Wright JM. Blood pressure lowering efficacy of nonselective beta-blockers for primary hypertension. Cochrane Database Syst Rev 2014; 2: CD007452
• 43 Hess NC, Carlson DJ, Inder JD. et al. Clinically meaningful blood pressure reductions with low intensity isometric handgrip exercise. A randomized trial. Physiol Res 2016; 65: 461-468
• 44 Turnbull F, Neal B, Algert C. et al. Effects of different blood-pressure-lowering regimens on major cardiovascular events: Results of prospectively-designed overviews of randomised trials. Lancet 2003; 362: 1527-1535
• 45 Bradley R, Kozura E, Buckle H. et al. Description of clinical risk factor changes during naturopathic care for type 2 diabetes. J Altern Complement Med 2009; 15: 633-638
• 46 Slade SC, Dionne CE, Underwood M. et al. Consensus on Exercise Reporting Template (CERT): Explanation and Elaboration Statement. Br J Sports Med 2016; 50: 1428-1437
• 47 Huang SW, Ku JW, Lin LF. et al. Body composition influenced by progressive elastic band resistance exercise of sarcopenic obesity elderly women: A pilot randomized controlled trial. Eur J Phys Rehabil Med 2017; 53: 556-563
• 48 So WY, Song M, Park YH. et al. Body composition, fitness level, anabolic hormones, and inflammatory cytokines in the elderly: A randomized controlled trial. Aging Clin Exp Res 2013; 25: 167-174
• 49 Williams AD, Almond J, Ahuja KD. et al. Cardiovascular and metabolic effects of community based resistance training in an older population. J Sci Med Sport 2011; 14: 331-337
• 50 Van Roie E, Delecluse C, Opdenacker J. et al. Effectiveness of a lifestyle physical activity versus a structured exercise intervention in older adults. J Aging Phys Act 2010; 18: 335-352
• 51 Andersen TR, Schmidt JF, Pedersen MT. et al. The effects of 52 weeks of soccer or resistance training on body composition and muscle function in+65-year-old healthy males–a randomized controlled trial. PLoS One 2016; 11: e0148236
• 52 Marcos-Pardo PJ, Orquin-Castrillón FJ, Gea-García GM. et al. Effects of a moderate-to-high intensity resistance circuit training on fat mass, functional capacity, muscular strength, and quality of life in elderly: A randomized controlled trial. Sci Rep 2020; 10: 21236
• 53 Vincent HK, Bourguignon C, Vincent KR. Resistance training lowers exercise-induced oxidative stress and homocysteine levels in overweight and obese older adults. Obesity (Silver Spring) 2006; 14: 1921-1930
• 54 Sterne JAC, Sutton AJ, Ioannidis JPA. et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ 2011; 343: d4002
• 55 Hwang CL, Yoo JK, Kim HK. et al. Novel all-extremity high-intensity interval training improves aerobic fitness, cardiac function and insulin resistance in healthy older adults. Exp Gerontol 2016; 82: 112-119
• 56 Wickramasinghe CD, Ayers CR, Das S. et al. Prediction of 30-year risk for cardiovascular mortality by fitness and risk factor levels: The Cooper Center Longitudinal Study. Circ Cardiovasc Qual Outcomes 2014; 7: 597-602
• 57 Page P, Hoogenboom B, Voight M. Improving the reporting of therapeutic exercise interventions in rehabilitation research. Int J Sports Phys Ther 2017; 12: 297-304
• 58 Benjamin EJ, Muntner P, Alonso A. et al. Heart disease and stroke statistics-2019 update: A report from the American Heart Association. Circulation 2019; 139: e56-e528
• 59 Riebe D. ACSM's Guidelines for Exercise Testing and Prescription. 10th edition. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health; 2018
• 60 Millán J, Pintó X, Muñoz A. et al. Lipoprotein ratios: Physiological significance and clinical usefulness in cardiovascular prevention. Vasc Health Risk Manag 2009; 5: 757-765
• 61 Jones MD, Wewege MA, Hackett DA. et al. Sex differences in adaptations in muscle strength and size following resistance training in older adults: A systematic review and meta-analysis. Sports Med 2021; 51: 503-517
• 62 Seals DR, Nagy EE, Moreau KL. Aerobic exercise training and vascular function with ageing in healthy men and women. J Physiol 2019; 597: 4901-4914