A síndrome metabólica (SM) é uma somatória de fatores de risco para desenvolvimento de doenças cardiovasculares (DCV), intimamente ligada à obesidade e, assim como a última, sua prevalência cresce mundialmente. Sua etiologia é complexa e suas causas são influenciadas por fatores ambientais e genéticos. Sabe-se que a elevação da capacidade cardiorrespiratória (VO2máx) seja um melhor atenuador do risco de mortalidade por DCV do que a própria obesidade. Atualmente a forma conhecida para aumento do VO2máx é o exercício físico aeróbio, porém vários indivíduos reportam falta de tempo para realização de uma rotina de exercícios físicos. Neste contexto, o presente trabalho teve como objetivo comparar dois protocolos de treinamento aeróbio de alta intensidade e outro contínuo de moderada intensidade quanto à influência na capacidade cardiorrespiratória, variáveis de síndrome metabólica (circunferência da cintura - CC, glicemia de jejum, HDL, triglicérides e pressão arterial) e composição corporal (massa e percentual de gordura) em indivíduos com sobrepeso/obesidade e; observar a influência de polimorfismos dos genes visfatina e receptor tipo 1 de angiotensina 2 (AGTR1) nos níveis de glicemia, HDL, triglicérides e pressão arterial. 40 indivíduos foram divididos aleatoriamente em três grupos de treinamento: contínuo moderado (CM), 4x1 e 4x4. O grupo CM realizou cinco sessões semanais de treino por 30 minutos; os grupos 4x1 e 4x4 realizaram 3 sessões semanais com duração de 19 e 40 minutos, respectivamente. A intervenção durou 16 semanas e as sessões foram monitoradas quanto à frequência cardíaca para controlar a intensidade do exercício. O grupo CM se exercitou a 70% da frequência cardíaca máxima, enquanto os grupos 4x1 e 4x4 realizaram estímulos a 90% da frequência cardíaca máxima. Os resultados encontrados apontaram uma melhora na capacidade cardiorrespiratória em todos os grupos, sem diferença entre eles. Diminuição da massa corpórea, IMC, percentual de gordura somente no grupo 4x4. Diminuição de CC nos grupos 4x4 e CM. Os dados da análise genética não apontaram nenhuma relação entre os polimorfismos avaliados e as variáveis de interesse. Por fim, concluiu-se que o treinamento de alta intensidade com duração de 19 minutos promove resultados semelhantes ao treinamento de mesma intensidade e duração de 40 minutos e ao treinamento de intensidade moderada na capacidade cardiorrespiratória em indivíduos com sobrepeso/obesidade, sendo uma alternativa viável para treinamento físico com pouco volume. / Metabolic syndrome (MS) is a sum of risk factors for developing cardiovascular disease (CVD), closely linked to obesity and, like the latter, its prevalence is growing worldwide. Its etiology is complex and its causes are influenced by environmental and genetic factors. It is known that the increase in cardiorespiratory fitness (VO2max) is a better attenuator of CVD mortality risk rather than obesity itself. Currently, the best known way to increase VO2max is aerobic exercise, but many people report lack of time to perform a exercise routine exercise. In this context, this study aimed to compare two high intensity aerobic exercise protocols and a continuous moderate exercise regarding their effects on cardiorespiratory fitness, metabolic syndrome variables (waist circumference - WC, fasting plasma glucose, HDL, triglycerides, and blood pressure) and body composition (body mass and fat percentage) in overweight/obese individuals and; observe the influence of genetic polymorphisms of visfatin and angiotensin 2 receptor type 1(AGTR1) in blood glucose levels, HDL, triglycerides and blood pressure. 40 subjects were randomly divided into three training groups: continuous moderate intensity (CM), 4x1 and 4x4. The CM group held five weekly training sessions for 30 minutes; the 4x1 and 4x4 groups performed three weekly sessions lasting 19 and 40 minutes, respectively. The intervention lasted 16 weeks and the sessions were monitored for heart rate to control the exercise intensity. The CM group exercised at 70% of maximum heart rate, while the 4x1 and 4x4 groups performed stimuli to 90% of maximum heart rate. The findings showed an improvement in cardiorespiratory fitness in all groups, with no difference between them. A decreased body mass, BMI, body fat percentage only in the group 4x4. WC decrease in 4x4 and CM groups. Data from genetic analysis did not show any relationship between the evaluated polymorphisms and the variables of interest. Finally, it was concluded that the high intensity training lasting 19 minutes promotes similar results to the training of the same intensity and duration of 40 minutes and moderate intensity training on cardiorespiratory fitness in overweight/obese individuals, being a viable alternative for exercise training with low volume.

abstract: Cardiovascular disease (CVD) is the number one cause of death in the United States and type 2 diabetes (T2D) and obesity lead to cardiovascular disease. Obese adults are more susceptible to CVD compared to their non-obese counterparts. Exercise training leads to large reductions in the risk of CVD and T2D. Recent evidence suggests high-intensity interval training (HIT) may yield similar or superior benefits in a shorter amount of time compared to traditional continuous exercise training. The purpose of this study was to compare the effects of HIT to continuous (CONT) exercise training for the improvement of endothelial function, glucose control, and visceral adipose tissue. Seventeen obese men (N=9) and women (N=8) were randomized to eight weeks of either HIT (N=9, age=34 years, BMI=37.6 kg/m2) or CONT (N=8, age=34 years, BMI=34.6 kg/m2) exercise 3 days/week for 8 weeks. Endothelial function was assessed via flow-mediated dilation (FMD), glucose control was assessed via continuous glucose monitoring (CGM), and visceral adipose tissue and body composition was measured with an iDXA. Incremental exercise testing was performed at baseline, 4 weeks, and 8 weeks. There were no changes in weight, fat mass, or visceral adipose tissue measured by the iDXA, but there was a significant reduction in body fat that did not differ by group (46±6.3 to 45.4±6.6%, P=0.025). HIT led to a significantly greater improvement in FMD compared to CONT exercise (HIT: 5.1 to 9.0%; CONT: 5.0 to 2.6%, P=0.006). Average 24-hour glucose was not improved over the whole group and there were no group x time interactions for CGM data (HIT: 103.9 to 98.2 mg/dl; CONT: 99.9 to 100.2 mg/dl, P>0.05). When statistical analysis included only the subjects who started with an average glucose at baseline > 100 mg/dl, there was a significant improvement in glucose control overall, but no group x time interaction (107.8 to 94.2 mg/dl, P=0.027). Eight weeks of HIT led to superior improvements in endothelial function and similar improvements in glucose control in obese subjects at risk for T2D and CVD. HIT was shown to have comparable or superior health benefits in this obese sample with a 36% lower total exercise time commitment. / Dissertation/Thesis / Ph.D. Exercise and Wellness 2013

O objetivo do presente estudo foi verificar os efeitos do treinamento intervalado de alta intensidade (TIAI), específico e não específico, sobre respostas fisiológicas e desempenho em testes aeróbios e anaeróbios, bem como sobre ações técnicas e táticas durante a luta de judô. 35 atletas de judô realizaram uma série de testes antes e após quatro semanas de treinamento, sendo aleatoriamente divididos em quatro grupos: TIAI para membros inferiores, TIAI para membros superiores, TIAI específico [por meio de entrada de golpes (uchi-komi)] e grupo controle. Os grupos experimentais treinaram o exercício intervalado de alta intensidade (EIAI) adicionalmente ao treino de judô e o grupo controle realizou apenas judô. Foi utilizado o mesmo tipo de estímulo em regiões corporais distintas: realização de duas sessões semanais de EIAI constituídas por dois blocos de 10 estímulos de 20s por 10s de intervalo entre os estímulos e 5 min entre os blocos, i.e., grupo de membros superiores e inferiores utilizaram cicloergômetros específicos para cada região corporal, enquanto o grupo específico desempenhou uchi-komi em intensidade all-out com atleta de massa corporal similar. Os grupos e momentos foram comparados via análise de variância (ANOVA) a dois fatores (grupo e momento do treinamento) ou a três fatores (grupo, momento do treinamento e momento da medida), seguida pelo teste de Bonferroni. Quando encontrada diferença entre os grupos durante as semanas de treinamento, foi efetuada uma ANOVA a um fator com medidas repetidas, bem como o teste-t pareado para os valores pré e pós-treinamento. Os principais resultados apontam que: para o grupo de membros inferiores houve aumento da potência equivalente ao onset blood lactate accumulation (OBLA) no teste progressivo para membros superiores, aumento da potência média no teste de Wingate adaptado para membros inferiores, redução da frequência cardíaca após o Special Judo Fitness Test (SJFT), redução do número de sequências em pé durante a simulação de luta e aumento da razão testosterona/cortisol (T/C) pós-simulação de luta no momento pós-treinamento; para o grupo de membros superiores, houve elevação da potência aeróbia máxima no teste progressivo máximo para membros superiores, aumento do número total de projeções no SJFT, redução das concentrações de CK e elevação da razão T/C pós-simulação de luta no pós-treinamento, bem como elevação das concentrações de LDH nas mensurações conduzidas em repouso; para o grupo uchi-komi, houve aumento da potência pico no teste de Wingate para membros superiores e inferiores, redução do índice no SJFT e aumento da razão T/C pós-simulação de luta no momento pós-treinamento. Não foram detectadas alterações no desempenho para o grupo controle pós-treinamento. Além disso, não foram detectadas quaisquer alterações para as respostas psicométricas, hormonais, assim como para o sistema nervoso autônomo após as quatro semanas de intervenção. Os resultados indicam que a adição do TIAI à rotina de treinamento usual de judô eleva a potência aeróbia máxima para membros superiores e desempenho intermitente de alta intensidade para membros superiores e inferiores em testes genéricos. Adicionalmente, o TIAI melhora aspectos relevantes para o desempenho em tarefas específicas do judô. Por fim, o TIAI de baixo volume não promoveu alterações nas respostas do sistema nervoso autônomo, questionários psicométricos e respostas hormonais ao longo das quatro semanas de treinamento / The aim of the present study was to verify the effects, specific and non-specific, of high intensity interval training (HIIT) on physiological and performance responses to aerobic and anaerobic tests, as well as on technical and tactical actions during judo combat. In order to achieve this purpose, 35 judo athletes were randomly selected into four groups: HIIT for lower-body, upper-body, specific group (by means of technique-entrance, uchi-komi) and a control group. These groups completed a series of tests, before and after a 4-week training period. The experimental groups did high intensity interval exercise (HIIE) in addition to judo training while the control group did judo training only. The same type of stimulus was used on distinct body regions: two weekly sessions of HIIE consisting of two blocks of 10 x 20s stimuli with a 10s interval between stimuli and a 5-min interval between blocks, i.e., the lower and upper-body group used cycle-ergometer for each body region, while the specific group carried out uchi-komi at all-out intensity with another athlete of similar body mass and stature. The groups and moments were compared via variance analysis (ANOVA) to two factors (group and training) or to three factors (group, training and time of measurement), followed by the Bonferroni test. When a difference was detected between groups during the training weeks, a one-way (ANOVA) was carried out with repeated measures, as well as the paired t-test, for pre and post-training values. The main results indicate that: The lower-body group showed increase in the equivalent power to onset blood lactate accumulation (OBLA), in aerobic fitness test for upper- limbs, increase in the mean power in the Wingate test (4 sets of 30s interspersed with 3-min recovery period) for lower limbs, heart rate reduction after the Special Judo Fitness Test (SJFT), reducing the number of standing sequences during the match simulation and increasing the testosterone/cortisol ratio (T/C) after the match simulation in the post-training period; For the upper-body group, showed an increase of the maximum aerobic power in aerobic fitness test for upper limbs, increase in the total number of projections in SJFT, reduced CK concentrations (post-training period), increase in T/C ratio post-match in the post-training period and increase in LDH concentrations in measurements conducted at rest. Uchi-komi group, showed an increased in the peak power in the Wingate test for upper and lower limbs, reduction of the SJFT index and increasing the T/C ratio after the match-simulations in the post-training period. As expected, were not found any performance changes after 4-weeks of intervention for the control group Furthermore, were not detected any changes to the psychometric, hormonal responses, as well as the autonomic nervous system after four weeks of intervention for all experimental groups. Therefore, these findings suggest that addition of the HIIT to usual judo training increases the maximum aerobic power for upper limbs and high-intensity intermittent performance for upper and lower limbs, in generic tests. Moreover, HIIT improves relevant aspects to performance in specific judo tasks. Finally, low volume HIIE did not bring about any alterations to the autonomous nervous system responses, psychometric responses or hormonal responses throughout the four weeks of training

Orientador: Daniele Cristina Cataneo / Resumo: Introdução: Há evidências que o exercício físico é benéfico em pacientes com câncer pois fornece independência funcional ao indivíduo. Entretanto pouco se sabe sobre os efeitos do treinamento intervalado de alta intensidade (HIIT) nesses indivíduos, fazendo-se necessário uma revisão sistemática para reunir estudos que utilizaram esta modalidade de exercício, possibilitando o conhecimento de seus reais efeitos no paciente com câncer. Objetivos: Avaliar a efetividade, viabilidade e segurança do treinamento intervalado de alta intensidade nos pacientes com câncer. Método: Foi conduzida uma revisão sistemática (RS) de ensaios clínicos randomizados (ECR), quase randomizados ou controlados que avaliaram o HIIT em pacientes com câncer. Foram avaliados os desfechos: Efetividade (condicionamento físico e qualidade de vida), Viabilidade (fadiga, composição corporal e aderência ao tratamento) e Segurança (efeitos adversos e sobrevida). Todas as buscas foram conduzidas sem restrição de idiomas ou datas nas seguintes bases de dados: Lilacs, Pubmed, Cochrane, Web of Science, Embase e Scopus. Resultados: A pesquisa identificou 333 estudos, dos quais 20 artigos foram incluídos. A duração média da intervenção foi de 9,5 ± 4,7 semanas, com 2,9 ± 0,2 sessões por semana. A meta- análise do consumo de oxigênio (VO2) para o condicionamento físico mostrou superioridade do HIIT em comparação aos Cuidados Usuais (UC) (MD 3,29, IC95% 1,94, 4,64; p<0,00001), mas não quando comparado ao exercício modera... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: There is evidence that physical exercise is beneficial in cancer patients as it provides functional independence to the individual. However, little is known about the effects of high-intensity interval training (HIIT) on these individuals, making a systematic review necessary to gather studies that used this exercise modality, enabling the knowledge of its real effects on cancer patients. Objectives: To evaluate the effectiveness, feasibility and safety of high-intensity interval training in cancer patients. Method: A systematic review of randomized, quasi-randomized or controlled clinical trials that evaluated HIIT in cancer patients was conducted. The outcomes evaluated were: Effectiveness (physical conditioning and quality of life), Viability (fatigue, body composition and adherence to treatment) and Safety (adverse effects and survival). All searches were conducted without restriction of languages or dates in the following databases: Lilacs, Pubmed, Cochrane, Web of Science, Embase and Scopus. Results: The research identified 333 studies, of which 20 articles were included. The average duration of the intervention was 9.5 ± 4.7 weeks, with 2.9 ± 0.2 sessions per week. The meta-analysis of oxygen consumption (VO2) for physical conditioning determined superiority of HIIT compared to Usual Care (UC) (MD 3.29, 95% CI 1.94, 4.64; p <0.00001), but not when compared to moderate continuous intensity exercise (MIC) (MD 1.83, 95% CI -0.40, 4.06; p = 0.11). Likewise, d... (Complete abstract click electronic access below) / Mestre

This study investigated the effects of ungraded running and graded walking as modalities of HIIT on enjoyment, perceived exertion, and affect. 29 healthy males and females (aged 23.3 ± 5.1) volunteered to participate in the study. Participants completed six visits to the laboratory: the first was a medical screening to ensure safety of the participants. For the second and third visits, participants completed two maximal treadmill exercise tests, one running and one walking. On the fourth visit, the speed needed for the run HIIT (running speed: 6.9 ± 1.2mph) and the grade needed for the walk HIIT (walking speed: 3.3 ± 0.3mph, walking grade: 17.2 ± 3.1%) experimental trials were confirmed. During the last two visits, participants completed both of the two (run HIIT and walk HIIT) randomized and counterbalanced experimental trials. Affective valence was measured at baseline and post-exercise. The single-item Feeling Scale (FS) and the Borg 6-20 RPE scale (both overall exertion and legs-only exertion) were used to measure in-task ratings of affect and exertion. The Physical Activity Enjoyment Scale (PACES) and FS were used to measure post-exercise ratings of enjoyment and affect. Results revealed a main effect for condition for post-exercise enjoyment (p < 0.001), with the run HIIT being more enjoyable. A main effect was also found for time for both overall exertion and legs-only exertion (p < 0.001 for both interactions), with the walk HIIT producing higher exertion ratings. There was a main effect for condition of legs-only exertion (p = 0.004), again walk HIIT produced higher exertion ratings. Lastly, there was a main effect when comparing 20% and 100% of total time in the run HIIT and the walk HIIT conditions, for both overall exertion and legs-only exertion (p < 0.001 for all interactions). This shows that exertion increased over time for both conditions. Exertion ratings, both overall and legs-only tended to be highest during the run HIIT condition when compared to the walk HIIT. The opposite was true for affective valence, the ratings were higher in the run HIIT condition than the walk HIIT. In conclusion, the perceptual responses in this study, which represent enjoyment, exertion and affective valence, were generally more favorable during the run HIIT condition. These results support previous findings to suggest that doing a running protocol is a well-tolerated and favorable modality for HIIT exercise.

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<p>This thesis investigated the acute and chronic responses of human skeletal muscle to high-intensity exercise, with a particular focus on markers of mitochondrial content, and the potential for nutrition to manipulate the adaptive response in recreationally active individuals. The acute response was primarily assessed via measurement of signalling proteins and mRNA species linked to exercise-induced mitochondrial biogenesis. The chronic response was determined via changes in the protein content or maximal activities of mitochondrial enzymes after training. Study 1 examined whether the manner in which a given amount of high-intensity cycling work was performed (i.e., in an intermittent or continuous fashion) altered the acute metabolic response to exercise, and whether the acute response was indicative of longer-term adaptations. Despite the similar acute activation of signalling proteins after the intermittent and continuous matched-work exercise protocols, 6 wk of training with the continuous protocol did not increase mitochondrial content, contrary to what we have previously shown after 6 wk training with the intermittent protocol. This suggests that the intermittent application of a low-volume, high-intensity stimulus is important to elicit training-induced increases in mitochondrial content. Furthermore, Study 1 showed that acute changes in specific signalling proteins did not necessarily predict chronic adaptations. Studies 2 and 3 examined whether specific nutritional interventions, previously shown to modulate acute exercise capacity or metabolic response, altered the mitochondrial adaptive response to several weeks of HIT. Neither manipulating carbohydrate availability between twice daily training sessions, or chronic ingestion of β-alanine, augmented skeletal muscle adaptations in response to 2-6 wk of HIT. It is possible that small influences of nutrition were overwhelmed by the potency of HIT, which stimulated marked increases in mitochondrial content in this population. Overall this thesis advances our basic understanding of the skeletal muscle adaptive response to HIT and the influence of nutrition.</p> / Doctor of Philosophy (PhD)

<p>This thesis examined the effect of high-intensity "sprint" interval training (SIT) on aerobic-based exercise performance and metabolic adaptations in human skeletal muscle. It has long been recognized that several weeks of interval-based training increased skeletal muscle oxidative capacity; however, little was known regarding the minimum "dose" of SIT necessary to elicit this adaptive response or the time-course and magnitude of adaptation in other markers of skeletal muscle metabolic control. Our general hypothesis was that low-volume SIT would induce rapid improvements in a wide array of metabolic variables that were comparable to traditional high-volume endurance training (ET). Healthy young men and women were recruited to perform four to six 30- second "all out" Wingate Tests, three times per week with one to two days of recovery, for up to six weeks. The weekly dose of SIT corresponded to ~10 minutes of maximal cycling exercise (-225-300 kJ) over a total training time commitment of 60-90 minutes, including recovery. The SIT response was compared against control subjects who performed no training or an ET group who performed up to one hour per day of moderate-intensity cycling exercise, five days per week for six weeks (-2250 kJ per week). Our major findings were that one to two weeks of SIT increased performance during aerobic-based exercise (time-to-fatigue tests and time-trials of varying duration) and the maximal activity or total protein content of mitochondrial enzymes and transport proteins associated with carbohydrate metabolism (e.g., citrate synthase, cytochrome oxidase, glucose transporter 4). Six weeks of SIT or ET induced similar increases in markers of skeletal muscle carbohydrate (pyruvate dehydrogenase E1a protein content) and lipid oxidation (3-hydroxyacyl CoA dehydrogenase maximal activity) and peroxisome-proliferator-activated receptorgamma coactivator-1a protein content, and similar reductions in phosphocreatine and glycogen utilization during matched-work exercise. These data suggest that SIT is a time-efficient strategy to increase skeletal muscle oxidative capacity and to induce specific metabolic adaptations during exercise that are comparable to ET.</p> / Doctor of Philosophy (PhD)

<p>Research in this thesis has focused on development and application of novel methodologies that enhance sample throughput and data fidelity when performing untargeted metabolome profiling by multisegment injection-capillary electrophoresis-mass spectrometry (MSI-CE-MS). Metabolomics is a valuable tool in functional genomics research to investigate underlying molecular mechanisms associated with human health since metabolites are “real-world” end-products of gene expression. CE-MS is well-suited for metabolomics because it is a high efficiency microseparation technique that can be used to resolve complex mixtures of polar metabolites in human biofluids without complicated sample workup. In this thesis, a novel CE-MS assay for estrogens and their intact ionic conjugates has been described (<em>Chapter II</em>) to expand metabolome coverage that enables resolution of positional isomers with high selectivity. This is critical for better understanding of underlying perturbations in estrogen metabolism since the biological activity of estrogens are dependent on specific primary and secondary metabolic transformations. MSI-CE-MS has been introduced as a high-throughput approach for large-scale metabolomic studies based on serial injection of multiple segments of sample within a single fused-silica capillary (<em>Chapter III</em>). It reduces analysis times while increasing data quality and confidence in peak assignment together with better quality assurance. An accelerated workflow for metabolomics has also been developed when using MSI-CE-MS, where a dilution trend filter is used as a primary screen to authenticate reproducible sample-derived metabolites from a pooled sample while eliminating spurious artifact and background signals. In this way, complicated time alignment and peak picking algorithms are avoided when processing data in metabolomics to reduce false discoveries. This strategy was subsequently used in two metabolomics applications (<em>Chapters IV</em> and <em>V</em>) to identify plasma markers associated with strenuous exercise and adaptive training responses following a six-week high intensity interval training. The impact of exercise intervention to improve the glucose tolerance of a cohort of overweight/obese yet non-diabetic women was investigated on an individual level when using a cross-over design. Personalized interventions are critical in designing more effective therapies to prevent metabolic diseases due to inter-subject variations in treatment responses, including potential adverse effects. MSI-CE-MS offers a revolutionary approach for biomarker discovery in metabolomics with high sample throughput and high data fidelity, which is critical for validation of safe yet effective lifestyle interventions that promote human health and reduce risk for chronic diseases.</p> / Doctor of Philosophy (PhD)