Aerobic Training Program Designmyweb.facstaff.wwu.edu/chalmers/PDFs/Aerobic Training Program... ·...

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U 1

Aerobic Training Program Design

Readings:

NSCA text: Chapter 16 pp 389 – 406

Course web site:

Physical Activity Guidelines For Americans 2008 - Fact Sheet

Aerobic Training Program Design 2

Synonyms for “Aerobic Training”

Aerobic training/exercise

Endurance training/exercise

Cardiovascular training/exercise

Cardiorespiratory training/exercise

Aerobic capacity = VO2 (dot over V omitted)

[ml O2/kg/min]

3Aerobic Training Program Design

General Training Principles

Specificity of Exercise

You must stress the cardiorespiratory system to produce adaptations in aerobic capacity

Resistance training is not a effective stimulus to produce significant increases in aerobic capacity

There is some transfer of capacity from one aerobic exercise mode to another, but it is not 100%

Swimming peak aerobic capacity in a trained swimmer will not be produced if swimmer runs, due to different muscle use pattern


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Program Design Variables

1. Mode

2. Intensity

3. Duration

4. Frequency

5. Progression

6. Variation


More commonly known as: F.I.T.T. FrequencyIntensityTypeTime

Mode of exercise

Variety of modes discussed in “Cardiovascular Activity Techniques” unit

Select mode based on:

Training goal (“I want to run a 5KM race” vs, “I want to lose weight”)

Enjoyment preference (“I hate to swim”, “I find machines boring”, “I like the social aspect of group exercising”)

Equipment available, weather

Client physical characteristics (e.g., obese, knee injuries, etc.)



1. Mode

2. Intensity

3. Duration

4. Frequency

5. Progression

6. Variation


Terms, Abbreviations, Basic Formulae

Resting Heart Rate = RHR

Maximum Heart Rate = MHR

Age-predicted maximal heart rate = APMHR = 220-age (most common formula)

Heart Rate Reserve = HRR = APMHR-RHR


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Intensity of Exercise


Resting VO2

VO2 Max

Resting HR

Maximum HR

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We use Heart Rate as an easy to measure indicator of aerobic work the body is doing.

We don’t have to measure VO2

while a person exercises



MHRTrue maximum method: Graded exercise test (increasing intensity) to point where HR no longer increases

•Have physician clearance &/or presence•Not typically done outside of training athletes



MHRUse Age-predicted maximal heart rate (APMHR) equation:

APMHR = 220-age•Error ±10-15 beats/min•Client must not be using medication that affects HR

Obese clients use: APMRH = 200-(0.5 x age)



“Training Zone” “Target Heart Rate Range” (THRR) determined using:

1) Percent of APMHROR

2) Karvonen Formula takes into account client’s resting HR

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Training zone = 70%-85% APMHR(55%-65% APMHR for very low capacity clients)

Target HR upper limit = APMHR(.85)

Target HR lower limit = APMHR(.70)


Resting HR

APMHR

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“Training Zone” by % APMHR

70% APMHR

85% APMHR



Resting HR

APMHR

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relationship to %VO2 max

70% APMHR = 55% VO2 max

85% APMHR = 75% V02 max

So, a person training at 70% APMHR, is training at approximately 55% of VO2 max


EXAMPLE:

30 yr-old client

APMHR = 220-age = 220-30 = 190 beats/min

Target HR upper limit = APMHR(.85)=190(.85) =162

Target HR lower limit = APMHR(.70)=190(.70)=133

THRR (Target Heart Rate Range) = 133 to 162 beats / min

= 22 to 27 beats / 10 sec


Resting HR

APMHR

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70% APMHR

85% APMHR

65% APMHR

55% APMHR

Low CapacityClient




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“Training Zone” by % APMHRIntensity of Exercise

Takes into account client’s resting HR

HRR (Heart Rate Reserve) = APMHR-RHR

Training zone = 50%-85% HRR

Target HR upper limit = HRR(.85)+RHR

Target HR lower limit = HRR(.50)+RHR

Measure RHR in bed after waking up in the morning, or after laying quietly for 15 minutes


Resting HR

APMHR

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“Training Zone” by Karvonen (HRR) formula

50% HRR

85% HRR He

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EXAMPLE:

30 yr-old client, RHR = 70 beats/min

APMHR = 220-age = 220-30 = 190 beats/min

HRR = APMHR-RHR = 190-70 = 120 beats/min

Target HR upper limit = HRR(.85)+RHR

= 120(.85)+70 = 172 beats/min

Target HR lower limit = HRR(.50)+RHR

= 120(.50)+70 = 130 beats/min

THRR (Target Heart Rate Range)=130 to 172 bpm

= 22 to 29 beats / 10 sec


Resting HR

APMHR

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50% HRR

85% HRR He

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Resting HR

APMHR

Inc

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50% HRR

85% HRR He

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rve

Trained client

Beginner client

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Comparison of “Training Zone” by %APMHR & Karvonen formula

0

20

40

60

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100

120

140

160

180

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30 50 70 90 110

He

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be

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/min

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For 20 year-old

FOR VERY FITPERSONno differencebetween formulaetop end

FOR NOT FIT PERSON% APMHR formula,more conservative, soperhaps better

Useless rangeof Karvonen

0

20

40

60

80

100

120

140

160

180

200

30 50 70 90 110

For 30 year-old

Karvonen lower limit

Karvonen upper limit

APMHR upper limit

APMHR lower limit

FOR MID RANGE FITNESSLEVEL, No big differenceBetween formulae

0

20

40

60

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100

120

140

160

180

200

30 50 70 90 110

Resting HR (beats/min)

For 40 year-old0

20

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160

180

200

30 50 70 90 110

Resting HR (beats/min)

For 50 year-old



Resting HR

APMHR

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“Training Target Intensity” by Talk Test

Can not speak comfortably

Comfortable speech is just barely possible

Breathing rate will increase with intensity of aerobic exercise. You should exercise at an intensity that is just below the level at which you can no longer speak comfortably (i.e. When comfortable speech is just barely possible you are at the correct exercise intensity) (1,2).

1. Fahey, T. I. (2009). Fit & Well, Core Concepts and Labs in Physical Fitness and Wellness. 8th edition. McGraw Hill.

2. Persinger, R. F. (2004). Consistency of the talk test for exercise prescription. Medicine & Science Sports & Exercise , 36 , 1632-1636.



by Perceived Exertion

For women For men

RPE % of VO2 max RPE % of VO2 max

3.5 58 3 48

6 82 5 68

8 92 7 89

A 10 step OMNI Rating of Perceived Exertion (RPE*) scale has been used to gauge exercise intensity, and relate that perceived intensity to aerobic work intensity (1). The interpretation of the 0-10 scale is aided by illustrations.

Example: For a male, a 68% of VO2 max training level corresponds to a RPE of 5 (see also next slide)

1. Utter AC . Validation of the Adult OMNI Scale of perceived exertion for walking/running exercise. Med Sci Sports Exerc. 2004, 36:1776-80

*A widely used Borg RPE scale also exists, and the Utter 2004 article table 2 also relates that scale to % VO2 max. Dr. Chalmers has

found that some trainers prefer a 0-10 scale, such as the OMNI scale, to the Borg scale of 6-20.

For womenaerobic training intensity

For men aerobic

training intensity

RPE 3.5 - 5 RPE 4 – 5.5


EXAMPLE:

72 yr-old client exercises at APMHR?

42 yr-old client unable to exercise at 70% APMHR


Resting HR

APMHR

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At start of exercise program, check the training intensity HR target calculated using formula with client’s subjective assessment of intensity (talk test or perceived exertion)

WHY?

70% APMHR

85% APMHR

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HR targets can be wrong70-85% APMHR may be:•Way too hard for one person•Too easy for another personBUT….“Exertion does not lie”

RPE technique to set aerobic exercise intensity in:

Faster, Better, Stronger, Heiden, Testa, Musolf, pg 215-7



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Faster, Better, Stronger, Heiden,

Testa, Musolf, pg 215-7

Rating Description

0 Nothing at all

0.5 Very, very weak

1 Very weak

2 Weak

3 Moderate

4 Somewhat strong

5 Strong

6 Between strong and very strong

7 Very strong

8 Between very strong and very, very strong

9 Very, very strong

10 Maximal

RPE < 2, ZONE 1= easy aerobic, for warming up and cooling down

RPE 2-3, ZONE 2 = Aerobic base, mild stress, good for beginners RPE 3-5, ZONE 3 =

Aerobic capacity zone, Intensive aerobic/Cardio-fitness zone RPE 5-7, ZONE 4 =

Aerobic-anaerobic transition (required zone for athletes only)

RPE 8-10, ZONE 5 = only for elite athletes



HR targets can be wrong.Pinkstaff et al., Quantifying Exertion Level During Exercise Stress Testing Using Percentage of Age-Predicted Maximal Heart Rate, Rate Pressure Product, and Perceived Exertion. Mayo Clin Proc. December 2010 85(12):1095-1100; doi:10.4065/mcp.2010.0357

“An APMHR of 85% or more and peak RPP of 25,000 or more were both ineffective in identifying patients who put forth a maximal exercise effort (ie, peak RER, ≥1.10). Perceived exertion was a significant indicator (P=.04) of patient exertion, with a threshold of 15 (6-20 scale) being an optimal cut point.” Exertion does not lie



RPE and HR targets can result in same outcomes.Lavie CJ et al. Effects of Running on Chronic Diseases and Cardiovascular and All-Cause. Mortality. Mayo Clin Proc. 2015 Nov;90(11):1541-52. doi: 10.1016/j.mayocp.2015.08.001.

• 40 untrained males• HR- and RPE-prescribed run training

resulted in similar exercise intensity and performance outcomes over six weeks.

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“Heart rate by itself is not a very meaningful measure. It must be in context with other measures. Impossible to base training on heart rate, too many variables affect it. 99% of the time RPE is a great window into stress and adaptation.”

Vern Gambetta Blog, June 11, 2012

http://www.functionalpathtrainingblog.com/archives.html


1. Mode

2. Intensity

3. Duration

4. Frequency

5. Progression

6. Variation


Duration of exercise2008 Physical Activity Guidelines for Americans. US Dept of Health & Human Services. www.health.gov. Adults 18-64 yrs

Minimum 2 hr 30 min/wk (150 min/wk) moderate

intensity or 1 hr 15 min/wk (75 min/wk) vigorous

intensity (or combination), at least 10 min episodes, spread throughout week (intensity defn next slide)

E.g. 5x/wk @ 30 min moderate exercise

Aim for additional benefits with 5 hr/wk (300 min/wk)

moderate intensity or 2 hr 30 min/wk vigorous intensity exercise (or combination)

Durations over 10 min, spread through

week, adding up to target time31Aerobic Training Program Design

Duration of exercise2008 Physical Activity Guidelines for Americans. US Dept

of Health & Human Services. www.health.gov

Note the use of a “talk test” to judge intensity of exercise32Aerobic Training Program Design

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Duration of exerciseHaskell et al., (2007) Physical Activity & Public Health. ACSM

Recommendation Statement. Med Sci Sports Ex. 39:1423-34

Minimum of:

30 min moderate intensity, at least 10 min episodes, 5 days/week (= 150 min/wk)

i.e. 5x/wk @ 30 min moderate exercise

or

20 min vigorous intensity, 3 days/week (= 60 min/wk)


Duration of exerciseHaskell et al., (2007) Physical Activity & Public Health. ACSM



moderate intensity vigorous intensity

“Noticeably accelerates the heart rate”e.g., Walking briskly

“Rapid breathing and substantial increase in heart rate”e.g. Jogging


1. Mode

2. Intensity

3. Duration

4. Frequency

5. Progression

6. Variation


Frequency of exercise

# training sessions / week2008 Physical Activity Guidelines for Americans. US Dept of Health & Human Services. www.health.gov. Adults 18-64 yrs

Exercise “spread through week”, adding up to target time

Haskell et al., (2007) Physical Activity & Public Health. ACSM


Moderate intensity, 5 days/week

Vigorous intensity, 3 days/week


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Frequency of exercise

Note that with aerobic training (unlike resistance) it is common that once a client is beyond the beginner stage, there is often no rest day between 2 training days of the same tissues, to allow 4+ workouts/wk

Rest days most likely placed after higher volume (intensity &/or duration) day



1. Mode

2. Intensity

3. Duration

4. Frequency

5. Progression

6. Variation


Progression

By increase in exercise intensity, frequency, &/or duration Typically, frequency, &/or duration are increased first

Later, intensity must also be increased to continue to stimulate aerobic capacity

General Rule: Limit increases to 10% per week

E.g. 20 min run increased to 22 min next week


Maintenance of aerobic fitness

Maintain exercise intensity & duration

Frequency can be decreased (no less than 2x/wk)


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1. Mode

2. Intensity

3. Duration

4. Frequency

5. Progression

6. Variation


Variation

Cross training: Variety in exercise mode (across or within sessions)

Modifications in exercise intensity & durationonce base aerobic capacity is developed

LSD (Long Slow Distance) – see next slide…

Lower intensity and greater duration

Pace/Tempo Training– see next slide…

Interval Training -more after next slide…

Brief (3-5 min) high intensity (≥ lactate threshold) and longer lower intensity exercise (1:1 – 1:3 work:rest)


LSD (Long Slow Distance)Vern Gambetta Blog: Feb 7, 2012

“Long slow distance was a term coined to describe running at a steady pace to develop the aerobic base. Unfortunately as it evolved the emphasis was on SLOW. This is a huge mistake. The result was proficiency at running slow for a prolonged period. This has little carryover to racing, remember the goal of training is to prepare to race. The emphasis in this method should be on long steady distance. Select a degree of effort that allows the runner to run a steady effort for the duration of the distance with good running mechanics. This type of training needs to be a means to an end. Unfortunately for many runners it has become an end to itself.”


Tempo TrainingIntensity is generally between:

High Intensity Interval Training

and

Steady state aerobic work

For more information see the article:

Optimal Tempo Training Concepts for Performance and Recovery

August 27, 2014 by Derek M. Hansen

http://www.strengthpowerspeed.com/optimal-tempo-training/


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Interval Traininghttp://www.coreperformance.com/knowledge/training/energy-system-development.htm

The New Science of Cardio January 27, 2009

Overview: Energy System Development (ESD) is the cardiovascular component of Core Performance training programs. The intensity of the workouts is broken up into three different heart rate zones.

How It Works Forget everything you currently believe about cardio work. Forget keeping your heart rate in some “fat-burning” zone. Forget plodding along with the vague goal of increasing the distance you can plod. Instead of training like a plow horse, start training like a thoroughbred.

You’ll only work at the same effort level for an extended period of time, as you would with traditional cardio exercise on regeneration or recovery days. But

you’re going to take the time you typically spend on cardio and develop the ability to perform at a more intense level. You’ll improve your energy levels, gaining physical strength and stamina without investing additional time.


Interval Training –The usefulness of interval

training for recreational athletes is now being explored…

Effects of high intensity training and continuous endurance training on aerobic capacity and body composition in recreationally active runners Journal of Sports Science and Medicine (2012) 11, 483-488

The aim of the study was to examine the effects of two different training programs (high-intensity-training vs. continuous endurance training) on aerobic power and body composition in recreationally active men and women and to test whether or not participants were able to complete a half marathon after the intervention period. Thirty-four recreational endurance runners were randomly assigned either to a Weekend-Group (WE, n = 17) or an After-Work-Group (AW, n = 17) for a 12 week-intervention period. WE weekly completed 2 h 30 min of continuous endurance running composed of 2 sessions on the weekend. In contrast, AW performed 4 30 min sessions of high intensity training and an additional 30 min endurance run weekly, always after

work.

…….

Only the improvements of VO2 peak were significantly greater in AW compared with WE. Both groups completed a half marathon with no significant differences in performance (p

= 0.63). Short, intensive endurance training sessions of about 30 min are effective in improving aerobic fitness in recreationally active runners


Interval Training –The science of designing

interval training workouts


Buchheit & Laursen, High-Intensity Interval Training, Solutions to the Programming Puzzle.

Part I. Sports Medicine, 2013, 43:5, 313-338

Part II. Sports Medicine, 2013, 43:10, 927-954

High-Intensity Interval Training (HIIT) can stress (i.e., train):

Aerobic system (“…one of the most effects means of improving cardiorespiratory and metabolic function…”

Anaerobic system

Neuromuscular and musculoskeletal systems


interval training workouts. Buchheit & Laursen 2013


Athlete must spend at least several minutes per session reaching at least 90% VO2max

Nine different variables can be manipulated to allow athlete to spend time above 90% VO2max, AND to control stress (and training) of anaerobic and neuromuscular and musculoskeletal system

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interval training workouts. Buchheit & Laursen 2013


RESTING LEVEL OF WORK

9: EXERCISE MODALITY

1: WORK INTERVAL INTENSITY

2: WORK INTERVAL DURATION

3: RELIEF INTERVAL INTENSITY

4: RELIEF INTERVAL DURATION

5: NUMBER OF REPS IN A SERIES

6: NUMBER OF SERIES

7: BETWEEN SERIES RECOVERY DURATION

8: BETWEEN SERIES RECOVERY INTENSITY

Interval Training


An appropriate pattern of work and relief cycles

WILL

produce a progressive increase in fatigue and RPE

over the duration of the session

Interval Training – Tabata Training


TABATA et al., Effects of moderate-intensity endurance and high-intensity intermittent training on anaerobic capacity and VO2max. Medicine & Science in Sports & Exercise: 1996, 28: 10, 1327-1330 (in moderately trained young men)

Tabata intervals:• Eight, 20 second all out exercise bouts

(170% VO2max) + 10 sec rest

• Total workout duration=4 min!• Work time = 2 min 40 sec (does not

meet requirement in Buchheit & Laursen2013 of several min at high work level)

• 5 days/week, 6 weeks

Steady state aerobic training:• 60 min at 70% VO2max

• 5 days/week, 6 weeks

Tabata results:• VO2max increased by 7 ml*kg-1*min-1

• Anaerobic capacity increased significantly

Steady state aerobic training results:• VO2max increased by 5 ml*kg-1*min-1

• No change in anaerobic capacity

Interval Training – and fat loss


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Interval Training – and fat lossCHALMERS’ 5-MINUTE DISCUSSION OF FAT REDUCTION




Stephen H. Boutcher, High-Intensity Intermittent Exercise and Fat Loss, Journal of Obesity, Article ID 868305, 2011. doi:10.1155/2011/868305

“The effect of regular aerobic exercise on body fat is negligible; however, other forms of exercise may have a greater impact on body composition. For example, emerging research examining high-intensity intermittent exercise (HIIE) indicates that it may be more effective at reducing subcutaneous and abdominal body fat than other types of exercise.”



Wilson, et al., Concurrent Training: A Meta-Analysis Examining Interference of Aerobic and Resistance Exercises, Journal of Strength & Conditioning Research: 2012, 26:8, 2293–2307, doi: 10.1519/JSC.0b013e31823a3e2d

Interval Training – and fat lossCHALMERS’ 5-MINUTE DISCUSSION OF FAT REDUCTIONCONCLUSION…


DO INTERVAL TRAINING TO LOSE FAT(or develop your photo editing skills to make it look like you lost fat)

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Exercise Dose (intensity, duration & freq)

Is it proven to be effective?


Duration of exerciseMichael Lauer, Editorial: And What About Exercise? Fitness and Risk of Death in “Low-Risk” Adults, J Am Heart Assoc. 2012; 1:e003228, published online June 27, 2012, doi:10.1161/JAHA.112.003228


Current US guidelines recommend that most adults seek to engage in at least moderate-level exercise for ≥150 minutes a week (eg, 30 minutes a day for 5 days a week). Barlow and colleagues argue that their data support widespread prescription of higher doses of exercise even among low-risk adults. To date, though, there are no large-scale randomized trials supporting exercise recommendations. One small trial of sedentary obese women found that as little as 72 minutes of exercise per week could lead to potentially meaningful improvements in physical fitness. A large-scale observational study of >400 000 adults suggested that even as little as 15 minutes of exercise per day predicted a 14% reduction in risk

of death. Some of us worry that that people might misinterpret public health recommendations to mean that anything less than 150 minutes of exercise per week is of no value and therefore not worth pursuing at all. To add to the confusion, we now are aware of data suggesting that some adults might be harmed by exercise. It is critically important to avoid oversimplifications that overlook nuanced quantitative and qualitative issues:



Source: http://www.cdc.gov/physicalactivity/everyone/health/

Increase Your Chances of Living Longer….2. You don't have to do high amounts of activity or vigorous-intensity

activity to reduce your risk of premature death. You can put yourself at lower risk of dying early by doing at least 150 minutes a week of moderate-intensity aerobic activity. (Chalmers emphasis added)



VERSUS…..

Can you do less than 150 min/week and still get benefits??

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Exercise Dose (intensity, duration & freq)Duck-chul Lee, et al., Leisure-Time Running Reduces All-Cause and Cardiovascular Mortality Risk, J Am Coll Cardiol. 2014;64(5):472-481. doi:10.1016/j.jacc.2014.04.058.


• Mortality Risk reduced by <51 min/wk, < 6 miles/wk, 1-2x/wk(not by <6mph)

• Risk has similar level up to 120-175 min/wk, 13-19 miles/wk, 5x/wk.

• Risk INCREASES (still less than sedentary) for ≥176 min/wk, ≥ 20 miles/wk, ≥ 6x/wk.



Arem H et al., Leisure time physical activity and mortality: a detailed pooled analysis of the dose-response relationship. JAMA Intern Med. 2015 Jun 1;175(6):959-67. doi:10.1001/jamainternmed.2015.0533.

• At LESS than 1x daily recommended PA level, risk decreases 20%

• Most (31%) benefit of risk reduction occurs at 1-2x recommended PA level (150 min/wk moderate PA)

• Maximal (39%) benefit of risk reduction occurs at 3-5x recommended PA level

• No significant elevated risk with > 10x PA level

LTPA = Leisure Time Physical Activity

Exercise Dose (intensity, duration & freq)Lavie CJ, et al. Effects of Running on Chronic Diseases and Cardiovascular and All-CauseMortality. Mayo Clin Proc. 2015 Nov;90(11):1541-52. doi:10.1016/j.mayocp.2015.08.001


Follow-up to previous Duck-chul Lee, et al study, combined with other studies concludes…



Chalmers’ CONCLUSIONS:

• Less than current PA recommendations reduces risk of all-cause mortality (and so IS useful).

• Current PA recommendations may reduce risk of all-cause mortality further.

• Very high levels of PA may, or may not, increase risk compared to moderate exerciser.

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Exercise Dose (intensity, duration & freq)Lavie CJ, et al. Effects of Running on Chronic Diseases and Cardiovascular and All-CauseMortality. Mayo Clin Proc. 2015 Nov;90(11):1541-52. doi:10.1016/j.mayocp.2015.08.001


WALKING VERSUS RUNNING?? Is longer duration + lower intensity the same FOR HEALTH as shorter duration higher intensity?


and Health OutcomesPatel et al., Leisure time spent sitting in relation to total mortality in a prospective cohort of US adults. Am J Epidemiol. 2010 Aug 15;172(4):419-29.Epub 2010 Jul 22.

Owen et al., Too Much Sitting: The Population Health Science of Sedentary Behavior, Exercise & Sport Sciences Reviews: July 2010 - Volume 38 - Issue 3 - pp 105-113, doi: 10.1097/JES.0b013e3181e373a2

Hamilton et al., Too little exercise and too much sitting: Inactivity physiology and the need for new recommendations on sedentary behavior Current Cardiovascular Risk Reports, Volume 2, Number 4, 292-298, doi: 10.1007/s12170-008-0054-8

Owen et al., Too much sitting: a novel and important predictor of chronic disease risk? Br J Sports Med 2009;43:81-83 doi:10.1136/bjsm.2008.055269

Genevieve N. Healy et al., Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003–06. Eur Heart J. first published online January 11, 2011 doi:10.1093/eurheartj/ehq451

Hidde P. et al. Sitting Time and All-Cause Mortality Risk in 222 497 Australian Adults. Arch Intern Med. 2012;172(6):494-500. doi:10.1001/archinternmed.2011.2174

Do the standard exercise recommendations really work for our sedentary population?


Exercise Dose (intensity, duration & freq) and Health OutcomesDo the standard exercise recommendations really work for our sedentary population?

FINDINGS… Time spent sitting was independently associated with total

mortality, regardless of physical activity level. This means:Even when adults meet physical activity guidelines, sitting for prolonged periods can compromise metabolic health and increase mortality.

Reduction of too much sitting, or too few breaks from sitting, should be included in physical activity and health guidelines.

Excess sitting should be considered a health hazard

Reduction in overall sedentary time is desirable.

Breaking up sedentary time, even without a reduction, is beneficial.



and Health OutcomesDo the standard exercise recommendations really work for our sedentary population?

Similar FINDINGS in another study…Stamatakis E, et al., Screen-based entertainment time, all-cause mortality, and cardiovascular events population-based study with ongoing mortality and hospital events follow-up. J Am Coll Cardiol. 2011 Jan 18;57(3):292-9.

Spending more than four hours a day sitting more than doubles your risk of dying from or being hospitalized for heart disease, even for those who exercise more than two hours (!) per day.

Perhaps due to other unhealthy lifestyle factors associated with the sitting, or due to elevated inflammation resulting from the sitting (blood levels of C- reactive protein were elevated in the prolonged sitters).


9/2/2016

U 18


and Health Outcomes


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