Cristóbal Durán-Marín

Background/Objectives: Cancer pathophysiology involves metabolic disturbances, and exercise improves muscle metabolism, but little is known about the effect of concurrent high-intensity interval plus resistance training (CT_HIIT+RT) on the resting and exercise metabolism of breast cancer survivors with risk factors related to metabolic syndrome (MetS). The purpose of this study was to determine the effects of 8 weeks of CT_HIIT+RT on the fat and carbohydrate (CHO) metabolism during rest and progressive exercise post-exercise intervention in breast cancer survivors with histories of high- and low-volume chemotherapy. Methods: An experimental study was conducted in which (n = 21) women breast cancer survivors (age: 58.7 ± 8.7 years) were divided by history of high- (HV_chemo, ≥8 to 16 sessions, n = 10) or low-volume (LV_chemo, ≤7 chemo sessions, n = 11) chemotherapy. The fat (RFAT_ox) and CHO oxidation during 10 min of resting was measured (i.e., including the area under curve [AUC] points within this time), as well as the fat (ExFAT_ox) and CHO (ExCHO_ox) oxidation during progressive exercise, before and after 8 weeks of CT_HIIT+RT by indirect calorimetry. Additionally, risk factors related to MetS were described from pre- to post-intervention. Results: At rest, the HV_chemo group showed significant increases in the AUC of RFAT_ox (∆ + 23.7, p < 0.0001), similar to the LV_chemo group (∆ + 14.0, p < 0.0001). The HV_chemo group showed significant increases in the AUC of RCHO_ox (∆ + 109.7, p < 0.0001), similar to the LV_chemo group (∆ + 107.5, p < 0.0001). During progressive exercise, the ExFAT_ox was increased in the HV_chemo group (∆ + 0.12 g/min, p = 0.006), similar to the ExCHO_ox (∆ + 0.52 g/min, p = 0.013) of this group. The proportion of subjects categorized with MetS were significantly reduced in blood pressure, Glu and triglyceride components. Conclusions: Eight weeks of CT_HIIT+RT may promote favorable metabolic and cardiometabolic adaptations in breast cancer survivors regardless of the chemotherapy exposure volume. However, these findings should be interpreted cautiously due to the small sample size and lack of a true non-exercise control group.

Introduction: Although exercise is known to improve vascular outcomes associated with weight loss, there is limited evidence of whether similar benefits occur in the absence of weight loss. Objective: To examine the effects of 6-week concurrent training on pulse wave velocity (PWV) and flow-mediated dilation (FMD) in adults who were responders and nonresponders to ‘weight loss’ to exercise. Methodology: A secondary analysis of an experimental randomized controlled clinical trial was conducted in 60 adult participants (BMI: 29.7 kg/m2) reported into 3 groups; weight loss responders’ (WLRET, n=14), ‘weight loss nonresponders to exercise’ (WLNRET, n=14), and a control group (CG, n=30). Participants underwent a 6-week intervention consisting of three sessions per week of concurrent high-intensity interval and resistance training where delta changes (∆) of pulse wave velocity (∆PWV) and flow-mediated dilation (∆FMD) were reported. Results: After intervention and comparing groups WLRET vs. WLNRET, there were similar significant changes in outcomes; ∆PWV (˗0.9 vs. ˗0.8 m/s-1), ∆FMD (6.5 vs. 6.5%), both outcomes different vs. CG P<0.05. Likewise, the prevalence of responders and nonresponders was comparable ∆PWV (Rs: 78.5%; NRs 21.4%) and ∆FMD (Rs: 57.1%; NRs 42.8%). Despite significant superior ∆DBP decreases in WLNRET (˗5.5 mmHg vs. ˗1.3 mmHg, P<0.05), no other differences were detected for other outcomes. Conclusions: Adult participants classified as weight loss nonresponders (WLNRET) also experienced reductions in ∆PWV and increased the ∆FMD in similar physiological adaptations to WLRET. These findings are supported by additional benefits observed in WLNRET, including reductions in blood pressure and improvements in vascular function.

Objective: This study aimed to (1) characterize cardiometabolic factors in self-reported hip and knee osteoarthritis (OAD) across four body composition phenotypes defined by muscle mass and adiposity, and (2) associate risk factors with diabetes and hypertension (HTN). Methods: A cross-sectional analysis of the Chilean National Health Survey 2016–17 (n = 4996) stratified participants into four groups: low skeletal muscle mass/high waist circumference (Low-SMM/High-WC), low SMM/low WC (Low-SMM/Low-WC), high SMM/high WC (High-SMM/High-WC), and high SMM/low WC (reference group). Each group was further divided into subgroups with or without diagnosed hip or knee OAD. The main outcomes were fasting plasma glucose, systolic (SBP)/diastolic (DBP) blood pressure (continuous outcomes), and other secondary factors such as cardiovascular risk (CVR). Results: In the hip OAD subgroup, the Low-SMM/High-WC groups had significantly higher SBP versus the reference value (145 vs. 127 mmHg, p < 0.0001, diff +18 mmHg). In the knee OAD subgroup, the Low-SMM/High-WC groups had significantly higher SBP versus the reference value (141 vs. 134 mmHg, p < 0.0001, diff +7 mmHg). The SBP showed a significant interaction between the group and OAD diagnosis (p = 0.007 hip OAD; p < 0.0001 knee OAD). Conclusions: Hip and knee OAD associates with elevated SBP/DBP in older adults. OAD groups showed an OR above 2 for diabetes, 2.7 for HTN, 4.5 for metabolic syndrome, and over 2 for moderate-to-high cardiovascular risk. OAD interacts substantially with cardiometabolic factors, especially in low muscle mass/high adiposity phenotypes. Lifestyle optimization of physical activity and nutrition to preserve muscle mass and mitigate adiposity is essential for cardiometabolic health promotion in OAD patients.

Background: A progressive volitional cycling test is useful in determining exercise prescription in populations with cardiovascular and metabolic diseases. However, little is known about the association between heart rate during this test and endothelial dysfunction (EDys) parameters in hypertensive (HTN) patients. Objective: To investigate the association between EDys markers (flow-mediated dilation [FMD], pulse wave velocity of the brachial artery [PWVba], and carotid-intima media thickness [cIMT]) and heart rate during a cycling test in HTN adults. A secondary aim was to characterize cardiovascular, anthropometric, and body composition outcomes in this population. Methods: This was a descriptive clinical study in which adults (men and women) were assigned to one of three groups: HTN, elevated blood pressure (Ele), or a normotensive control group (CG), and completed a progressive cycling test. The primary outcomes were FMD, PWVba, cIMT, and heart rate (HR) at 25–50 watts (HR_25–50), 50–100 watts (HR_50–100), and 75–150 watts (HR_75–150) of the Astrand test. Secondary outcomes included body mass index (BMI), waist circumference, body fat percentage (BF%), skeletal muscle mass (SMM), resting metabolic rate (RMR), and estimated body age, as measured by a bio-impedance digital scale. Results: Analyses of the associations between FMD, PWV, and HR_25–50, HR_50–100, and HR_75–150 watts revealed no significant association in the HTN, Ele, and CG groups. However, a significant association was found between cIMT and HR_75–150 watts in the HTN group (R² 47.1, β −0.650, p = 0.038). There was also a significant trend (p = 0.047) towards increasing PWVba in the CG, Ele, and HTN groups. Conclusion: Heart rate during a progressive cycling test is associated with the EDys parameters cIMT in HTN patients, with particularly strong predictive capacity for vascular parameters in the second and third stages of the Astrand exercise test compared to normotensive control.