To establish if aerobic exercise training is associated with beneficial effects on clinical outcomes and glycaemic profile in people with type II diabetes. A systematic search was conducted to identify studies through a search of MEDLINE (1985 to Sept 1, 2016, Cochrane Controlled Trials Registry (1966 to Sept 1, 2016), CINAHL, SPORTDiscus and Science Citation Index. The search strategy included a mix of MeSH and free text terms for related key concepts. Searches were limited to prospective randomized or controlled trials of aerobic exercise training in humans with type II diabetes, aged >18 years, lasting >2 weeks. Our analysis included 27 studies (38 intervention groups) totalling 1372 participants, 737 exercise and 635 from control groups. The studies contain data from 39,435 patient-hours of exercise training. Our analyses showed improvements with exercise in glycosylated haemoglobin (HbA1C%) MD: −0.71%, 95% CI −1.11, −0.31; p value = 0.0005. There were significant moderator effects; for every additional week of exercise HbA1C% reduces between 0.009 and 0.04%, p = 0.002. For those exercising at vigorous intensity peak oxygen consumption (peak VO2) increased a further 0.64 and 5.98 ml/kg/min compared to those doing low or moderate intensity activity. Homeostatic model assessment of insulin resistance (HOMA-IR) was also improved with exercise MD: −1.02, 95% CI −1.77, −0.28; p value = 0.007; as was fasting serum glucose MD: −12.53 mmol/l, 95% CI −18.94, −6.23; p value <0.0001; and serum MD: −10.39 IU, 95% CI −17.25, −3.53; p value = 0.003. Our analysis support existing guidelines that for those who can tolerate it, exercise at higher intensity may offer superior fitness benefits and longer program duration will optimize reductions in HbA1C%.

Aims To investigate the effects of exercise training (ET) on left ventricular (LV) volumes, cardiopulmonary functional capacity and N-terminal pro-brain natriur...

Aging is inexorably accompanied by a progressive decline of muscle mass, quality and strength. The resulting condition has been termed sarcopenia. Age-related sarcopenia can be accelerated by a variety of factors including changes in the hormonal milieu, inactivity, poor nutrition, chronic illness, and loss of integrity and function in the peripheral and central nervous systems. The downstream mechanisms by which these risk factors cause sarcopenia are not completely understood. Exercise training (particularly resistance training) has long been identified as the most promising method for increasing muscle mass and strength among older people. New interventions aimed at preventing muscle atrophy, promoting muscle growth and ultimately, maintaining muscle functions during aging are discussed. Understanding how age affects muscle-related gene expression, protein recycling and resynthesis, post-translational modification and turnover will be crucial to identify new treatment options. RiassuntoL’invecchiamento è inesorabilmente accompagnato da un progressivo declino della massa, della qualità e della forza muscolare. La conseguente condizione viene definita sarcopenia. La sarcopenia correlata all’invecchiamento può essere accelerata da una serie di fattori tra cui le modifiche degli equilibri ormonali, la sedentarietà , la scarsa nutrizione, le patologie croniche, e la perdita di integrità e funzione del sistema nervoso centrale e periferico. I meccanismi attraverso i quali questi fattori causano sarcopenia sono ancora non completamente chiari. L’esercizio fisico (in particolare il training di resistenza) è da tempo identificato come una delle più promettenti stratefie per aumentare la massa muscolare e la forza negli anziani. Interventi mirati a prevenire la atrofia muscolare, a promuovere la crescita muscolare e, in ultima analisi, preservare le funzioni muscolari durante l’invecchiamento verranno discussi. Comprendere come l’invecchiamento interferisce con l’espressione genica ai livello muscolare, con i sistemi di riciclo e resintesi proteica, con le modifiche post-traslatzionali e il turnover, sarà cruciale per identificare e implementare nuove strategie terapeutiche.

Background Heart rate recovery (HRR) is a marker of vagal tone that is a powerful predictor of mortality in patients with coronary artery disease. Design This s...

Polycystic ovary syndrome (PCOS) is a heterogeneous disease affecting about 5–10% of reproductive-age female population, which is predominantly characterized by chronic anovulation, hyperandrogenism and insulin resistance. PCOS women represent an intriguing biological model illustrating the relationship between hormonal pattern and cardiovascular risk profile, presenting a cluster of cardiovascular features, such as obesity, insulin resistance, hypertension, impaired cardiopulmonary functional capacity, autonomic dysfunction and low-grade chronic inflammation. Metabolic syndrome should be also considered in the clinical evaluation and management of PCOS. The treatment of PCOS and its complications should not be based solely on pharmacological therapies trying to improve hyperandrogenism, hyperinsulinemia and insulin resistance. Although mounting evidence recognizes the beneficial effects of lifestyle modifications, the clinical management of PCOS is not sufficiently focused on long-term maintenance of both exercise and dietary interventions and on further aspects of this syndrome (i.e. psychological status). Taking into consideration the patients' young age and the devastating effects of PCOS on hormonal and metabolic pattern, this complex and multifaceted disease requires a comprehensive approach in order to achieve concrete beneficial effects for PCOS patients. Multidisciplinary programs, including dietary and educational counseling, exercise training, stress management and psychosocial support, might represent the gold standard for adequate reduction of cardiovascular risk in young women with PCOS.

Cardiovascular diseases (CVD) have a lower prevalence in women than men; although, a higher mortality rate and a poorer prognosis are more common in women. However, there is a misperception of CVD female risk since women have commonly been considered more protected so that the real threat is vastly underestimated. Consequently, female patients are more likely to be treated less aggressively, and a lower rate of diagnostic and interventional procedures is performed in women than in men. In addition, there are substantial sex differences in CVD, so different strategies are needed. This review aims to evaluate the main gender-specific approaches in CVD.