The concept of a “polypill” is receiving growing attention to prevent cardiovascular disease. Yet similar if not overall higher benefits are achievable with regular exercise, a drug-free intervention for which our genome has been haped over evolution. Compared with drugs, exercise is available at low cost and relatively free of adverse effects. We summarize epidemiological evidence on the preventive/therapeutic benefits of exercise and on the main biological mediators involved.

Regular exercise has multi-system anti-aging effects. Here we summarize how exercise impacts the major hallmarks of aging. We propose that, besides searching for novel pharmaceutical targets of the aging process, more research efforts should be devoted to gaining insights into the molecular mediators of the benefits of exercise and to implement effective exercise interventions for elderly people.

When evaluating dyspnea in patients with heart or lung disease it is useful to measure the quantity of ventilation needed to eliminate metabolically produced CO₂ (i.e., the ventilatory efficiency). Mathematically, the relationship between ventilation (V̇E) and CO₂ output is determined by the arterial CO₂ pressure and the physiologic dead space–tidal volume ratio. We decided to determine how age, sex, size, fitness, and the type of ergometer influenced ventilatory efficiency in normal subjects. Three methods were compared for expressing this relationship: (1) the V̇E versus CO₂ output slope below the ventilatory compensation point, commonly used by cardiologists for estimating the severity of heart failure; (2) the V̇E/CO₂ output ratio at the anaerobic threshold, commonly used by pulmonologists; and (3) the lowest V̇E/CO₂ output ratio during exercise, the latter parameter not previously reported. We studied 474 healthy adults, between 17 and 78 years of age during incremental cycle and treadmill cardiopulmonary exercise tests at three test sites, correcting the total V̇E for the equipment dead space. The lowest V̇E/CO₂ output ratio was insignificantly different from the ratio at the anaerobic threshold, less variable than that for the slope relationship, and unaffected by the site, ergometer, and gas exchange measurement systems. The regression equation for the lowest V̇E/CO₂ output ratio was 27.94 + 0.108 × age + (0.97 = F, 0.0 = M) − 0.0376 × height, where age is in years and height is in centimeters. We conclude that the lowest V̇E/CO₂ output ratio is the preferred noninvasive method to estimate ventilatory inefficiency.

The aims of this study were: to compare energy expenditure (EE) estimated from the existing GT3X accelerometer equations and EE measured with indirect calorimetry; to define new equations for EE estimation with the GT3X in youth, adults and older people; and to define GT3X vector magnitude (VM) cut points allowing to classify PA intensity in the aforementioned age-groups. The study comprised 31 youth, 31 adults and 35 older people. Participants wore the GT3X (setup: 1-s epoch) over their right hip during 6 conditions of 10-min duration each: resting, treadmill walking/running at 3, 5, 7, and 9 km · h⁻¹, and repeated sit-stands (30 times · min⁻¹). The GT3X proved to be a good tool to predict EE in youth and adults (able to discriminate between the aforementioned conditions), but not in the elderly. We defined the following equations: for all age-groups combined, EE (METs)=2.7406+0.00056 · VM activity counts (counts · min⁻¹)−0.008542 · age (years)−0.01380 · body mass (kg); for youth, METs=1.546618+0.000658 · VM activity counts (counts · min⁻¹); for adults, METs=2.8323+0.00054 · VM activity counts (counts · min⁻¹)−0.059123 · body mass (kg)+1.4410 · gender (women=1, men=2); and for the elderly, METs=2.5878+0.00047 · VM activity counts (counts · min⁻¹)−0.6453 · gender (women=1, men=2). Activity counts derived from the VM yielded a more accurate EE estimation than those derived from the Y-axis. The GT3X represents a step forward in triaxial technology estimating EE. However, age-specific equations must be used to ensure the correct use of this device.