Regular exercise at the intensity matching maximal fat oxidation (FAT_max) has been proposed as a key element in both athletes and clinical populations when aiming to enhance the body’s ability to oxidize fat. In order to allow a more standardized and tailored training approach, the connection between FAT_max and the individual aerobic thresholds (AerT) has been examined. Although recent findings strongly suggest that a relationship exists between these two intensities, correlation alone is not sufficient to confirm that the intensities necessarily coincide and that the error between the two measures is small. Thus, this systematic review and meta-analysis aim to examine the agreement levels between the exercise intensities matching FAT_max and AerT by pooling limits of agreement in a function of three parameters: (i) the average difference, (ii) the average within-study variation, and (iii) the variation in bias across studies, and to examine the influence of clinical and methodological inter- and intra-study differences on agreement levels. This study was registered with PROSPERO (CRD42021239351) and ClinicalTrials (NCT03789045). PubMed and Google Scholar were searched for studies examining FAT_max and AerT connection. Overall, 12 studies with forty-five effect sizes and a total of 774 subjects fulfilled the inclusion criteria. The ROBIS tool for risk of bias assessment was used to determine the quality of included studies. In conclusion, the overall 95% limits of agreement of the differences between FAT_max and AerT exercise intensities were larger than the a priori determined acceptable agreement due to the large variance caused by clinical and methodological differences among the studies. Therefore, we recommend that future studies follow a strict standardization of data collection and analysis of FAT_max- and AerT-related outcomes.

This study examined substrate oxidation at high-intensity exercise and aimed to determine when fat oxidation ends (FATmin). We hypothesized the existence of a connection between the anaerobic threshold (AnT) and FATmin point. Breath-by-breath data obtained from indirect calorimetry during a graded treadmill test were used to measure substrate oxidation and maximal oxygen uptake (VO2max) on 47 males (30 athletes (ATL) and 17 non-athletes (NATL)). Pearson correlation coefficient (r) and effect size (R 2) were used to test correlations between VO2 at AnT and at FATmin. Maximal oxygen uptake (VO2max) was 56.17 ± 4.95 and 46.04 ± 3.25 ml kg−1 min−1 in ATL and NATL, respectively. In ATL, AnT was observed at 87.57 ± 1.30 % of VO2max and FATmin was observed at 87.60 ± 1.60 % of VO2max. In NATL, AnT and FATmin were at 84.64 ± 1.10 % of VO2max and 85.25 ± 1.10 % of VO2max, respectively. Our data show large correlations between VO2 at AnT and VO2 at FATmin for ATL (r = 0.99, p < 0.01, 95 % CI 0.99 to 1.00) and NATL (r = 0.97, p < 0.01, 95 % CI 0.91 to 0.98). The effect size of correlations for ATL and NATL were 0.98 and 0.94, respectively. Our results show high correlation between AnT and FATmin in both ATL and NATL with equal substrate oxidation rates at AnT.

Over the past two decades, scientists have attempted to evaluate whether the point of maximal fat oxidation (FAT_max) and the aerobic threshold (AerT) are connected. The existence of such a relationship would allow a more tailored training approach for athletes while improving the efficacy of individualized exercise prescriptions when treating numerous health-related issues. However, studies have reported conflicting results, and this issue remains unresolved. This systematic review and meta-analysis aimed: (i) to examine the strength of the association between FAT_max and AerT by using the effect size (ES) of correlation coefficient (r) and standardized mean difference (SMD); (ii) to identify potential moderators and their influence on ES variability. This study was registered with PROSPERO (CRD42021239351) and ClinicalTrials (NCT03789045). PubMed and Google Scholar were searched and fourteen articles, consisting of overall 35 ES for r and 26 ES for SMD were included. Obtained ESs were analyzed using a multilevel random-effects meta-analysis. Our results support the presence of a significant association between FAT_max and AerT exercise intensities. In conclusion, due to the large ES variance caused by clinical and methodological differences among the studies, we recommend that future studies follow strict standardization of data collection and analysis of FAT_max and AerT-related outcomes.

Employing non-invasive measures of cardiac function to identify detrimental changes in cardiovascular health shows promising value in pediatric populations. This study investigated how being overweig...

A new method based on the Recurrence Quantification Analysis (RQA) of the heart rate (HR) offers an objective, efficient alternative to traditional methods for Aerobic Threshold (AerT) identification that have practical limitations due to the complexity of equipment and interpretation. This study aims to validate the RQA-based method’s applicability across varied demographics, exercise protocols, and health status. Data from 123 cardiopulmonary exercise tests were analyzed, and participants were categorized into four groups: athletes, young athletes, obese individuals, and cardiac patients. Each participant’s AerT was assessed using both traditional ventilatory equivalent methods and the automatic RQA-based method. Ordinary Least Products (OLP) regression analysis revealed strong correlations (r > 0.77) between the RQA-based and traditional methods in both oxygen consumption (VO₂) and HR at the AerT. Mean percentage differences in HR were below 2.5%, and the Technical Error for HR at AerT was under 8%. The study validates the RQA-based method, directly applied to HR time series, as a reliable tool for the automatic detection of the AerT, demonstrating its accuracy across diverse age groups and fitness levels. These findings suggest a versatile, cost-effective, non-invasive, and objective tool for personalized exercise prescription and health risk stratification, thereby fulfilling the study’s goal of broadening the method’s applicability.

Purpose: To investigate the association between the heart rate (HR) at maximal fat oxidation (MFO) and the HR at the aerobic threshold (AerT) in adolescent boys and girls, and to identify sex differences in the intensity that elicits MFO (Fat_max) as a percentage of HR peak (HR_peak). Methods: Fifty-eight healthy adolescents participated in this study (29 boys and 29 girls). Participants performed a cardiopulmonary exercise test on a cycle ergometer. MFO was calculated using a stoichiometric equation, and the AerT was identified using gas exchange parameters. Results: A strong correlation between HR at Fat_max and HR at AerT was found in both boys and girls (r = .96 and .94, respectively). Fat_max as a percentage of HR_peak occurred at 61.0% (4.9%) of HR_peak and 66.8% (6.9%) of HR_peak in adolescent boys and girls (P = .001, F = 13.6), respectively. MFO was higher in boys compared with girls (324 [150] and 240 [95] mg/min, respectively), and no sex differences were observed in the relative contribution of fat to energy expenditure at Fat_max. Conclusions: HR at Fat_max and HR at AerT were highly correlated in adolescent boys and girls. Girls obtained Fat_max at a higher percentage of HR_peak than boys.