Cosio PL, Nacher-Castellet V, Moreno-Simonet L
… +5 more, Rabost-Garcia G, Brotons D, Muñoz X, González JR, Cadefau JA
Med Sci Sports Exerc
· 2026 Jun · PMID 42319296
·
Publisher ↗
PURPOSE: To evaluate continuous and non-invasive sweat-inferred blood lactate monitoring for determining the exercise intensity at the second metabolic threshold (MT2) and maximal lactate steady state (MLSS), compared to...PURPOSE: To evaluate continuous and non-invasive sweat-inferred blood lactate monitoring for determining the exercise intensity at the second metabolic threshold (MT2) and maximal lactate steady state (MLSS), compared to capillary blood lactate and gas exchange analysis. METHODS: 17 physically active individuals (11 males and 6 females) and 19 endurance athletes (14 males and 5 females) completed a maximal graded exercise test (GXT) to quantify oxygen uptake (VO2), percentage of peak oxygen uptake (%VO2peak) and power output (watts) at MT2, using sweat-inferred blood lactate and capillary blood lactate for the second lactate threshold (LT2), and gas exchange analysis for the second ventilatory threshold (VT2). Participants also completed a MLSS test to quantify the power output (watts) at MLSS. Between-methods agreement was assessed using linear mixed models with mean differences (MD), mean absolute error (MAE), mean absolute percentage error (MAPE), Lin's concordance correlation coefficient (CCC) and Bland-Altman analysis. RESULTS: Compared with VT2, LT2 derived from sweat-inferred blood lactate showed no significant differences when using the Log-Exp-Mod-Dmax method, yielding the strongest agreement across VO2 (MD = 0.3 mL·min -1·kg -1, p = 0.999; MAE = 2.1 mL·min -1·kg -1, MAPE = 5.2%), %VO2peak (MD = 0.4%, p = 0.999; MAE = 4.1%, MAPE = 5.2%), and power output (MD = 1.9W, p = 0.999; MAE = 9.1W, MAPE = 5.0%). Direct comparison of capillary blood and sweat-inferred blood lactate using the Log-Exp-Mod-Dmax method showed high agreement for VO2 (MD = 0.2 mL·min -1·kg -1, p = 0.999; MAE = 2.4 mL·min -1·kg -1, MAPE = 6.4%), %VO2peak (MD = -0.1%, p = 0.999; MAE = 4.9%, MAPE = 6.4%), and power output (MD = 0.0W, p = 0.999; MAE = 10.6W, MAPE = 6.1%). Capillary blood and sweat-inferred blood lactate also showed excellent agreement for MLSS-associated power output (MD = -2.0 W, p = 0.089; MAE = 3.1 W, MAPE = 2.5%). CONCLUSIONS: Continuous sweat-inferred blood lactate can be used to determine MT2 and MLSS intensities, providing an alternative to capillary blood lactate.
Otsuka J, Yamakoshi R, Yokoyama S
… +2 more, Kato H, Amano T
Med Sci Sports Exerc
· 2026 Jun · PMID 42319294
·
Publisher ↗
PURPOSE: The present study investigated whether advanced footwear technology alters thermoregulatory and metabolic responses during running in a hot environment. METHODS: In a randomized crossover design, 14 trained male...PURPOSE: The present study investigated whether advanced footwear technology alters thermoregulatory and metabolic responses during running in a hot environment. METHODS: In a randomized crossover design, 14 trained male runners (V̇O2peak: 55.0 ± 3.7 mL·kg⁻¹·min⁻¹) performed treadmill running while wearing traditional running shoes (Hyper Speed 3; CON) or advanced footwear (Metaspeed Sky Paris; SKY) in a hot environment (30°C, 40% RH). On each experimental trial, participants firstly completed two 5-min running economy tests at 12 km·h⁻¹: the first in CON (RE1) and the second in the assigned shoes (CON or SKY; RE2). While continuing to wear the RE2 shoes, participants then performed two 30-min runs at 60% and 80% V̇O2peak, during which metabolic and thermoregulatory variables were continuously measured. RESULTS: V̇O₂ was reduced in SKY compared with CON by 3.4 ± 3.1% during the 5-min test and by 2.5 ± 4.2% on average during the prolonged trials (both P≤0.031). However, metabolic heat production (M) and rectal temperature did not differ between shoe conditions during the prolonged exercise (both P≥0.070). In contrast, when wearing SKY, the evaporative requirement for heat balance (Ereq; Δ5.4 ± 5.3%, P=0.013) and whole-body sweat loss (Δ54 ± 71 g, P=0.018) were reduced compared with CON. These changes were accompanied by an elevated mean skin temperature (Δ0.31 ± 0.48°C, P=0.045) and increased dry heat loss via radiation and convection (Δ12.2 ± 17.5%, P=0.015) in SKY. CONCLUSIONS: Advanced footwear technology reduces metabolic cost and attenuates Ereq and sweat production while increasing skin temperature and reliance on dry heat dissipation during running in hot conditions. The magnitude of metabolic savings was likely insufficient to influence M or core body temperature.
PURPOSE: In children (≤14 yr) and adolescents (15-19 yr), cancer is highly heterogeneous and essentially differs from adult malignancies. Given the numerous sequelae and fitness impairments associated with treatment, the...PURPOSE: In children (≤14 yr) and adolescents (15-19 yr), cancer is highly heterogeneous and essentially differs from adult malignancies. Given the numerous sequelae and fitness impairments associated with treatment, there is a growing number of randomized controlled trials assessing the effects of exercise interventions in affected children/adolescents. As such, the purpose of this American College of Sports Medicine Expert Consensus Statement was to develop the first set of exercise guidelines for children/adolescents with cancer. METHODS: We identified a list of outcomes with clinical relevance for the target population on which exercise may theoretically induce an improvement and developed exercise recommendations for those outcomes where there is sufficient evidence supporting such effect during/beyond treatment in children/adolescents. RESULTS: Exercise training can generally be performed safely for children/adolescents with cancer. There is moderate evidence that concurrent (aerobic and strength) exercise training can improve two common cancer/treatment-related health outcomes, muscle strength and physical function, but not physical activity levels. Moderate evidence also supports that aerobic exercise improves cardiorespiratory fitness after (but not during) treatment. The evidence is, however, insufficient for other important outcomes (e.g., cardiac function, bone health, and immune function), reflecting a gap in the current state of knowledge. CONCLUSIONS: The proposed recommendations should serve as an initial guide for healthcare and fitness professionals working with children/adolescents with cancer. Although current advances in the field are tantalizing, more research is needed to fill remaining gaps in knowledge to better serve this population and to improve clinical practice.
Zarnashan A, Fazli F, Talebi V
… +1 more, Patel DI
Med Sci Sports Exerc
· 2026 Jun · PMID 42231099
·
Publisher ↗
PURPOSE: This study aims to investigate the effects of voluntary exercise on liver levels of amyloid β (Aβ) and serum concentrations of LRP1, focusing on peripheral clearance in a rat Alzheimer's disease model. METHODS:...PURPOSE: This study aims to investigate the effects of voluntary exercise on liver levels of amyloid β (Aβ) and serum concentrations of LRP1, focusing on peripheral clearance in a rat Alzheimer's disease model. METHODS: Forty male Wistar rats (aged 4-6 weeks) were randomly divided into four groups: Healthy control, Alzheimer's disease (Alz), control + exercise (Con-Ex) and Alzheimer's disease + exercise (Alz-Ex). Alzheimer's disease was induced by an intraventricular STZ injection and the disease was confirmed with the shuttle box test. Rats randomized to the exercise intervention were given continuous access to a running wheel of 12 weeks. At the end of the study memory (Morris Water Maze), serum LRP1 level and liver Aβ40 were measured. Data were analyzed by one-way ANOVA and Tukey's post hoc test. RESULTS: The results of the study indicate that compared to Alz voluntary exercise significantly improved Morris Water Maze performance (Alz: 153.2 ± 19.95; Alz-Ex:106.8 ± 18.89; p<0.001) and decreased liver concentration of Aβ40 (Alz: 40.06 ± 6.17; Alz-Ex: 25.12 ± 2.92; p<0.001) levels similar to non-exercising control animals. Serum concentrations of LRP1 were not impacted by exercise. CONCLUSIONS: These results suggest that voluntary wheel running may positively reduce hepatic concentrations of Aβ40 in Alzheimer's disease independent of changes in circulating LRP1. Further research is needed to better understand the role of exercise in assisting in clearing Aβ40 in this model.
Med Sci Sports Exerc
· 2026 Jun · PMID 42228876
·
Publisher ↗
PURPOSE: Sedentary behavior is associated with premature aging and mortality; however, its relationship with epigenetic age acceleration and the pathways mediating this association remain unclear. We applied a triangulat...PURPOSE: Sedentary behavior is associated with premature aging and mortality; however, its relationship with epigenetic age acceleration and the pathways mediating this association remain unclear. We applied a triangulation approach integrating observational and Mendelian randomization (MR) analyses to investigate these associations and identify potential mediators. METHODS: First, observational analyses were conducted using data from the National Health and Nutrition Examination Survey (1999-2002). Weighted multivariable linear regression was used to examine associations between leisure screen time (a proxy for sedentary behavior) and epigenetic age acceleration, assessed using four epigenetic clocks (HorvathAge, HannumAge, PhenoAge, GrimAge). Second, two-sample MR was performed using genetic instruments for leisure screen time and epigenetic age acceleration in individuals of European descent (N=34,170 to 526,725). Two-step MR was then applied to evaluate the mediating roles of 21 modifiable traits, including adiposity, inflammation, lipids, and diseases, in these associations. RESULTS: In observational analyses (N=2,397; mean age, 63.2 years; 54.1% female), leisure screen time ≥5 h/day (1 h/day as reference) was suggestively associated with a 1.66-year GrimAge acceleration (95% CI, 0.40 to 2.92; P=0.02) after Bonferroni correction, with an inflection point at 4 h/day; no associations were observed for the other three clocks. MR corroborated these findings, demonstrating a significant association that each additional 1.9 h/day of leisure screen time was causally associated with a 0.62-year GrimAge acceleration (95% CI, 0.35 to 0.89; P=5.2×10 -6). Two-step MR identified genetically determined body mass index, C-reactive protein, high-density lipoprotein cholesterol, type 2 diabetes, and heart failure as mediators, accounting for 3.2% to 11.5% of the observed association. CONCLUSIONS: These findings underscore the importance of reducing leisure screen time and inform intervention strategies for mitigating epigenetic aging disparities.
Ko J, Chung E, Cosio-Lima L
… +2 more, Mahmoudian A, Lee Y
Med Sci Sports Exerc
· 2026 May · PMID 42201803
·
Publisher ↗
INTRODUCTION: Endurance exercise (EXE) has been recognized as a cardioprotective strategy against metabolic diseases, including obesity and type 2 diabetes. However, the precise molecular mechanisms remain incompletely u...INTRODUCTION: Endurance exercise (EXE) has been recognized as a cardioprotective strategy against metabolic diseases, including obesity and type 2 diabetes. However, the precise molecular mechanisms remain incompletely understood, especially in female populations. This study investigates the molecular metabolic signaling nexus in a female mouse model of obese type 2 diabetes (OT2D) induced by a high-fat diet (HFD) and a single dose of streptozotocin (STZ). METHODS: Female mice (n=31) were assigned into three groups: a normal diet control (CON, n=11), HFD+STZ (n=11), and HFD+STZ + a 15-week treadmill exercise (HFD+STZ+EXE, n=11). Left ventricles were collected 90 minutes after the last EXE session for analyzing key molecular signaling pathways, mitochondrial function, autophagy/mitophagy, and apoptosis. RESULTS: EXE significantly reduced hyperglycemia and cell death, independent of body weight changes and enhanced cardiac insulin signaling (IR β , PI3K, and AKT) and restored GLUT4 levels. Also, EXE increased protein expression of lipolysis-related proteins (p-PKA, ATGL, and ABHD5) and beta-oxidation-related proteins (ACADVL and HADHSC). Intriguingly, this coincided with a remarkable increase in intramyocardial lipid content (myocardial steatosis) concomitant with de novo lipogenesis (ACSS2, reduced p-ACC via PP2A activation, DGAT upregulation). Despite myocardial steatosis, EXE restored OT2D-induced mitochondrial respiratory dysfunction by downregulating uncoupling protein 3 (UCP3). Moreover, EXE-induced cardioprotection was associated with improved autophagy/mitophagy; The mitophagy was linked to the restoration of the mitochondrial fission protein DRP1. CONCLUSIONS: These findings demonstrate that weight loss is not a prerequisite for EXE-induced cardioprotection in OT2D females. The benefits arise from a multifaceted adaptive network involving improved metabolic signaling, mitochondrial function, and cellular quality control.
Midttun S, Lydersen S, Kaminsky LA
… +2 more, Wisløff U, Stensvold D
Med Sci Sports Exerc
· 2026 May · PMID 42189670
·
Publisher ↗
PURPOSE: The long-term impact of exercise training on change in cardiorespiratory fitness (CRF) with age remains uncertain. Given that CRF appears to be one of the strongest predictors of current and future health, we ex...PURPOSE: The long-term impact of exercise training on change in cardiorespiratory fitness (CRF) with age remains uncertain. Given that CRF appears to be one of the strongest predictors of current and future health, we examined the differences between high intensity training (HIT) and moderate intensity training (MIT) on 5-year changes in CRF in older adults. METHODS: In this post-hoc observational analysis of the Generation 100 Study, we included 500 participants (52% women; aged 70-77 years) who consistently reported engaging in HIT or MIT for 5 years. Participants underwent clinical assessments, including CRF measured as peak oxygen uptake (V̇O2peak) at four timepoints. Linear mixed model was used to examine the longitudinal change in V̇O2peak and differences in trajectories across the 5-year period. RESULTS: Across 5 years, men reporting HIT and MIT showed V̇O2peak declines of -3.1% (p=0.007) and -7.7% (p<0.001), respectively. Women reporting HIT showed no change (p=0.96) in V̇O2peak, whereas those reporting MIT showed a decline of -4.6% (p<0.001). At 5-years, the difference in V̇O2peak was 1.31 mL/kg/min (95% Confidence interval (CI) 0.17 to 2.45) and 1.33 mL/kg/min (95% CI 0.28 to 2.37) in favor HIT, in men and women respectively. In exploratory analyses, higher self-reported exercise intensity was associated with 1.11 (95% CI 0.60 to 1.62) and 0.64 (95% CI 0.22 to 1.06) mL/kg/min smaller decline in V̇O2peak in men and women, respectively, whereas weekly exercise duration showed weaker and inconsistent associations. CONCLUSIONS: Among men and women aged 70-77 years, consistent engagement in aerobic exercise training was associated with more favorable age-related V̇O2peak trajectories, with HIT showing the smallest declines over 5 years. Exploratory interaction analyses suggested that exercise intensity may become increasingly important over time for preserving V̇O2peak.
Hogan C, Cross TJ, Tiong M
… +4 more, Pratheepan P, Blaxland A, Machan E, Rooney K
Med Sci Sports Exerc
· 2026 May · PMID 42166325
·
Publisher ↗
BACKGROUND: The relationship between the exercise intensity at which maximal fat oxidation occurs (Fatmax) and the lactate threshold/gas-exchange threshold (LT/GET) has gained interest in both sport performance and healt...BACKGROUND: The relationship between the exercise intensity at which maximal fat oxidation occurs (Fatmax) and the lactate threshold/gas-exchange threshold (LT/GET) has gained interest in both sport performance and health-related communities, yet the absolute agreement between these two "thresholds" remains inconsistent. This review aims to systematically assess the available literature to determine whether Fatmax occurs at the same exercise intensity as the LT/GET and to examine whether aspects of study design moderated this relationship. METHODS: PubMed, MEDLINE, Embase and Scopus were systematically searched from inception to 20 th January 2025. Studies were included if they reported Fatmax and measures of the LT/GET in healthy adults. Exercise intensities corresponding to these thresholds were analysed using a random effects multilevel meta-analysis. Univariate moderator analyses were performed to identify potential methodological or participant-related moderators of the effect size (ES). RESULTS: The meta-analysis (N = 42 studies) revealed that Fatmax occurred at a significantly lower exercise-intensity than LT/GET, by approximately 5.78% V̇O2max, 4.75 ml/min/kg V̇O2, 22 watts, or 11 beats per minute (ES=0.74, 95% CI=0.32-1.16, P=0.001). Moderator analyses indicated that differences between Fatmax and LT/GET varied according to participant characteristics (e.g., age, sex, fitness level), nutritional status, study design, testing protocols and analytical methods. CONCLUSIONS: Although Fatmax typically occurs at a lower exercise intensity than the LT/GET, this difference appears smaller in sedentary individuals (<20 years), when testing is performed with <6 hour fasting period, and when treadmill-based, two separate sessions protocols are employed. Under these conditions, the LT/GET could serve as a surrogate for Fatmax when direct substrate oxidation measurement is not feasible.
D'Souza AC, Van Every DW, Bhinder A
… +12 more, Elango S, Lamont GAC, Lees MJ, Lim C, McKendry J, Newbold JP, Naphin C, Rebalka IA, Roxburgh L, Suthaharan A, Wilson BK, Phillips SM
Med Sci Sports Exerc
· 2026 May · PMID 42160459
·
Publisher ↗
AIM: We investigated the influence of MCPBT on muscle hypertrophy and strength in response to RET over three MCs. METHODS: Employing a randomized, unilateral design, twenty-four healthy, eumenorrheic females completed a...AIM: We investigated the influence of MCPBT on muscle hypertrophy and strength in response to RET over three MCs. METHODS: Employing a randomized, unilateral design, twenty-four healthy, eumenorrheic females completed a within-participant resistance training trial across three consecutive MCs (12.2 ± 1.3 weeks; mean ± SD). Each individual's legs were randomly assigned to one of four conditions: non-exercising control (CON), continuous exercise training (balanced across both MC phases; EX), high-volume in the follicular phase with low volume in the luteal phase (HV-FOL), or the converse (HV-LUT). HV was defined as five sets per exercise twice weekly (≥10 sets·muscle⁻¹·week⁻¹), and low volume comprised one set per exercise twice weekly (≤5 sets·muscle⁻¹·week⁻¹). The primary outcome was thigh lean mass via dual-energy x-ray absorptiometry. Secondary outcomes were vastus lateralis cross-sectional area (VL CSA), leg fat-free mass (FFM) via bioelectrical impedance analysis, one-repetition maximum (1RM) strength and maximal voluntary isometric contraction. RESULTS: All RET conditions produced greater gains than CON for thigh lean mass, VL CSA, FFM, and 1RM strength (all, p < 0.001), with no differences (all, p ≥ 0.17) between any of the training conditions (EX, HV-FOL, and HV-LUT). CONCLUSIONS: MCPBT confers neither hypertrophy nor strength advantages over traditional continuous RET. Training volume-load, not MCPBT, was associated with several adaptations. MC phase-based adjustments in RET could be based on individual preference but are not necessary to achieve muscular adaptations to RET.
Michiko N, Alhadad SB, Tan XR
… +2 more, Lee JKW, Low ICC
Med Sci Sports Exerc
· 2026 May · PMID 42150133
·
Publisher ↗
PURPOSE: Exertional hyperthermia impairs endurance performance. Although the central nervous system mediates premature fatigue, limited understanding of when and how neural perturbations arise during exertional hyperther...PURPOSE: Exertional hyperthermia impairs endurance performance. Although the central nervous system mediates premature fatigue, limited understanding of when and how neural perturbations arise during exertional hyperthermia hinders efforts to develop effective strategies to mitigate its impacts. METHODS: Fifteen physically active males completed a familiarization trial and three randomized crossover controlled trials involving treadmill walking at 54 ± 4% maximal oxygen consumption (mean ± SD) in a temperate environment (COOL; dry bulb temperature [Tdb]: 22.3 ± 0.4°C, relative humidity [RH]: 68 ± 10%), warm environment with (WARM+FC; Tdb: 32.0 ± 0.2°C, RH: 71 ± 2%) and without (WARM; Tdb: 32.1 ± 0.2°C, RH: 70 ± 2%) isolated facial fan cooling, until volitional exhaustion or rectal temperature of 39.5°C. Brachioradialis activation was assessed via electromyography (EMG) through maximal (MVC) and submaximal (sMVC) voluntary isometric handgrip contractions. Primary motor cortex oxygenation was continuously monitored using functional near-infrared spectroscopy (fNIRS). Δ[Hbdiff] (difference between oxyhemoglobin and deoxyhemoglobin changes) indexed cortical activation. Δ[Hbdiff]/EMG quantified cortical activation relative to muscle activation. RESULTS: Δ[Hbdiff]/EMG was higher during MVC in WARM relative to COOL (P < 0.05) but similar across trials during sMVC. This was observed alongside reduced muscle activation (P < 0.05). Isolated facial cooling in WARM+FC trials did not mitigate heat-induced neural deficits observed during MVC. CONCLUSIONS: Greater cortical activation is required to sustain similar muscle activation during exercise in warm compared with temperate conditions, suggesting a suboptimal neural drive for muscle output with exertional hyperthermia. This may contribute to the onset and development of central fatigue. fNIRS-derived markers may serve as early indicators to mitigate heat-induced deficits and enhance safety during exercise.
Zhang D, Sánchez-Polán M, Díaz-Blanco Á
… +6 more, Brik M, Hernando P, Nagpal TS, Rui D, Liu H, Barakat R
Med Sci Sports Exerc
· 2026 May · PMID 42118948
·
Publisher ↗
PURPOSE: To examine the effects of a supervised hybrid prenatal exercise program (combined in-person and online sessions) on the incidence of macrosomia and excessive gestational weight gain (EGWG). METHODS: A randomized...PURPOSE: To examine the effects of a supervised hybrid prenatal exercise program (combined in-person and online sessions) on the incidence of macrosomia and excessive gestational weight gain (EGWG). METHODS: A randomized clinical trial (NCT04563065) was conducted. A total of 260 pregnant women were assessed for eligibility and randomized (1:1). This manuscript reports results from a per-protocol analysis including 138 participants (exercise group [EG] n=62; control group [CG] n=76). The EG participated in a supervised moderate-intensity exercise program delivered in a hybrid format (1 in-person session/week at the hospital and 2 online sessions/week via Zoom), from 11 weeks' gestation until delivery. The CG received usual obstetric care, printed lifestyle education materials, and a brief phone-based physical activity interview once per trimester. Macrosomia (>4000 g) and EGWG (Institute of Medicine criteria) were extracted from hospital records and compared between groups. RESULTS: The incidence of macrosomia was lower in the EG (0%) than in the CG (7.3%; χ²=6.70, p=0.01). The incidence of EGWG did not differ between groups (9.6% vs. 19.4%, p =0.13). Apgar score at 5 minutes was slightly higher in the EG than in the CG (9.91±0.34 vs. 9.82±0.56, p =0.03). CONCLUSIONS: A supervised hybrid prenatal exercise program was associated with a lower incidence of macrosomia and slightly higher 5-minute Apgar scores compared with usual care. These findings support hybrid delivery as a feasible strategy for implementing supervised prenatal exercise.