Cumulative effects of training at different weekly energy expenditures on cardiorespiratory fitness and markers of metabolic syndrome in STRRIDE-Extension.
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2025-06
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Assess the cumulative effects of different weekly exercise energy expenditures, with similar total program volume and intensity, on cardiorespiratory fitness (CRF) and metabolic syndrome (MetS). Following the 9-mo Studies of a Targeted Risk Reduction Intervention through Defined Exercise (STRRIDE) trial, 22 participants continued exercise training for 6-24 mo in one of two groups: 1) low-amount/vigorous-intensity (LAVI; n = 14): 14 kcal/kg/wk (KKW) at 65%-80% peak V̇o2 and 2) high-amount/vigorous-intensity (HAVI; n = 8): 23 KKW at 65%-80% peak V̇o2. Outcomes included absolute (AV̇o2) and relative peak oxygen consumption (RV̇o2), body fat percentage, waist circumference, HDL-C, triglycerides, fasting glucose, insulin sensitivity index (SI), and modified MetS z score. Group comparisons were made at equivalent and differential timepoints with similar total exercise volumes. SI improvements were greater in HAVI compared with LAVI at the LAVI 21-mo/HAVI 15-mo contrast (mean difference ± SD: 2.13 ± 0.68 mU/L/min, P = 0.008). AV̇o2 and RV̇o2 improvements were greater in HAVI at both the LAVI 21-mo/HAVI 15-mo contrast (model estimate [95% CI]: 0.21 [0.01, 0.40] L/min, P = 0.038 and 3.05 [0.14, 5.96] mL/kg/min, P = 0.041), respectively, and the LAVI 33-mo/HAVI 21-mo contrast (0.25 [0.04, 0.45] L/min, P = 0.022 and 3.21 [0.10, 6.32] mL/kg/min, P = 0.044). These AV̇o2 contrasts remained significant after adjusting for age and sex. Adherence declined over time. When cumulative exercise volumes were similar, body composition and MetS markers adapted similarly between groups. However, continued training at greater weekly volumes of vigorous exercise resulted in more substantial CRF and SI improvements compared with lesser weekly volumes. Findings suggest factors beyond total energy expenditure-such as exercise frequency or duration-may modulate some longitudinal health improvements.NEW & NOTEWORTHY This exploratory analysis investigated longitudinal effects of accumulating similar total exercise program volumes at different weekly exercise energy expenditures on cardiorespiratory fitness and metabolic syndrome measures over months to years. In general, adaptations are similar; however, factors other than total energy cost-such as exercise frequency or duration-may modulate longitudinal improvements in cardiorespiratory fitness and skeletal muscle insulin sensitivity over 33 mo of training among sedentary adults with overweight or obesity and dyslipidemia.
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Moseley, Garrett A, Leanna M Ross, Katherine A Collins-Bennett, Rebecca North, Johanna L Johnson and William E Kraus (2025). Cumulative effects of training at different weekly energy expenditures on cardiorespiratory fitness and markers of metabolic syndrome in STRRIDE-Extension. Journal of applied physiology (Bethesda, Md. : 1985), 138(6). pp. 1532–1542. 10.1152/japplphysiol.00743.2024 Retrieved from https://hdl.handle.net/10161/33848.
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Leanna Ross
Dr. Ross's research focuses on understanding the mechanisms by which exercise interventions elicit short- and long-term cardiometabolic health benefits. As cardiometabolic disease remains the leading cause of morbidity and mortality in the United States, the goal of her translational research is to enhance the development of evidence-based, precision exercise interventions that optimally prevent and treat disease.
Areas of Research Interest
Exercise dose-response and cardiometabolic health
Insulin action and glucose homeostasis
Legacy health benefits of exercise
Heterogeneity of response to exercise intervention
Precision lifestyle medicine
Epidemiology of physical activity and cardiorespiratory fitness
Katherine Collins-Bennett
Katherine A. Collins-Bennett, PhD, NBC-HWC, is an Assistant Professor in the Department of Population Health Sciences and affiliated with the Duke Molecular Physiology Institute at Duke University School of Medicine, and is a board-certified health and wellness coach. She studies barriers and predictors of health-promoting behavior change. The ultimate goal of her translational research is to design trials to optimize health-promoting behaviors for those at risk for "relapse" or cessation of behavioral modification, in order to improve long-term health and well-being.
Rebecca North
Rebecca North, PhD
Dr. North is a collaborative biostatistician who lets clinical application drive methodological innovation. This has been true since graduate school at NC State University, where her dissertation focused on variable selection methods for functional data for the purpose of identifying a sparse set of electromyogram signals that would accurately predict the velocity of a prosthetic arm. Also while in graduate school, Dr. North was supported by a T32 Traineeship, the National Heart, Lung, and Blood Institute Integrated Biostatistical Training Program for Cardiovascular Disease Research, through which she gained clinical research experience at the Duke Clinical Research Institute with particular focus on atrial fibrillation research.
Since joining the Duke Aging Center, Dr. North has gained statistical experience in latent class analysis, mediation analysis, and meta-analysis, to add to her knowledge of functional data analysis, variable selection techniques, random forests and decision trees, survival analysis, longitudinal data analysis, and other classical frequentist statistical methods. Her clinical areas of interest include circadian rhythm research, cardiovascular research (particularly atrial fibrillation), and Veteran health.
William Erle Kraus
My training, expertise and research interests range from human integrative physiology and genetics to animal exercise models to cell culture models of skeletal muscle adaptation to mechanical stretch. I am trained clinically as an internist and preventive cardiologist, with particular expertise in preventive cardiology and cardiac rehabilitation. My research training spans molecular biology and cell culture, molecular genetics, and integrative human exercise physiology and metabolism. I practice as a preventive cardiologist with a focus on cardiometabolic risk and exercise physiology for older athletes. My research space has both a basic wet laboratory component and a human integrative physiology one.
One focus of our work is an integrative physiologic examination of exercise effects in human subjects in clinical studies of exercise training in normal individuals, in individuals at risk of disease (such as pre-diabetes and metabolic syndrome; STRRIDE), and in individuals with disease (such as coronary heart disease, congestive heart failure and cancer).
A second focus of my research group is exploration of genetic determinates of disease risk in human subjects. We conduct studies of early onset cardiovascular disease (GENECARD; CATHGEN), congestive heart failure (HF-ACTION), peripheral arterial disease (AMNESTI), and metabolic syndrome. We are exploring analytic models of predicting disease risk using established and innovative statistical methodology.
A third focus of my group’s work is to understand the cellular signaling mechanisms underlying the normal adaptive responses of skeletal muscle to physiologic stimuli, such as occur in exercise conditioning, and to understand the abnormal maladaptive responses that occur in response to pathophysiologic stimuli, such as occur in congestive heart failure, aging and prolonged exposure to microgravity.
Recently we have begun to investigate interactions of genes and lifestyle interventions on cardiometabolic outcomes. We have experience with clinical lifestyle intervention studies, particularly the contributions of genetic variants to interventions responses. We call this Lifestyle Medicopharmacogenetics.
KEY WORDS:
exercise, skeletal muscle, energy metabolism, cell signaling, gene expression, cell stretch, heart failure, aging, spaceflight, human genetics, early onset cardiovascular disease, lifestyle medicine
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