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      Refuting the myth of non‐response to exercise training: ‘non‐responders’ do respond to higher dose of training

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          Abstract

          Key points

          • The prevalence of cardiorespiratory fitness (CRF) non‐response gradually declines in healthy individuals exercising 60, 120, 180, 240 or 300 min per week for 6 weeks.

          • Following a successive identical 6‐week training period but comprising 120 min of additional exercise per week, CRF non‐response is universally abolished.

          • The magnitude of CRF improvement is primarily attributed to changes in haemoglobin mass.

          • The potential for CRF improvement may be present and unveiled with appropriate exercise training stimuli in healthy individuals without exception.

          Abstract

          One in five adults following physical activity guidelines are reported to not demonstrate any improvement in cardiorespiratory fitness (CRF). Herein, we sought to establish whether CRF non‐response to exercise training is dose‐dependent, using a between‐ and within‐subject study design. Seventy‐eight healthy adults were divided into five groups (1–5) respectively comprising one, two, three, four and five 60 min exercise sessions per week but otherwise following an identical 6‐week endurance training (ET) programme. Non‐response was defined as any change in CRF, determined by maximal incremental exercise power output ( W max), within the typical error of measurement (±3.96%). Participants classified as non‐responders after the ET intervention completed a successive 6‐week ET period including two additional exercise sessions per week. Maximal oxygen consumption ( V ˙ O 2 max ), haematology and muscle biopsies were assessed prior to and after each ET period. After the first ET period, W max increased ( < 0.05) in groups 2, 3, 4 and 5, but not 1. In groups 1, 2, 3, 4 and 5, 69%, 40%, 29%, 0% and 0% of individuals, respectively, were non‐responders. After the second ET period, non‐response was eliminated in all individuals. The change in V ˙ O 2 max with exercise training independently determined W max response (partial correlation coefficient, r partial ≥ 0.74, P < 0.001). In turn, total haemoglobin mass was the strongest independent determinant of V ˙ O 2 max ( r partial = 0.49, P < 0.001). In conclusion, individual CRF non‐response to exercise training is abolished by increasing the dose of exercise and primarily a function of haematological adaptations in oxygen‐carrying capacity.

          Key points

          • The prevalence of cardiorespiratory fitness (CRF) non‐response gradually declines in healthy individuals exercising 60, 120, 180, 240 or 300 min per week for 6 weeks.

          • Following a successive identical 6‐week training period but comprising 120 min of additional exercise per week, CRF non‐response is universally abolished.

          • The magnitude of CRF improvement is primarily attributed to changes in haemoglobin mass.

          • The potential for CRF improvement may be present and unveiled with appropriate exercise training stimuli in healthy individuals without exception.

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          Most cited references36

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          Aerobic high-intensity intervals improve VO2max more than moderate training.

          The present study compared the effects of aerobic endurance training at different intensities and with different methods matched for total work and frequency. Responses in maximal oxygen uptake (VO2max), stroke volume of the heart (SV), blood volume, lactate threshold (LT), and running economy (CR) were examined. Forty healthy, nonsmoking, moderately trained male subjects were randomly assigned to one of four groups:1) long slow distance (70% maximal heart rate; HRmax); 2)lactate threshold (85% HRmax); 3) 15/15 interval running (15 s of running at 90-95% HRmax followed by 15 s of active resting at 70% HRmax); and 4) 4 x 4 min of interval running (4 min of running at 90-95% HRmax followed by 3 min of active resting at 70%HRmax). All four training protocols resulted in similar total oxygen consumption and were performed 3 d.wk for 8 wk. High-intensity aerobic interval training resulted in significantly increased VO2max compared with long slow distance and lactate-threshold training intensities (P<0.01). The percentage increases for the 15/15 and 4 x 4 min groups were 5.5 and 7.2%, respectively, reflecting increases in V O2max from 60.5 to 64.4 mL x kg(-1) x min(-1) and 55.5 to 60.4 mL x kg(-1) x min(-1). SV increased significantly by approximately 10% after interval training (P<0.05). : High-aerobic intensity endurance interval training is significantly more effective than performing the same total work at either lactate threshold or at 70% HRmax, in improving VO2max. The changes in VO2max correspond with changes in SV, indicating a close link between the two.
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            High responders and low responders: factors associated with individual variation in response to standardized training.

            The response to an exercise intervention is often described in general terms, with the assumption that the group average represents a typical response for most individuals. In reality, however, it is more common for individuals to show a wide range of responses to an intervention rather than a similar response. This phenomenon of 'high responders' and 'low responders' following a standardized training intervention may provide helpful insights into mechanisms of training adaptation and methods of training prescription. Therefore, the aim of this review was to discuss factors associated with inter-individual variation in response to standardized, endurance-type training. It is well-known that genetic influences make an important contribution to individual variation in certain training responses. The association between genotype and training response has often been supported using heritability estimates; however, recent studies have been able to link variation in some training responses to specific single nucleotide polymorphisms. It would appear that hereditary influences are often expressed through hereditary influences on the pre-training phenotype, with some parameters showing a hereditary influence in the pre-training phenotype but not in the subsequent training response. In most cases, the pre-training phenotype appears to predict only a small amount of variation in the subsequent training response of that phenotype. However, the relationship between pre-training autonomic activity and subsequent maximal oxygen uptake response appears to show relatively stronger predictive potential. Individual variation in response to standardized training that cannot be explained by genetic influences may be related to the characteristics of the training program or lifestyle factors. Although standardized programs usually involve training prescribed by relative intensity and duration, some methods of relative exercise intensity prescription may be more successful in creating an equivalent homeostatic stress between individuals than other methods. Individual variation in the homeostatic stress associated with each training session would result in individuals experiencing a different exercise 'stimulus' and contribute to individual variation in the adaptive responses incurred over the course of the training program. Furthermore, recovery between the sessions of a standardized training program may vary amongst individuals due to factors such as training status, sleep, psychological stress, and habitual physical activity. If there is an imbalance between overall stress and recovery, some individuals may develop fatigue and even maladaptation, contributing to variation in pre-post training responses. There is some evidence that training response can be modulated by the timing and composition of dietary intake, and hence nutritional factors could also potentially contribute to individual variation in training responses. Finally, a certain amount of individual variation in responses may also be attributed to measurement error, a factor that should be accounted for wherever possible in future studies. In conclusion, there are several factors that could contribute to individual variation in response to standardized training. However, more studies are required to help clarify and quantify the role of these factors. Future studies addressing such topics may aid in the early prediction of high or low training responses and provide further insight into the mechanisms of training adaptation.
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              Mortality trends in the general population: the importance of cardiorespiratory fitness

              Cardiorespiratory fitness (CRF) is not only an objective measure of habitual physical activity, but also a useful diagnostic and prognostic health indicator for patients in clinical settings. Although compelling evidence has shown that CRF is a strong and independent predictor of all-cause and cardiovascular disease mortality, the importance of CRF is often overlooked from a clinical perspective compared with other risk factors such as hypertension, diabetes, smoking, or obesity. Several prospective studies indicate that CRF is at least as important as the traditional risk factors, and is often more strongly associated with mortality. In addition, previous studies report that CRF appears to attenuate the increased risk of death associated with obesity. Most individuals can improve their CRF through regular physical activity. Several biological mechanisms suggest that CRF improves insulin sensitivity, blood lipid profile, body composition, inflammation, and blood pressure. Based on the evidence, health professionals should encourage their patients to improve CRF through regular physical activity.
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                Author and article information

                Contributors
                carsten.lundby@access.uzh.ch
                Journal
                J Physiol
                J. Physiol. (Lond.)
                10.1111/(ISSN)1469-7793
                TJP
                jphysiol
                The Journal of Physiology
                John Wiley and Sons Inc. (Hoboken )
                0022-3751
                1469-7793
                14 May 2017
                01 June 2017
                : 595
                : 11 ( doiID: 10.1113/tjp.2017.595.issue-11 )
                : 3377-3387
                Affiliations
                [ 1 ] Zurich Center for Integrative Human Physiology (ZIHP), Institute of Physiology University of Zurich Switzerland
                [ 2 ] Department of Cardiology University Hospital Zurich Switzerland
                Author notes
                [*] [* ] Correspondence C. Lundby: Institute of Physiology, ZIHP, University of Zurich, Office 23 H 6, Winterthurerstrasse 190, 8057 Zurich, Switzerland. Email:  carsten.lundby@ 123456access.uzh.ch
                Author information
                http://orcid.org/0000-0002-0438-8271
                Article
                PMC5451738 PMC5451738 5451738 TJP12240
                10.1113/JP273480
                5451738
                28133739
                026f624e-f407-4dae-aecd-2e3fe966d890
                © 2017 The Authors. The Journal of Physiology © 2017 The Physiological Society
                History
                : 15 September 2016
                : 06 January 2017
                Page count
                Figures: 4, Tables: 4, Pages: 11, Words: 7728
                Funding
                Funded by: Zurich Center for Integrative Human Physiology
                Categories
                Research Paper
                Integrative
                Editor's Choice
                Custom metadata
                2.0
                tjp12240
                1 June 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.1.0 mode:remove_FC converted:01.06.2017

                hemoglobin mass,cardiorespiratory fitness,non‐response,trainability

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