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Re: Health benefits of high-intensities aerobic training.

Dear Editor,

The influence of a regular physical exercise on health and fitness is well-established, as physically active subjects are characterized by a consistently decreased risk of cardiovascular disease, diabetes, cancer, osteoporosis, obesity, fractures and mental health problems. Accordingly, the current guidelines recommend 30 minutes or more of moderate-intensity activity on most days of the week, and that people already achieving this would benefit further from participation in more vigorous activity.[1]

However, there is still an open debate regarding the intensity and the type of physical activity required to achieve most favourable health changes in the general population without overwhelming the relative benefits or eliciting osteoarthritis and cardiovascular abnormalities not present at rest.[2] It was recently observed that the volume of lifestyle activities of moderate intensity in leisure time was inversely associated with all cause mortality in women but not in men and. Therefore, with regard to the health enhancing physical activity recommendation as a threshold, there were favourable findings only in women.[3]

In recent investigations on male professional athletes, we demonstrated that a vigorous and regular endurance aerobic training regimen does not influence markers of hemostatic or endothelial activation,[4] does not induce any persistent phlogistic reaction,[5] nor it is associated with biochemical signs of significant and irreversible chronic cardiac involvement, as reflected by normal concentrations of the NT-pro-brain natriuretic peptide.[6]

Therefore, as a substantial intensification in leisure-time physical activity within the population does not apparently produces any acute increase of the risk of adverse cardiovascular events[4-6] and it is likely to be more effective for eliciting supplemental gains in health,[2] we suggest that higher intensities and amounts of aerobic training may be safely implemented in free-living sedentary individuals as a preventive or therapeutic measure to increase the health benefits, especially in individuals who are most at risk of developing health problems.

References

1. Willett W. Harvesting the fruits of research: new guidelines on nutrition and physical activity. Cancer J Clin 2002; 52: 66-67.

2. Lee, IM, Sesso, HD, Oguma, Y, Paffenbarger, RS Jr Relative intensity of physical activity and risk of coronary heart disease. Circulation 2003; 107: 1110-1116.

3. Bucksch J. Physical activity of moderate intensity in leisure time and the risk of all cause mortality. Br J Sports Med 2005;39:632-8.

4. Lippi, G, Salvagno, GL, Montagna, M, Guidi, GC Chronic influence of vigorous aerobic training on hemostasis. Blood Coagul Fibrinolysis 2005; 16: 533-534.

5. Lippi, G, Salvagno, GL, Guidi, GC Other advantages to aerobic exercise. CMAJ 2005;173:1066.