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Objectives The aim of this study was to compare the measured physiological factors that limit running performance with real marathon results from world-class distance runners, evaluating the compatibility between measured data and predicted results based on the previously suggested model. Methods Four world-class East African marathon runners (three male, one female) underwent physiological running assessments to predict marathon performance times using a model based on V ˙ $\dot {\mathrm{V}}$ O 2 peak, percentage of V ˙ $\dot {\mathrm{V}}$ O 2 peak at the second ventilatory threshold, and running economy. Predictions were then compared to participants’ best marathon times. Results The measured V ˙ $\dot {\mathrm{V}}$ O 2 peak of the world-class runners was 75.1 ± 2.7 mL/kg/min. The second ventilatory threshold occurred at 85 ± 3 % of the peak, with a running economy of 63.7 ± 2.4 mL/kg/min at 19.6 ± 0.9 km/h. The predicted marathon performance time was 2:06:51 ± 0:03:17 h:min:s for the males and 2:17:36 h:min:s for the female. Comparing these predictions to their personal best times, the average difference was 00:55 ± 00:51 min:s (range: 00:20-02:08). Conclusions This research provides laboratory data on world-class road running athletes, reinforcing the link between marathon performance and V ˙ $\dot {\mathrm{V}}$ O 2 peak, the percentage of V ˙ $\dot {\mathrm{V}}$ O 2 peak at the second ventilatory threshold, and running economy. The examined athletes had lower V ˙ $\dot {\mathrm{V}}$ O 2 peak compared to predicted values, highlighting the importance of running economy and fractional utilization of V ˙ $\dot {\mathrm{V}}$ O 2 peak in achieving such performances. Future studies should continue to advance the field by including additional bioenergetic parameters measured during race conditions and expanding the participant cohort of elite marathoners, encompassing both sexes.

Objectives Aerobic exercise training can increase skeletal muscle mitochondrial content. Supine exercise training with legs above the heart potentially augments these increases. However, the impact of supine exercise training on mitochondrial biogenesis and cardiovascular adaptations remains unclear. Methods In this single-centred, randomized, parallel arm trial, 19 recreationally active individuals underwent seven sessions of either supine with legs up (SUP; n=9, 6 females) or upright with legs down (UP; n=10, 7 females) aerobic training on a recumbent bike at 71 ± 7 % and 71 ± 2 % of peak work rate (WR peak ), respectively. The study aimed to test the effects of training with decreased muscle oxygenation on indices of muscle mitochondrial remodelling. Secondary outcomes included exercise performance, muscle oxygenation, and cardiovascular responses. Results Secondary outcomes revealed significant interaction effects for time to fatigue (TTF) and WR peak in the SUP group during supine testing, suggesting enhanced exercise tolerance and performance. No between group interaction effects were observed for upright testing. No clear effects on mitochondrial biogenesis were observed based on expression of mitochondrial protein subunits and transcriptional regulators. Acutely, HR peak was lower during the SUP Test compared to the UP Test. No central cardiovascular adaptations were observed following training. Conclusions Our exploratory analyses showed that supine aerobic training more effectively improves supine exercise tolerance and performance compared with upright training, despite no differences in measured proteins related to mitochondrial biogenesis. Further research is needed to elucidate the mechanisms underlying these postural-specific training effects. Registration clinicaltrials.gov: NCT04151095.

Current scientific endeavours in the field of geroscience have begun to reveal how factors such as exercise could modulate the brain aging process. In this review, we ask how exercise could potentially modulate aging, and by extension, the development of Alzheimer’s Disease (AD). Furthermore, we discuss how exercise could mitigate the cascade of debilitating manifestations in AD. Mechanistically, we discuss how biomolecules such as brain-derived neurotrophic factor (BDNF) and its cognate receptor, tropomyosin receptor kinase B (TrkB) could change during the life course and how its signalling pathways could be altered with exercise (acute sessions or chronic training). Tackling these questions could help the scientific and medical community mitigate age-related decline in terms of neurological functions.

Objectives The purpose of this narrative review is to offer an updated perspective on the current research on the glycoprotein Osteoprotegerin (OPG), including its potential therapeutic impact and mechanisms of action, and interaction with bone and muscle tissues. Content As health and social care advances people are living longer, with projections suggesting that in 2050 there will be 2 billion people who are aged over 60 years. Yet musculoskeletal health still declines into older age and as a result there is an increase in the proportion of older populations that spend more time with persistent disabilities. Although physical exercise is repeatedly demonstrated to minimise detrimental effects of ageing, it is not always a feasible intervention, and other directions must be considered. Summary and outlook OPG, a glycoprotein decoy receptor for the receptor activator of nuclear factor kappa-β ligand (RANKL) is a key regulator of bone formation yet emerging evidence has presented its potential to offer positive outcomes in regard to the preservation of skeletal muscle mass and function. Animal models have shown that OPG levels increase during exercise, and independently acts to restore losses of muscle strength and reduce bone resorption. Interventions to increase circulating OPG alongside exercise may act as a therapeutic target to combat the decline in quality of life in older age in humans. Further research is needed on the mechanisms of its action and interaction in humans in combination with exercise.

Objectives To investigate the impact of a supervised blood-flow restriction (BFR) training program performed at different times of the morning on body composition and muscle performance in older, inactive adults. Methods A single-arm intervention of supervised BFR resistance training was performed three times per week for six weeks. Participants (n=24; aged 65+ years) were categorized into early morning (n=13; 05:00–08:59) or late morning (n=11; 09:00–12:00) groups. Primary outcomes were changes in body composition, total work, average peak power, average peak torque, muscle strength, and physical function. Results Mixed model analysis of variance revealed a significant within-subject effect of time for all strength measures (p ranging from 0.017 to <0.001) and some physical function measures including the 30 s chair stand test, 30 s bicep curl test, and grip strength (p ranging from 0.015 to <0.001). No between-group or time by group interaction effect was observed for all outcomes. Conclusions This study showed that only six weeks of BFR training, performed at different time of the morning, did not enhance muscle mass and performance, but provided similar changes in muscle strength and some physical function tests in older adults.

Here we compare the efficacy of anti-obesity drugs alone or combined with exercise training on body weight and exercise capacity of obese patients. Randomized clinical trials that assessed the impact of any anti-obesity drug alone or combined with exercise training on body weight, body fat, fat-free mass and cardiorespiratory fitness in obese patients were retrieved from Pubmed and EMBASE up to May 2024. Risk of bias assessment was performed with RoB 2.0, and the GRADE approach assessed the certainty of evidence (CoE) of each main outcome. We included four publications summing up 202 patients. Two publications used orlistat as an anti-obesity drug treatment, while the other two adopted GLP-1 receptor agonist (liraglutide or tirzepatide) as a pharmacotherapy for weight management. Orlistat combined with exercise was superior to change body weight (mean difference (MD): −2.27 kg; 95 % CI: −2.86 to −1.69; CoE: very low), fat mass (MD: −2.89; 95 % CI: −3.87 to −1.91; CoE: very low), fat-free mass (MD: 0.56; 95 % CI: 0.40–0.72; CoE: very low), and VO 2 Peak (MD: 2.64; 95 % CI: 2.52–2.76; CoE: very low). GLP-1 receptor agonist drugs combined with exercise had a great effect on body weight (MD: −3.96 kg; 95 % CI: −5.07 to −2.85; CoE: low), fat mass (MD: −1.76; 95 % CI: −2.24 to −1.27; CoE: low), fat-free mass (MD: 0.50; 95 % CI: −0.98 to 1.98; CoE: very low) and VO 2 Peak (MD: 2.47; 95 % CI: 1.31–3.63; CoE: very low). The results reported here suggest that exercise training remains an important approach in weight management when combined with pharmacological treatment.