Vascular Function Improvements Derived From Exercise Are Not Sex-Dependent

1. The exercise training prevented increases in total cholesterol and LDL cholesterol which were observed in the non-exercise group and this positive change was not dependent on sex.

2. Changes in visceral fat and lean fat-free mass in response to exercise were dependent on sex.

Evidence Rating Level: 1b

One of the leading causes of morbidity in older individuals can be attributed to cardiovascular (CV) causes. As such, an emphasis on lifestyle modifications, namely exercise, has been a large part of reducing the incidence of such diseases. Although, we know exercise to be beneficial for reducing CV events, it is uncertain whether this is through the reduction of traditional risk factors (ex. obesity) or through direct arterial function improvement. Furthermore, although there are studies to compare sex differences concerning arterial function in response to exercise, there is a gap in these studies in older individuals. This project aimed to investigate if there exist any sex differences in arterial function response to exercise independent from other CV risk factors.

This was a randomized control trial that included 72 healthy middle-aged/older males and females. These participants were prospectively registered before randomization. Exclusion criteria included having smoked <12 months ago, BMI >40, hypertension, alcohol consumption of >280g/week, and total cholesterol >7.0. Participants were randomized to either: no exercise, walking in water, or land-walking for 50 minutes 3 times a week. The primary outcome measures were cholesterol levels, body composition metrics, and flow-mediated brachial artery dilation.

The results showed that there was a significant increase in LDL cholesterol and total cholesterol/HDL ratios in the non-exercise group whereas this increase was not observed in the water-walking or land-walking groups. There were no significant sex differences in this observed relationship. However, males lost significantly more visceral fat than females while females gained more total lean body mass than males. However, the study had a small number of participants with around ~25 participants in each intervention. This made investigating a variable such as sex more difficult and the results less generalizable. Nonetheless, this study identified that walking as exercise provides vascular benefits and reduces risk factors for CV events independent of sex.

Click here to read this study in Medicine & Science in Sports & exercise

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