As you strengthen your abs, it's vital to tone the back of the body as well. Lie on your back with your knees bent and your feet hip-width apart. Keep your arms at your sides and raise your hips without arching your back. Tighten the muscles of your buttocks and hamstrings, and hold for five breaths. Lower down one vertebra at a time to the floor if you're stopping here, or go on to the advanced posture.
Selection bias may limit generalizability to other populations of older adults since the included participants in the Generation 100 study were healthier, more educated and more physically active than nonparticipants [19]. However, our study population was diverse and included both healthy as well as older adults with comorbidities, and both inactive and very active older adults were included. The findings in the present study are based on a very large data material, and represent the most comprehensive data material on exercise patterns among older adults to date.
The EMG signals were filtered with a Butterworth band pass filter (cutoff frequencies 20 and 400 Hz). Then, the root mean square (RMS) of the EMG signal was automatically calculated with the software. During the incremental test, the EMG RMS was averaged for the last 5 EMG bursts of each step (at the end of each minute) and at exhaustion. During the time to exhaustion tests, the EMG RMS was averaged for the last 5 EMG bursts prior each time point measurement (10, 20, 30, 40, 50, 60, 70, 80, 90 and 100% of the time to exhaustion). EMG RMS of each muscle during the time to exhaustion tests was normalized by the maximal EMG RMS of the respective muscle obtained during the pre-exercise KE MVC performed at 100 deg/s. During the KE MVCs, maximal EMG RMS was averaged over a range of 20 deg extension (± 10 deg) around the peak torque.
Anyone who watched Jackie Warner on Bravo's Work Out knows she takes a tough-love approach to fitness. And, clearly, if you've checked out her abs lately, it works. She shares her signature circuit-training workout in this high-energy DVD that gives the option of four different 15-minute workouts or one 40-minute total body circuit, and left me feeling like I just had an up-close-and-personal training session with the exercise guru.
^ Jump up to: a b Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR, McMurdo M, Mead GE (September 2013). "Exercise for depression". Cochrane Database Syst. Rev. 9 (9): CD004366. doi:10.1002/14651858.CD004366.pub6. PMID 24026850. Exercise is moderately more effective than a control intervention for reducing symptoms of depression, but analysis of methodologically robust trials only shows a smaller effect in favour of exercise. When compared to psychological or pharmacological therapies, exercise appears to be no more effective, though this conclusion is based on a few small trials.

Video Abstract for the ESSR 46.3 article “The Microvasculature and Skeletal Muscle Healthin Aging” from authors Rian Q. Landers-Ramos and Steven J. Prior. Aging and aging-related declines in physical activity are associated with physical and metabolic impairments. Skeletal muscle capillarization is reduced in sedentary older adults, may contribute to impairments in skeletal muscle, and is modifiable by exercise training. This article examines the hypothesis that preservation of skeletal muscle capillarization is essential to maintain metabolism, fitness, and function with aging.
Jump up ^ Tarumi T, Zhang R (January 2014). "Cerebral hemodynamics of the aging brain: risk of Alzheimer disease and benefit of aerobic exercise". Front Physiol. 5: 6. doi:10.3389/fphys.2014.00006. PMC 3896879. PMID 24478719. Exercise-related improvements in brain function and structure may be conferred by the concurrent adaptations in vascular function and structure. Aerobic exercise increases the peripheral levels of growth factors (e.g., BDNF, IFG-1, and VEGF) which cross the blood-brain barrier (BBB) and stimulate neurogenesis and angiogenesis (Trejo et al., 2001; Lee et al., 2002; Fabel et al., 2003; Lopez-Lopez et al., 2004). Consistent with this, exercise-related enlargement of hippocampus was accompanied by increases in cerebral blood volume and capillary densities (Pereira et al., 2007). Enhanced cerebral perfusion may not only facilitate the delivery of energy substrates, but also lower the risk of vascular-related brain damages, including WMH and silent infarct (Tseng et al., 2013). Furthermore, regular aerobic exercise is associated with lower levels of Aβ deposition in individuals with APOE4 positive (Head et al., 2012), which may also reduce the risk of cerebral amyloid angiopathy and microbleeds (Poels et al., 2010).
LSR, SBS, HV, NPA, JEI, UW and DS contributed to the conception and design of the study. LSR, SBS, HV and DS were responsible for the collection of the Generation 100 data in cooperation with colleagues at the Cardiac Exercise Research Group at the Norwegian University of Science and Technology, Norway. LSR, SBS and XT provided the data for analysis. LSR undertook the data analysis and drafted the manuscript. All authors provided critical insight and revisions to the manuscript. All authors read and approved the final version of the manuscript submitted for publication.

6.  If an exercise can be done for more than 90 seconds, increase the resistance so that momentary muscular failure occurs within 45 - 90 seconds (this is considered "high-intensity" exercise). If you can do sit-ups for ten minutes, the intensity is insufficient to cross that threshold mentioned above, and you're just wasting valuable physiological resources. If you can't do even one rep, reduce the resistance (i.e. if doing a push-up, change from being on your toes to on your knees, or start from the top and slowly lower yourself; if using a machine, choose a lower setting; if using free-weights, pick a lower weight; if doing a chin-up, use a chair to boost yourself up to the top, then take your feet off the chair and slowly lower yourself).

The second aim of this study was to describe the isokinetic muscle fatigue induced by high intensity OLDE and its recovery. Firstly, the absence of isometric KF MVC torque decrease confirms that our exercise only solicits the knee extensors and does not involve the knee flexors. Secondly, EMG RMS measured during KE MVCs shortly after exhaustion and during the recovery period was not altered by high intensity OLDE, confirming the results of a previous study [8]. Therefore, as a decrease in knee extensors force production capacity can be observed without concomitant changes in EMG signal, our data combined with the data of a previous study [8] suggest that EMG signal cannot be used to investigate dynamic exercise-induced muscle fatigue. The lack of changes in EMG signal is likely to be caused by a potentiation of the maximal evoked muscular wave (M-wave) induced by high intensity OLDE [8]. Finally, according to our hypothesis, isokinetic KE MVC torque quickly recovered and plateaued after exhaustion (within ~ 30 s at 60 and 100 deg/s, and within ~ 50 s at 140 deg/s). This quick recovery in torque production capacity is likely to be associated with recovery in both central and peripheral fatigue. This assumption is supported by one previous study in our laboratory demonstrating that not only peripheral and central fatigue, but also cortical and spinal excitability recovered shortly after exhaustion [8]. Froyd et al. [32] also demonstrated a significant recovery in skeletal muscle function within 1–2 minutes after completion of a one-leg isokinetic time trial performed at high intensity. Taking all together, these results demonstrate that to fully appreciate the extent of neuromuscular alterations induced by high intensity dynamic exercise, assessment of muscle fatigue must be performed within 30 s of cessation of the exercise.
In both groups, men had a significantly higher proportion of sessions at a gym compared to women (Fig. 6). Contrary, women had a higher proportion of sessions at a sports facility compared to men. In the MCT group, men had a significantly higher proportion of sessions outdoors compared to women, while the opposite was observed in the HIIT group (Fig. 6).
This program isn’t just for the true beginner who has never touched a weight before; it’s also suitable for anyone who has taken an extended leave of absence from training. How long has it been since you went to the gym regularly? Six months? A year? Five years? No worries: The following routines will get you back on track in—you guessed it—just four short weeks. Let’s get to work.
You'll need a box or sturdy bench to complete this move. If you've never attempted box jumps, start with a box that is mid-calf height and progress to higher heights from there. Stand in front of box with feet shoulder-width apart. Bend knees, send hips back, swing arms back, and, as you swing arms forward, explode up onto box. Land lightly on toes (no loud thuds!) then step down one foot at a time and repeat.
Want to target the upper back without a reformer? Lie face down on a mat with your feet together. Raise your head and chest slightly, and extend your arms perpendicular to your body, palms down. Exhale and sweep the arms back as you lift your chin and chest higher. Keep your waist on the mat and use your upper back muscles to bring your arms closer to your body. Return to starting position. Do five reps.
Around 1900, Tasmanian-born Australian professional reciter and theatrical producer Frederick Alexander developed a novel methodology to harmonize full-body functional movements. As a child, Alexander suffered respiratory ailments, leading to the initial purpose of developing the method – to normalize his personal voice function in order to materialize a stage performance dream. In 1902, Alexander established the Sydney Dramatic and Operatic Conservatorium and in 1904, moved to London to spread his teaching method. During the first years, Alexander focused on teaching ‘full chest breathing’ techniques mainly to stage artists and people with breathing pathologies.19 Staring J. Frederick Matthias Alexander 1869-1955. The Origins and History of the Alexander Technique. A medical historical analysis of F.M. Alexander’s life, work, technique, and writings. Nijmegen: Radboud Universiteit; 2005. [Google Scholar] However, he soon discovered that retrieving the natural ‘conscious control’ via mindful postures and movements resulted in benefits not only for the vocal health and performance but also the health and performance of the whole body and mind.20 Alexander FM. Man's supreme inheritance. London: Methuen; 1910. [Google Scholar] This holistic evolvement transformed the newly formed ‘Alexander Technique’ into a general remedy and preventative tool suitable for all populations. Alexander explained in his 1910 book ‘Man’s Supreme Inheritance:’20 Alexander FM. Man's supreme inheritance. London: Methuen; 1910. [Google Scholar]
It's no secret we love Denise Austin here at Woman's Day, and this DVD reinforces why. Her simple instructions and cheerful attitude help each of the three 15-minute routines zip by. She focuses on one area of the body per session — upper body, lower body or ab & core conditioning — so I can target a trouble zone (ahem, thighs) or get a great full-body workout.
“Everyone can dance! Just embrace your style! And, if it’s for fitness, well, the point is to get you moving, not to be a professional! So, if you’re sweating and having a good time, you’re doing it right!” says Blogilates creator Cassey Ho. In this video, she takes you through a step-by-step, 14-minute dance cardio workout, complete with instructions. This video is great for those who need a bit of extra guidance. After you’ve learned the exercises, you may even be able to take a few of these moves to the floor.

Exercising looks different in every country, as do the motivations behind exercising.[2] In some countries, people exercise primarily indoors, and in others, people primarily exercise outdoors. People may exercise for personal enjoyment, health and well-being, social interactions, competition or training, etc. These differences could potentially be attributed to geographic location, social tendencies, or otherwise.
Jump up ^ Silverman MN, Deuster PA (October 2014). "Biological mechanisms underlying the role of physical fitness in health and resilience". Interface Focus. 4 (5): 20140040. doi:10.1098/rsfs.2014.0040. PMC 4142018. PMID 25285199. Importantly, physical exercise can improve growth factor signalling directly or indirectly by reducing pro-inflammatory signalling [33]. Exercise-induced increases in brain monoamines (norepinephrine and serotonin) may also contribute to increased expression of hippocampal BDNF [194]. In addition, other growth factors—insulin-like growth factor-1 (IGF-1) and vascular endothelial growth factor—have been shown to play an important role in BDNF-induced effects on neuroplasticity [33,172,190,192], as well as exerting neuroprotective effects of their own [33,214,215], thereby contributing to the beneficial effects of exercise on brain health.
Choose 10 different exercises - For cardio, focus on exercises with different levels of intensity. For example, you might alternate a high-intensity exercise (such as jumping jacks or burpees) with an easier move (such as marching in place). For strength training, choose compound exercises such as squats, lunges, pushups and dips to work the entire body. Exercise ideas: Step by Step Cardio Exercises, Step by Step Body Weight Exercises
In summary, if you're only interested in a basic understanding of HIT methodology and where much of it originated I would suggest starting with a far less technical book. I suggest starting with the last published edition of Ellington Darden's "The Nautilus Book" and perhaps "Total Fitness: The Nautilus Way". If you like what you read and want to dig a little deeper into the evolution of HIT read Darden's more recent book, "The New High Intensity Training: The Best Muscle-Building System You've Never Tried". If the gears in your head are in high gear after that and you really want to get DEEP into what evolved from the original Nautilus protocol _then_ you go for "Superslow" or preferably "The Renaissance of Exercise: A Vitruvian Adventure Volume 1". When your grasp of all the aforementioned material is truly solid then move on to Doug McGuff's writing. McGuff's ideas do not surpass or supplant Hutchins' but rather sharpen the points with brilliant thoughts and clinical observations from a medical physician's perspective. Doug McGuff, MD published his "Ultimate Exercise: Bulletin #1" in the late 90's and later updated that with "Body by Science: A Research Based Program to Get the Results You Want in 12 Minutes a Week", both of which are hugely valuable contributions to the literature on HIT methodology and philosophy. His article about "Stoicism in Training" is critical reading.

SOURCES: Liz Neporent, video creator; president, Wellness 360 corporate wellness consulting firm, New York. Wendy Glenna, American Council on Exercise-certified fitness instructor; physical education teacher; fitness video reviewer, Collage Video, Minneapolis, Minn. Paula Zurowski, ACE-certified personal trainer; fitness video reviewer, Richmond, Calif.

Our exercise guide video animation feature is a great benefit since it shows you exactly how to perform each exercise safely and effectively. Multiple photos are merged together into a video style demonstration which displays the movement of the exercises smoothly which gives the viewer a real-time experience of how the exercise is performed. Under each exercise video is textual content with specific instructions and advice on how to properly execute the movement. This allows you to both visually see the exercise and read important facts about things you should follow when performing the exercises.

Jump up ^ Hubal MJ, Gordish-Dressman H, Thompson PD, Price TB, Hoffman EP, Angelopoulos TJ, Gordon PM, Moyna NM, Pescatello LS, Visich PS, Zoeller RF, Seip RL, Clarkson PM; Gordish-Dressman; Thompson; Price; Hoffman; Angelopoulos; Gordon; Moyna; Pescatello; Visich; Zoeller; Seip; Clarkson (June 2005). "Variability in muscle size and strength gain after unilateral resistance training". Medicine & Science in Sports & Exercise. 37 (6): 964–972. PMID 15947721.
* Exercise isn't supposed to be fun or enjoyable (that's what recreation is for). Exercise is a means-to-an-end. It shouldn't be something you look forward to, nor should you dread doing it; it should just be part of your lifestyle... like eating or sleeping. If you DO look forward to it, and even crave it, you could be hooked on the endorphin rush you get from doing an activity that is considered by the body to be over-doing it. And since the body would rather you not do this, it would be prudent to respect the body's wishes.

The study that kicked off this whole seven-minute workout fad four years ago notes that the secret-sauce is to strategically work different major muscles groups (upper body, lower body, core) each time you do the workout. This allows for one major muscle group to rest while you work the next muscle group, resulting in a super-efficient, super-effective routine.

Stretching helps maintain flexibility. We often overlook that in youth, when our muscles are healthier. But aging leads to a loss of flexibility in the muscles and tendons. Muscles shorten and don't function properly. That increases the risk for muscle cramps and pain, muscle damage, strains, joint pain, and falling, and it also makes it tough to get through daily activities, such as bending down to tie your shoes.
To try it, choose a medium-heavy weight (50 percent to 70 percent of your one-rep-max, or 1RM, if you know it). Lift it with as much velocity as you can muster, then lower it with control. For instance, if you are bench pressing, the push up will feel almost as though you are punching the weight up into the ceiling. Once you have completed the lift, slowly lower the weight to your chest. You can apply this technique using a variety of implements, including dumbbells, barbells, weight machines, elastic bands, and body weight, he explains.
Jump up ^ Rao AK, Chou A, Bursley B, Smulofsky J, Jezequel J (January 2014). "Systematic review of the effects of exercise on activities of daily living in people with Alzheimer's disease". Am J Occup Ther. 68 (1): 50–56. doi:10.5014/ajot.2014.009035. PMC 5360200. PMID 24367955. Alzheimer’s disease (AD) is a progressive neurological disorder characterized by loss in cognitive function, abnormal behavior, and decreased ability to perform basic activities of daily living [(ADLs)] ... All studies included people with AD who completed an exercise program consisting of aerobic, strength, or balance training or any combination of the three. The length of the exercise programs varied from 12 weeks to 12 months. ... Six studies involving 446 participants tested the effect of exercise on ADL performance ... exercise had a large and significant effect on ADL performance (z = 4.07, p < .0001; average effect size = 0.80). ... These positive effects were apparent with programs ranging in length from 12 wk (Santana-Sosa et al., 2008; Teri et al., 2003) and intermediate length of 16 wk (Roach et al., 2011; Vreugdenhil et al., 2012) to 6 mo (Venturelli et al., 2011) and 12 mo (Rolland et al., 2007). Furthermore, the positive effects of a 3-mo intervention lasted 24 mo (Teri et al., 2003). ... No adverse effects of exercise on ADL performance were noted. ... The study with the largest effect size implemented a walking and aerobic program of only 30 min four times a week (Venturelli et al., 2011).
The split jerk is a very powerful and fast move. HOW TO DO IT: The bar starts in the front rack position with your feet hip-width apart. Take a big breath to tighten your core, then dip straight down just a few inches to get more power. Next, drive the bar up overhead while splitting your legs into a lunge position. The goal is to get under the bar as fast as possible while driving the bar up overhead. MUSCLES USED: Glutes, quads, hamstrings, calves, core, shoulders, back and triceps.
Degenhardt B [Internet]. Once upon a time: the evolution of Pilates mat work. 2012 Nov 21 [cited 2015 Aug 30]. Available from:  Pilates swiftly gained prominence with dancers and celebrities, which led to his notoriety as a New York City exercise personality. In 1932, Pilates taught Contrology exercises at the mythological Jacob’s Pillow Dance Festival as he did every summer until 1951.42,43 Degenhardt B [Internet]. Once upon a time: the evolution of Pilates mat work. 2012 Nov 21 [cited 2015 Aug 30]. Available from:
Lauren Duhamel, a trainer for modelFIT says doing 30 seconds of sumo squats will transform the glutes and inner thighs. “Take a wide stance with your feet turned out instead of facing straight forward. Keep all your weight on your heels and slowly bend your knees and sit your booty back and down,” she explains. “Then, press back up without locking out your knees. Do ten of these then hold in a low squat for ten seconds.”
Perception of effort, defined as “the conscious sensation of how hard, heavy, and strenuous exercise is” [23, 24], was measured during the incremental test (at the end of each minute) and during the time to exhaustion tests (at the end of the warm-up and every 30 s) using the 15 points RPE scale (Borg 1998). Standardized instructions for the scale were given to each subject before the warm-up. Briefly, subjects were asked to rate how hard they were driving their leg during the exercise (leg RPE [8, 24, 25]). Subjects were also asked to not use this rating as an expression of leg muscle pain (i.e., the intensity of hurt that a subject feels in his quadriceps muscles only).
All three workout methods provide physical and mental benefits. In fact, the Centers for Disease Control and Prevention (CDC), reports that engaging in aerobic and/or muscle-strengthening activities 3 to 5 times a week for 30 to 60 minutes improves your physical health, mental health and mood. It serves to improve sleep, reduce stress and improve your overall sense of well-being. Exercising regularly can help you live a healthier, happier life.

The mental benefits of Pilates include an increase in the ability to focus. It takes a great deal of concentration to coordinate your breath and body position during workouts. In fact, Joseph Pilates often referred to his method as “the thinking man’s exercise” due to the improvement in memory and other cognitive functions that results from doing it. A clear mind also reduces stress levels, which translates to an improvement in your overall health.
Your muscles perform several functions during isotonic exercise. They push, pull, bend and straighten. For instance, when you bend your arm at the elbow to perform a bicep curl, you flex your bicep. When you unbend your arm at the elbow to perform a triceps kickback, you extend your triceps. When you lie on your back and push a weight up from your chest, you extend your pectoral muscles. When you perform a pull up, you flex your back muscles. Muscles that perform opposite functions of the same region (such as biceps and triceps flexing and extending the arm) are called complimentary muscle groups. When performing isotonic exercises, it is important to balance exercises between complimentary muscle groups in order to prevent injury and develop balanced strength throughout your body.
Did you know that there are actually four types of exercise, all of which serve varied purposes? Everyone knows that routine exercise is very important for healthy adults for varied functions, including bone and muscle strength, weight-loss or weight maintenance, heart health and even cognitive health. But there are four different types of exercise: Aerobic (or endurance), strength, flexibility and balance.
If you notice words like high intensity, fat blasting, sweat producing and similar phrases, you can almost guarantee that the video is for intermediates at the very least and probably more suited for advanced users. The reason you want to start off slow is so you don’t get burned out the very first time you struggle through it. This doesn’t mean don’t challenge yourself, it just means start off with something you can have success in finishing and build on that success.
If sit-ups give you a sore neck, try this alternative. Lie flat with the end of a resistance band or towel tucked under the center of your back. Bend your knees and grab the other end of the band above your head. Inhale and use your ab muscles to slowly peel your body up, letting your head rest against the band. Exhale and return to the starting position. Do five reps, making sure your abs do all the work.
So what's so special about tendon problems and eccentric exercise? It seems that eccentric exercise seems to be helpful to injured tendons. Why? Researchers still do not know why this type of exercise is special. Still, if you have a tendon injury, like Achilees tendonitis, your physical therapist may have you perform eccentric exercises to help treat your condition.
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Flexibility is a factor in yoga, but it is not a necessary for beginner classes. Continued practice over time will increase your agility and flexibility. You can see positive results over time even if you only attend an hour a week, but attending classes around 2-3 times per week will help you experience the most benefits. Yoga classes usually last around an hour from warm-up to cool down.

Pull-ups have become the quintessential move to any CrossFit workout. HOW TO DO IT: To complete a pull-up, start by hanging from a secured bar with your hands in an overhand grip (palm pointing outward, away from your body) and slightly wider than shoulder-width apart. While squeezing your traps together and engaging your abs, pull yourself up to the bar so that your chin passes over. MUSCLES USED: Back, core, shoulders and chest.

If there’s one travel-friendly workout tool, it’s the resistance band. Not only does it weigh next to nothing and take up little room in your bag, it’s also super versatile. And if you’re a fan of our full-body resistance band workout, you’ll definitely dig this free workout video. It combines strength movements, like rear lunges with a rotation, with heart rate-boosting exercises for a routine that’ll challenge your entire body.

Your body clock, that is. Try to work out at the time you have the most energy, suggests Jason Theodosakis, MD, exercise physiologist at the University of Arizona College of Medicine. If you're a morning person, schedule your fitness activities early in the day; if you perk up as the day goes along, plan your activities in the afternoon or evening.
It's important to note that you can spread your activity into intervals as short as 10 minutes. So if you have a very busy schedule, even doing three, 10-minute aerobic exercises per day, five days per week, will be sufficient. To get you started, here are the different types of exercise, how they benefit the body and what kind of activities they entail:
Although there is evidence of Pilates teaching standing exercises at Jacob’s Pillow,48 YouTube [Internet]. Difusión de Pilates. Joseph Pilates holistic video (1932). 2014 Dec 14 [cited 2015 Aug 30]. Available from: [Google Scholar] he excluded standing exercises from his 34 exercise Contrology home routine, in contrast to the documented repertoires of Checkley,9 Checkley E. A natural method of physical training. New York (NY): William C. Bryant & Co.; 1890. [Google Scholar] Müller,15 Müller JP. My system. London: Link House; 1904. [Google Scholar] Randell,25 Randell M. Training for childbirth from a mother's point of view. 4th ed. London: J. & A. Churchill Ltd.; 1949. [Google Scholar] Vaughan,47 Youtube [Internet]. Vaughan, K. Childbirth as an athletic feat (1939). 2009 Feb 23 [cited 2015 Aug 30]. Available from: [Google Scholar] and Morris33 Morris M. Basic physical training. London: Heinemann; 1937. [Google Scholar] that were dominated by standing exercises. He explained: ‘Note that all the exercises are performed while you are in a sitting or reclining position. This is done to relieve your heart from undue strain as well as to take advantage of the more normal (original) visceral organs.’46 Pilates J, Miller WJ. Return to life through Contrology. Nevada: Presentation Dynamics; 1945. [Google Scholar]
I love this DVD because it's basically the equivalent of seven DVDs in one — offering seven different 20-minute yoga practices to mix and match. I liked the freedom of being able to do a different one each day or combine two when I wanted to do a longer session. The flows range from slow-paced for relaxation to more intense for an energizing practice.
Video Abstract for the ESSR 46.3 article “The Microvasculature and Skeletal Muscle Healthin Aging” from authors Rian Q. Landers-Ramos and Steven J. Prior. Aging and aging-related declines in physical activity are associated with physical and metabolic impairments. Skeletal muscle capillarization is reduced in sedentary older adults, may contribute to impairments in skeletal muscle, and is modifiable by exercise training. This article examines the hypothesis that preservation of skeletal muscle capillarization is essential to maintain metabolism, fitness, and function with aging.
Continuous aerobic exercise can induce a transient state of euphoria, colloquially known as a "runner's high" in distance running or a "rower's high" in crew, through the increased biosynthesis of at least three euphoriant neurochemicals: anandamide (an endocannabinoid),[73] β-endorphin (an endogenous opioid),[74] and phenethylamine (a trace amine and amphetamine analog).[75][76][77]
The severity of angina and the effects of therapeutic interventions in patients with coronary artery disease have been assessed by determining changes in both exercise performance and the triple product (TP) of heart rate, systolic pressure, and ejection time occurring at angina. However, the validity of conclusions based on such changes is uncertain since the effects of different exercise protocols on these variables have not been determined. Twelve patients with angina were studied during upright bicycle exercise; repeated bouts of exercise using a standard protocol of 20-w increments every three minutes produced no consistent changes in TP at angina. When exercise began 20 to 60 w above the work load of the standard protocol that produced angina, exercise capacity was reduced (average 1'40'' vs. 4'40'', P < 0.001), and triple product at angina exceeded control anginal values (average 4,840 vs. 4,150, P < 0.001). In the control studies nitroglycerin (TNG) and carotid sinus nerve stimulation (CSNS) enabled patients to exercise to a higher level, although the triple product at angina was unaltered. However, at the higher work load TNG and CSNS exerted only minimal effects on exercise capacity, indicating that if the work load is excessive, a reduction in myocardial oxygen consumption produced by a therapeutic intervention may be comparatively minor so that a potentially salutary effect would be masked. We conclude that work loads causing angina in less than three minutes cannot reliably be used for studying the effects of therapy. However, if progressive work loads are chosen which cause angina in the control studies in three to six minutes, exercise capacity and triple product at angina provide important information about the efficacy and mechanism of action of a therapeutic intervention.