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Exercise Physiology of Normal Development, Sex Differences, and Aging

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Abstract

The scientific study of human development has evolved from studies of children to studies of the full lifespan. Many physiological changes occur throughout the lifespan and unique changes occur during normal development compared to healthy aging. An enlarging body of data supports the idea that there exist critical periods of development during which physiological perturbations to the internal milieu (e.g., disease or physical activity) can alter the overall programming of developmental processes. Although different physiological functions decline with age with widely varying rates, the aging changes accumulated throughout the physiological systems reduce the capacity to cope with the stress and maintain homeostasis. The understanding of this process of development and aging is complicated by important physiologic sex differences with regard to nearly all physiological systems. Regular physical activity can favorably modulate this developmental and aging process and can have important health benefits. However, a physically inactive lifestyle can markedly impair normal development and lead to numerous diseases. Life‐long physical activity is essential for preserving or delaying the onset of functional disability and chronic cardiovascular and metabolic diseases. © 2011 American Physiological Society. Compr Physiol 1:1649‐1678, 2011.

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Figure 1. Figure 1.

Bone mineral density (BMD) as a function of DXA‐derived measurements of whole‐body lean tissue in 102 prematurely born babies. BMD was significantly correlated to lean tissue (n = 102, r = 0.80, P < 0.001). These data support the notion of a “bone‐muscle” unit in which a synergistic response to factors like physical activity stimulates growth of both tissues. Data from Eliakim et al. .

Figure 2. Figure 2.

Effect of 10 days of increased physical activity on muscle mass and myofibrillar protein at day 65 of life in male rats. These variables were increased significantly only in the rats that had been exercised early in life. Data from Bodell et al. .

Figure 3. Figure 3.

Cross‐sectional relationships between thigh muscle volume and mean overnight growth hormone concentrations (r = 0.35; P < 0.05; top panel), growth hormone‐binding protein (GHBP) (r = 0.39; P < 0.04; middle panel), and circulating insulin‐like growth factor‐I (IGF‐I) (r = 0.50; P < 0.008; bottom panel). Data from Eliakim et al. .

Figure 4. Figure 4.

The inverse relationship between growth mediators (IGF‐I and GHBP) and indicators of inflammation (IL‐6 and IL‐1ra) in healthy, growing, inpatient premature babies. This study shows the remarkable association between the increase in weight and IGF‐I and the decrease in IL‐6 over a 6‐week period (*P < 0.001) in 51 prematurely born infants (all data mean ± SEM). In addition, GHBP increased significantly (**P < 0.05) and IL‐1ra decreased over the same period suggesting increased GH receptivity and reduced inflammation as the infants grew. We have also demonstrated in both premature babies and in adolescents a positive correlation between IGF‐I and lean body mass.

Figure 5. Figure 5.

Comparison of the effect of exercise on peripheral blood mononuclear cell (PBMC) genes in early‐ and late‐pubertal girls, showing the relative magnitude of the effect (circles) and the size of the overlap (shaded area). There were 622 PBMC genes that were significantly altered by exercise in both groups. Additional studies are required to determine whether or not the gene expression patterns represent true maturational differences in the exercise response.

Figure 6. Figure 6.

Profiles of estimated children's o2 during 10‐min periods. The data were derived from direct observations of children. The solid line represents the anaerobic or lactate threshold (LAT). (A) Profile of a girl's o2 during a representative 10‐min period of relatively low activity. (B) Profile of a girl's o2 during a representative 10‐min period of relatively moderate activity; 5% of observations are above LAT. (C) Profile of a boy's o2 during a 10‐min period of relatively intense activity; 26.5% of observations are above LAT.

Figure 7. Figure 7.

Comparison of weight, thigh muscle volume, and o2 peak in prepubertal and late‐adolescent girls. Although thigh muscle volume was significantly greater in the adolescent girls, the increase was not nearly as great as the increase in weight. Consequently, thigh muscle volume per weight was much lower in the adolescent girls. Neither o2peak nor o2peak normalized to muscle was significantly different between the two groups. Consequently, o2peak per kilogram body mass was significantly smaller in the adolescent girls. Significant difference, prepubertal versus adolescent girls, *P < 0.0001, **P < 0.05. Data from Eliakim et al. .

Figure 8. Figure 8.

O2 uptake response to 1‐min of high‐intensity exercise (125% of the maximal work rate) in an 8‐year‐old girl. Shown also is best‐fit single exponential as described in text. Vertical line indicates end of 60‐s exercise. Area under o2 curve from time 0 to end of 10‐min recovery period [mean baseline values (‐ – ‐) were subtracted] is used to calculate cumulative O2 cost of exercise. Area to right of vertical line to end of recovery (again, mean baseline values were subtracted) represents O2 cost for recovery period.

Figure 9. Figure 9.

Average o2 response to an increase in work rate at time 0 s in healthy controls and patients with cystic fibrosis. There was a significant difference in the time course of o2 between the groups.

Figure 10. Figure 10.

HR and o2 recovery times for control and Fontan group subjects. In control subjects, recovery times were longer after the higher work rate protocols (*P < 0.05). In Fontan group subjects, recovery times were prolonged compared with the same absolute (2 W/kg) and relative (3.5 W/kg) protocols in control subjects (**P < 0.001).

Figure 11. Figure 11.

Lactate production from 10, 2‐min bouts of high‐intensity exercise in early and late pubertal boys. Consistent with previous studies, lactate production is lower in younger children.

Figure 12. Figure 12.

co2 responses (above baseline 0‐W pedaling) to a 1‐min burst exercise in children and adults. The data are normalized to body weight and can be distinguished in order of work intensity because as the work intensity increases, the co2 response is progressively larger [i.e., 50% AT, 80% AT, 50%Δ (the difference between the work rate at the anaerobic or lactate threshold and max), 100% max, 125% max (in children the 50% AT exercise was excluded from the study)]. Note the generally faster recovery in children. Similar results, not shown, were observed for e responses. Data from Armon et al. .

Figure 13. Figure 13.

Recovery time constants (τ) for co2 (left panel) and e (right panel). Data are presented as mean ± SD. The recovery times were significantly shorter in children compared with adults. In adults, τ co2 increased with increasing work intensity from 50% AT to 80% AT (P < 0.01) and from 80% AT to 50% Δ. (P < 0.05), and for above‐AT exercise the co2 time constant at 50% Δ was significantly lower than 125% max. Note significantly shorter τ co2 than τ e in the high‐intensity range for adults (P < 0.001). In children, no significant differences were found between τ co2 and τ e. Data from Armon et al. .

Figure 14. Figure 14.

An overview of key discoveries in maturational determinants of substrate utilization during exercise in children. Figure from Riddell .

Figure 15. Figure 15.

Cumulative O2 cost per joule at different work intensities in adults and children determined from 1 min of constant work rate cycle ergometer exercise. Values are means ± SEM. Cumulative O2 cost was not affected by increasing work intensity in children and adults. However, cost was significantly higher in children than in adults at 50%Δ (i.e., 50% of the difference between the anaerobic threshold and peak o2) (*P < 0.001), 100% max, and 125% max (**P < 0.01) was used for the statistical analysis of work. Data from Zanconato et al. .

Figure 16. Figure 16.

31P‐MRS spectra from right calf of an 8‐year‐old boy at rest, during incremental exercise, and recovery. Data from Zanconato et al. .

Figure 17. Figure 17.

Effect of exercise on intramuscular increase in Pi/PCr (Panel A) and decrease in pH (Panel B) in children and adults. Exercise leads to significantly (*P < 0.05) smaller changes in ATP‐related kinetics, consistent with lower lactates observed during heavy exercise in children. Data adapted from Zanconato et al. .

Figure 18. Figure 18.

Response to progressive exercise, showing group mean tidal flow‐volume loops for less‐fit (n = 15; A) and highly fit women (n = 14; B) at rest and during light (55% o2max), moderate (74% o2max), heavy [90% o2max, near‐maximal (96% V o2max)], and maximal exercise plotted relative to group mean maximal voluntary flow volume loop. emax, maximal ventilation. Flow limitation is present when expiratory tidal flow‐volume loop intersects boundary of volitional maximal flow‐volume loop. Data are from McClaran et al. .

Figure 19. Figure 19.

Gender differences in arterial blood gases during exercise at 90% to 100% of o2max. Closed symbols are data from women and open symbols are data from men. Circles are cycle data and squares are running data. Faint dotted line represents level at which impairment is suggested to occur (see text for details). The A‐ado2 (A) is increased and the Pao2 (B) is less in women compared to men at any level of o2. However, alveolar ventilation is not reduced in women compared to men, as the Paco2 if anything, is lower in women at any given o2. Data from Dempsey et al. ; Harms et al. ; Hopkins et al. ; Olfert et al. .

Figure 20. Figure 20.

Life expectancy at birth (Sweden). Life expectancy at birth has increased remarkably over the past 200 years, contributing to the ever‐increasing population of the elderly. Data from the Human Mortality Database, University of California, Berkeley (USA), and Max Planck Institute for Demographic Research (Germany). Available at www.mortality.org. .

Figure 21. Figure 21.

Age‐associated reductions in physical fitness. There are substantial differences in the age‐related rates of declines in physical fitness components that are routinely measured in exercise physiology. Data from Einkauf et al. , Tanaka et al. , Duncan et al. , and Lindle et al. .

Figure 22. Figure 22.

Maximal oxygen consumption and age in three groups separated by their activity status. Rate of decline was smallest in sedentary women and greatest in endurance‐trained women. Data from FitzGerald et al. .

Figure 23. Figure 23.

Age‐related differences in carotid artery intima‐media thickness (IMT) in sedentary and endurance‐trained adults. In both sedentary and endurance‐trained groups, carotid IMT and IMT/lumen ratio were progressively higher in the young, middle‐aged, and older men. There were no statistically significant differences between sedentary and endurance‐trained men at any age. *P < 0.05 versus young. P < 0.05 versus middle. Data from Tanaka et al. .



Figure 1.

Bone mineral density (BMD) as a function of DXA‐derived measurements of whole‐body lean tissue in 102 prematurely born babies. BMD was significantly correlated to lean tissue (n = 102, r = 0.80, P < 0.001). These data support the notion of a “bone‐muscle” unit in which a synergistic response to factors like physical activity stimulates growth of both tissues. Data from Eliakim et al. .



Figure 2.

Effect of 10 days of increased physical activity on muscle mass and myofibrillar protein at day 65 of life in male rats. These variables were increased significantly only in the rats that had been exercised early in life. Data from Bodell et al. .



Figure 3.

Cross‐sectional relationships between thigh muscle volume and mean overnight growth hormone concentrations (r = 0.35; P < 0.05; top panel), growth hormone‐binding protein (GHBP) (r = 0.39; P < 0.04; middle panel), and circulating insulin‐like growth factor‐I (IGF‐I) (r = 0.50; P < 0.008; bottom panel). Data from Eliakim et al. .



Figure 4.

The inverse relationship between growth mediators (IGF‐I and GHBP) and indicators of inflammation (IL‐6 and IL‐1ra) in healthy, growing, inpatient premature babies. This study shows the remarkable association between the increase in weight and IGF‐I and the decrease in IL‐6 over a 6‐week period (*P < 0.001) in 51 prematurely born infants (all data mean ± SEM). In addition, GHBP increased significantly (**P < 0.05) and IL‐1ra decreased over the same period suggesting increased GH receptivity and reduced inflammation as the infants grew. We have also demonstrated in both premature babies and in adolescents a positive correlation between IGF‐I and lean body mass.



Figure 5.

Comparison of the effect of exercise on peripheral blood mononuclear cell (PBMC) genes in early‐ and late‐pubertal girls, showing the relative magnitude of the effect (circles) and the size of the overlap (shaded area). There were 622 PBMC genes that were significantly altered by exercise in both groups. Additional studies are required to determine whether or not the gene expression patterns represent true maturational differences in the exercise response.



Figure 6.

Profiles of estimated children's o2 during 10‐min periods. The data were derived from direct observations of children. The solid line represents the anaerobic or lactate threshold (LAT). (A) Profile of a girl's o2 during a representative 10‐min period of relatively low activity. (B) Profile of a girl's o2 during a representative 10‐min period of relatively moderate activity; 5% of observations are above LAT. (C) Profile of a boy's o2 during a 10‐min period of relatively intense activity; 26.5% of observations are above LAT.



Figure 7.

Comparison of weight, thigh muscle volume, and o2 peak in prepubertal and late‐adolescent girls. Although thigh muscle volume was significantly greater in the adolescent girls, the increase was not nearly as great as the increase in weight. Consequently, thigh muscle volume per weight was much lower in the adolescent girls. Neither o2peak nor o2peak normalized to muscle was significantly different between the two groups. Consequently, o2peak per kilogram body mass was significantly smaller in the adolescent girls. Significant difference, prepubertal versus adolescent girls, *P < 0.0001, **P < 0.05. Data from Eliakim et al. .



Figure 8.

O2 uptake response to 1‐min of high‐intensity exercise (125% of the maximal work rate) in an 8‐year‐old girl. Shown also is best‐fit single exponential as described in text. Vertical line indicates end of 60‐s exercise. Area under o2 curve from time 0 to end of 10‐min recovery period [mean baseline values (‐ – ‐) were subtracted] is used to calculate cumulative O2 cost of exercise. Area to right of vertical line to end of recovery (again, mean baseline values were subtracted) represents O2 cost for recovery period.



Figure 9.

Average o2 response to an increase in work rate at time 0 s in healthy controls and patients with cystic fibrosis. There was a significant difference in the time course of o2 between the groups.



Figure 10.

HR and o2 recovery times for control and Fontan group subjects. In control subjects, recovery times were longer after the higher work rate protocols (*P < 0.05). In Fontan group subjects, recovery times were prolonged compared with the same absolute (2 W/kg) and relative (3.5 W/kg) protocols in control subjects (**P < 0.001).



Figure 11.

Lactate production from 10, 2‐min bouts of high‐intensity exercise in early and late pubertal boys. Consistent with previous studies, lactate production is lower in younger children.



Figure 12.

co2 responses (above baseline 0‐W pedaling) to a 1‐min burst exercise in children and adults. The data are normalized to body weight and can be distinguished in order of work intensity because as the work intensity increases, the co2 response is progressively larger [i.e., 50% AT, 80% AT, 50%Δ (the difference between the work rate at the anaerobic or lactate threshold and max), 100% max, 125% max (in children the 50% AT exercise was excluded from the study)]. Note the generally faster recovery in children. Similar results, not shown, were observed for e responses. Data from Armon et al. .



Figure 13.

Recovery time constants (τ) for co2 (left panel) and e (right panel). Data are presented as mean ± SD. The recovery times were significantly shorter in children compared with adults. In adults, τ co2 increased with increasing work intensity from 50% AT to 80% AT (P < 0.01) and from 80% AT to 50% Δ. (P < 0.05), and for above‐AT exercise the co2 time constant at 50% Δ was significantly lower than 125% max. Note significantly shorter τ co2 than τ e in the high‐intensity range for adults (P < 0.001). In children, no significant differences were found between τ co2 and τ e. Data from Armon et al. .



Figure 14.

An overview of key discoveries in maturational determinants of substrate utilization during exercise in children. Figure from Riddell .



Figure 15.

Cumulative O2 cost per joule at different work intensities in adults and children determined from 1 min of constant work rate cycle ergometer exercise. Values are means ± SEM. Cumulative O2 cost was not affected by increasing work intensity in children and adults. However, cost was significantly higher in children than in adults at 50%Δ (i.e., 50% of the difference between the anaerobic threshold and peak o2) (*P < 0.001), 100% max, and 125% max (**P < 0.01) was used for the statistical analysis of work. Data from Zanconato et al. .



Figure 16.

31P‐MRS spectra from right calf of an 8‐year‐old boy at rest, during incremental exercise, and recovery. Data from Zanconato et al. .



Figure 17.

Effect of exercise on intramuscular increase in Pi/PCr (Panel A) and decrease in pH (Panel B) in children and adults. Exercise leads to significantly (*P < 0.05) smaller changes in ATP‐related kinetics, consistent with lower lactates observed during heavy exercise in children. Data adapted from Zanconato et al. .



Figure 18.

Response to progressive exercise, showing group mean tidal flow‐volume loops for less‐fit (n = 15; A) and highly fit women (n = 14; B) at rest and during light (55% o2max), moderate (74% o2max), heavy [90% o2max, near‐maximal (96% V o2max)], and maximal exercise plotted relative to group mean maximal voluntary flow volume loop. emax, maximal ventilation. Flow limitation is present when expiratory tidal flow‐volume loop intersects boundary of volitional maximal flow‐volume loop. Data are from McClaran et al. .



Figure 19.

Gender differences in arterial blood gases during exercise at 90% to 100% of o2max. Closed symbols are data from women and open symbols are data from men. Circles are cycle data and squares are running data. Faint dotted line represents level at which impairment is suggested to occur (see text for details). The A‐ado2 (A) is increased and the Pao2 (B) is less in women compared to men at any level of o2. However, alveolar ventilation is not reduced in women compared to men, as the Paco2 if anything, is lower in women at any given o2. Data from Dempsey et al. ; Harms et al. ; Hopkins et al. ; Olfert et al. .



Figure 20.

Life expectancy at birth (Sweden). Life expectancy at birth has increased remarkably over the past 200 years, contributing to the ever‐increasing population of the elderly. Data from the Human Mortality Database, University of California, Berkeley (USA), and Max Planck Institute for Demographic Research (Germany). Available at www.mortality.org. .



Figure 21.

Age‐associated reductions in physical fitness. There are substantial differences in the age‐related rates of declines in physical fitness components that are routinely measured in exercise physiology. Data from Einkauf et al. , Tanaka et al. , Duncan et al. , and Lindle et al. .



Figure 22.

Maximal oxygen consumption and age in three groups separated by their activity status. Rate of decline was smallest in sedentary women and greatest in endurance‐trained women. Data from FitzGerald et al. .



Figure 23.

Age‐related differences in carotid artery intima‐media thickness (IMT) in sedentary and endurance‐trained adults. In both sedentary and endurance‐trained groups, carotid IMT and IMT/lumen ratio were progressively higher in the young, middle‐aged, and older men. There were no statistically significant differences between sedentary and endurance‐trained men at any age. *P < 0.05 versus young. P < 0.05 versus middle. Data from Tanaka et al. .

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Further Reading

Borer KT.  The effects of exercise on growth.  Sports Med. 20(6): 375-97, 1995.

Heckman GA, McKelvie RS.  Cardiovascular aging and exercise in healthy older adults.  Clin J Sport Med. 18(6): 479-85, 2008.

Koch DW, Newcomer SC, Proctor DN.  Blood flow to exercising limbs varies with age, gender, and training status.  Can J Appl Physiol. 30(5): 554-75, 2005.

Motl RW, McAuley E.  Physical activity, disability, and quality of life in older adults.  Phys Med Rehabil Clin N Am. 21(2): 299-308, 2010.


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Craig A. Harms, Dan Cooper, Hirofumi Tanaka. Exercise Physiology of Normal Development, Sex Differences, and Aging. Compr Physiol 2011, 1: 1649-1678. doi: 10.1002/cphy.c100065