اثر تمرین همزمان استقامتی پایین تنه و مقاومتی بالاتنه بر CRP، نیمرخ لیپیدی خون و عملکرد استقامتی و مقاومتی دختران دارای اضافه وزن و چاق
محورهای موضوعی : فعالیت بدنی و تندرستی
خالید محمدزاده سلامت
1
(گروه تربیت بدنی، واحد سنندج، دانشگاه آزاد اسلامی، سنندج، ایران.)
پریسا مکری بابامیری
2
(گروه تربیت بدنی، واحد سنندج، دانشگاه آزاد اسلامی، سنندج، ایران)
کلید واژه: نیمرخ لیپیدی, توان هوازی, تمرین همزمان, التهاب سیستمی,
چکیده مقاله :
هدف از این تحقیق بررسی تاثیر دوازده هفته تمرین استقامتی پایین تنه(LBET، 40 دقیقه رکاب زدن بر چرخ کارسنج)، تمرین مقاومتی بالاتنه(UBRT، 40 تمرین وزنه اندام فوقانی)، تمرین همزمان(CERT، 20 تمرین استقامتی پایین تنه + تمرین مقاومتی بالاتنه) و کنترل (C، بدون تمرین) بر پروتئین واکنشگر-C(CRP)، لیپیدهای سرم، VO2max و حداکثر قدرت حرکات پرس پا (LP) و پرس سینه (CP) بر دختران دارای اضافه وزن و چاق بود. چهل و هشت دختر دارای اضافه وزن و چاق ( kg/m225> BMI) به طور تصادفی در چهار گروه 12 نفری تقسیم شدند. اندازه گیری متغیرها قبل از شروع تمرین و 24 ساعت پس از آخرین جلسه تمرین انجام شد. نتایج نشان داد اختلاف معنی داری نیز در CRP (001/0P=)، LDL-C (014/0P=)، کلسترول (001/0P=) و VO2max (001/0P=)، بین گروه های LBET و UBRT و CRP (031/0P=) و پرس پا(008/0P=)، بین گروه های LBET و UBRT مشاهده گردید. به هر حال، تفاوت بین گروهی معنی داری در مورد HDL-C و TG مشاهده نشد(05/0P>). پس از تمرین کاهش معنی داری در غلظت LDL-C و TG در هر سه گروه تمرین و CRP، HDL-C، VO2max، CP و کلسترول در گروه های LBET و CERT مشاهده شد(05/0P<). همچنین، افزایش معنی داری در حداکثر قدرت CP در گروه های UBRT و CERT دیده شد. بنابراین، می توان نتیجه گرفت انجام تمرین همزمان با اختصاص نصف مدت زمان تمرینی هر یک از تمرینات LBET و UBRT موجب بهبود التهاب، نیمرخ لیپیدی و عملکرد استقامتی و مقاومتی دختران دارای اضافه وزن و چاق می شود.
This study investigated the effect of 12weeks of lower body endurance training (LBET, 40 min endurance training on ergometer), upper body resistance training (UBRT, 40 min upper body resistance training), concurrent endurance and resistance training (CERT, 20 min lower body endurance + upper body resistance training) and control (C, no training) on CRP, serum lipids and lipoproteins, VO2max, and maximum strength of leg pressures (LP) and chest press (CP) in overweight girls. Forty-eight overweight and obese girls (BMI> 25 kg / m2) were randomly divided into four equally numbers groups. Measurements were performed before the beginning of the training and 24 hours after the last training session. The results showed a significant difference in CRP (P = 0.001), LDL-C (P = 0.014), cholesterol (P = 0.001) and VO2max (P = 0.001) between LBET and UBRT and also in CRP groups (P = 0.031) and LP (P = 0.008) between LBET and UBRT groups. However, there was no significant difference in HDL-C and TG between groups (P> 0.05). After the training, there was a significant decrease in LDL-C and TG concentrations in all intervention groups and CRP, HDL-C, VO2max, CP and cholesterol in LBET and CERT groups (P <0.05). Also, there was a significant increase in CP in UBRT and CERT groups. Therefore, it can be concluded that doing concurrent training with the allocation of half the duration of each of LBET and UBRT interventions, improves the inflammation, lipid profiles, and endurance and resistance performance of overweight and obese girls.
Albuquerque Filho, N. J. B., Mendes, G., Rebouças, V. A. F. M., de Mello, C. C., Salgueiro, M. I. K., & de Medeiros, H. J. (2014). Effect of concurrent training on body composition and lipid profile in overweight adolescents. Journal of Exercise Physiologyonline, 17(6): 34-44.
Annibalini, G., Lucertini, F., Agostini, D., Vallorani, L., Gioacchini, A., Barbieri, E., ... & Stocchi, V. (2017). Concurrent aerobic and resistance training has anti-inflammatory effects and increases both plasma and leukocyte levels of IGF-1 in late middle-aged type 2 diabetic patients. Oxidative medicine and cellular longevity, 2017: 10.
Bharath, L. P., Choi, W. W., Cho, J. M., Skobodzinski, A. A., Wong, A., Sweeney, T. E., & Park, S. Y. (2018). Combined resistance and aerobic exercise training reduces insulin resistance and central adiposity in adolescent girls who are obese: randomized clinical trial. European journal of applied physiology, 118(8), 1653-1660.
Brzycki, M. (1993). Strength testing-predicting a one-rep max from reps-to-fatigue. Journal of physical education, recreation & dance, 64(1), 88-90.
Colato, A., Abreu, F., Medeiros, N., Lemos, L., Dorneles, G., Ramis, T., ... & Peres, A. (2014). Effects of concurrent training on inflammatory markers and expression of CD4, CD8, and HLA-DR in overweight and obese adults. Journal of exercise science & fitness, 12(2), 55-61.
Dohoney, P. A. U. L. A., Chromiak, J. A., Lemire, D. E. R. E. K., Abadie, B. R., & Kovacs, C. H. R. I. S. T. O. P. H. E. R. (2002). Prediction of one repetition maximum (1-RM) strength from a 4-6 RM and a 7-10 RM submaximal strength test in healthy young adult males. Journal of Exercise Physiology, 5(3), 54-9.
García-Hermoso, A., Ramírez-Vélez, R., Ramírez-Campillo, R., Peterson, M. D., & Martínez-Vizcaíno, V. (2018). Concurrent aerobic plus resistance exercise versus aerobic exercise alone to improve health outcomes in paediatric obesity: a systematic review and meta-analysis. British Journal of Sports Medicine, 52(3), 161-166.
Ghahramanloo, E., Midgley, A. W., & Bentley, D. J. (2009). The effect of concurrent training on blood lipid profile and anthropometrical characteristics of previously untrained men. Journal of physical activity & health, 6(6), 760.
Glowacki, S. P., Martin, S. E., Maurer, A. N. N., Baek, W., Green, J. S., & Crouse, S. F. (2004). Effects of resistance, endurance, and concurrent exercise on training outcomes in men. Medicine and science in sports and exercise, 36, 2119-2127.
Goh, J., Lim, C. L., & Suzuki, K. (2019). Effects of endurance-, strength-, and concurrent training on cytokines and inflammation. In Concurrent aerobic and strength training (pp. 125-138). Springer, Cham.
Gondim, O. S., Camargo, V. T. N. D., Gutierrez, F. A., Martins, P. F. D. O., Passos, M. E. P., Momesso, C. M., ... & Cury-Boaventura, M. F. (2015). Benefits of regular exercise on inflammatory and cardiovascular risk markers in normal weight, overweight and obese adults. PloS one, 10(10), e0140596.
Ichikawa, T., Machida, N., Kaneko, H., Oi, I., & Fujino, M. A. (2019). C-reactive Protein Can Predict Patients with Cirrhosis at a High Risk of Early Mortality after Acute Esophageal Variceal Bleeding. Internal Medicine, 58(4), 487-495.
Ihalainen, J. K., Schumann, M., Eklund, D., Hämäläinen, M., Moilanen, E., Paulsen, G., ... & Mero, A. A. (2018). Combined aerobic and resistance training decreases inflammation markers in healthy men. Scandinavian journal of medicine & science in sports, 28(1), 40-47.
Jackson, A. S., Pollock, M. L., & Gettman, L. R. (1978). Intertester reliability of selected skinfold and circumference measurements and percent fat estimates. Research Quarterly. American Alliance for Health, Physical Education and Recreation, 49(4), 546-551.
Jorge, M. L. M. P., de Oliveira, V. N., Resende, N. M., Paraiso, L. F., Calixto, A., Diniz, A. L. D., ... & Geloneze, B. (2011). The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus. Metabolism, 60(9), 1244-1252.
LeMura, L. M., von Duvillard, S. P., Andreacci, J., Klebez, J. M., Chelland, S. A., & Russo, J. (2000). Lipid and lipoprotein profiles, cardiovascular fitness, body composition, and diet during and after resistance, aerobic and combination training in young women. European journal of applied physiology, 82(5), 451-458.
Libardi, C. A., De Souza, G. V., Cavaglieri, C. R., Madruga, V. A., & Chacon-Mikahil, M. (2012). Effect of resistance, endurance, and concurrent training on TNF-a, IL-6, and CRP. Med Sci Sports Exerc, 44(1), 50-6.
Libardi, C. A., Souza, G. V., Gaspari, A. F., Santos, C. F. D., Leite, S. T., Dias, R., ... & Chacon-Mikahil, M. P. (2011). Effects of concurrent training on interleukin-6, tumour necrosis factor-alpha and C-reactive protein in middle-aged men. Journal of sports sciences, 29(14), 1573-1581.
Lopes, W. A., Leite, N., da Silva, L. R., Brunelli, D. T., Gáspari, A. F., Radominski, R. B., ... & Cavaglieri, C. R. (2016). Effects of 12 weeks of combined training without caloric restriction on inflammatory markers in overweight girls. Journal of sports sciences, 34(20), 1902-1912.
Marta, C., Marinho, D. A., Barbosa, T. M., Izquierdo, M., & Marques, M. C. (2013). Effects of concurrent training on explosive strength and VO2max in prepubescent children. International journal of sports medicine, 34(10), 888-896.
Mirghani, S. J., Alinejad, H. A., Azarbayjani, M. A., Mazidi, A., & Mirghani, S. A. (2014). Influence of strength, endurance and concurrent training on the lipid profile and blood testosterone and cortisol response in young male wrestlers. Baltic Journal Of Health And Physical Activity, 6(1), 1.
Monteiro, P. A., Chen, K. Y., Lira, F. S., Saraiva, B. T. C., Antunes, B. M. M., Campos, E. Z., & Freitas, I. F. (2015). Concurrent and aerobic exercise training promote similar benefits in body composition and metabolic profiles in obese adolescents. Lipids in health and disease, 14(1), 1-9.
Murlasits, Z., Kneffel, Z., & Thalib, L. (2018). The physiological effects of concurrent strength and endurance training sequence: A systematic review and meta-analysis. Journal of sports sciences, 36(11), 1212-1219.
Olson, T. P., Dengel, D. R., Leon, A. S., & Schmitz, K. H. (2007). Changes in inflammatory biomarkers following one-year of moderate resistance training in overweight women. International journal of obesity, 31(6), 996-1003.
Pozza, C., & Isidori, A. M. (2018). What’s behind the obesity epidemic. In Imaging in bariatric surgery (pp. 1-8). Springer, Cham.
Rosa, C., Vilaça-Alves, J., Fernandes, H. M., Saavedra, F. J., Pinto, R. S., & dos Reis, V. M. (2015). Order effects of combined strength and endurance training on testosterone, cortisol, growth hormone, and IGF-1 binding protein 3 in concurrently trained men. The Journal of Strength & Conditioning Research, 29(1), 74-79.
Rossi, F. E., Diniz, T. A., Fortaleza, A. C., Neves, L. M., Picolo, M. R., Monteiro, P. A., ... & Freitas Jr, I. F. (2018). Concurrent training promoted sustained anti-atherogenic benefits in the fasting plasma triacylglycerolemia of postmenopausal women at 1-year follow-up. The Journal of Strength & Conditioning Research, 32(12), 3564-3573.
Salamat, K. M., Azarbayjani, M. A., Yusof, A., & Dehghan, F. (2016). The response of pre-inflammatory cytokines factors to different exercises (endurance, resistance, concurrent) in overweight men. Alexandria Journal of Medicine, 52(4), 367-370.
Sallam, N., & Laher, I. (2016). Exercise modulates oxidative stress and inflammation in aging and cardiovascular diseases. Oxidative medicine and cellular longevity, 2016.
Schwingshackl, L., Dias, S., Strasser, B., & Hoffmann, G. (2013). Impact of different training modalities on anthropometric and metabolic characteristics in overweight/obese subjects: a systematic review and network meta-analysis. PloS one, 8(12), e82853.
Shamim, B., Devlin, B. L., Timmins, R. G., Tofari, P., Lee Dow, C., Coffey, V. G., ... & Camera, D. M. (2018). Adaptations to concurrent training in combination with high protein availability: a comparative trial in healthy, recreationally active men. Sports Medicine, 48(12), 2869-2883.
Tseng, M. L., Ho, C. C., Chen, S. C., Huang, Y. C., Lai, C. H., & Liaw, Y. P. (2013). A simple method for increasing levels of high-density lipoprotein cholesterol: a pilot study of combination aerobic-and resistance-exercise training. International journal of sport nutrition and exercise metabolism, 23(3), 271-281.
Van Gaal, L. F., Mertens, I. L., & De Block, C. E. (2006). Mechanisms linking obesity with cardiovascular disease. Nature, 444(7121), 875-880.
Verney, J., Kadi, F., Charifi, N., Féasson, L., Saafi, M. A., Castells, J., ... & Denis, C. (2008). Effects of combined lower body endurance and upper body resistance training on the satellite cell pool in elderly subjects. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine, 38(3), 1147-1154.
Verney, J., Kadi, F., Saafi, M. A., Piehl-Aulin, K., & Denis, C. (2006). Combined lower body endurance and upper body resistance training improves performance and health parameters in healthy active elderly. European journal of applied physiology, 97(3), 288-297.
Vivian Heyward, A. G. (2014). Advanced Fitness Assessment and Exercise Prescription 7th Edition With Online Video. Environments, 552.
Wadhera, R. K., Steen, D. L., Khan, I., Giugliano, R. P., & Foody, J. M. (2016). A review of low-density lipoprotein cholesterol, treatment strategies, and its impact on cardiovascular disease morbidity and mortality. Journal of clinical lipidology, 10(3), 472-489.
WHO. (2018). Obesity and overweight. from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
Wilhelm, EN., & Pinto, RS. (2019). Concurrent Aerobic and Strength Training for Body Composition and Health. Concurrent Aerobic and Strength Training: Scientific Basics and Practical Applications. M. Schumann and B. R. Rønnestad. Cham, Springer International Publishing: 293-307.
_||_Albuquerque Filho, N. J. B., Mendes, G., Rebouças, V. A. F. M., de Mello, C. C., Salgueiro, M. I. K., & de Medeiros, H. J. (2014). Effect of concurrent training on body composition and lipid profile in overweight adolescents. Journal of Exercise Physiologyonline, 17(6): 34-44.
Annibalini, G., Lucertini, F., Agostini, D., Vallorani, L., Gioacchini, A., Barbieri, E., ... & Stocchi, V. (2017). Concurrent aerobic and resistance training has anti-inflammatory effects and increases both plasma and leukocyte levels of IGF-1 in late middle-aged type 2 diabetic patients. Oxidative medicine and cellular longevity, 2017: 10.
Bharath, L. P., Choi, W. W., Cho, J. M., Skobodzinski, A. A., Wong, A., Sweeney, T. E., & Park, S. Y. (2018). Combined resistance and aerobic exercise training reduces insulin resistance and central adiposity in adolescent girls who are obese: randomized clinical trial. European journal of applied physiology, 118(8), 1653-1660.
Brzycki, M. (1993). Strength testing-predicting a one-rep max from reps-to-fatigue. Journal of physical education, recreation & dance, 64(1), 88-90.
Colato, A., Abreu, F., Medeiros, N., Lemos, L., Dorneles, G., Ramis, T., ... & Peres, A. (2014). Effects of concurrent training on inflammatory markers and expression of CD4, CD8, and HLA-DR in overweight and obese adults. Journal of exercise science & fitness, 12(2), 55-61.
Dohoney, P. A. U. L. A., Chromiak, J. A., Lemire, D. E. R. E. K., Abadie, B. R., & Kovacs, C. H. R. I. S. T. O. P. H. E. R. (2002). Prediction of one repetition maximum (1-RM) strength from a 4-6 RM and a 7-10 RM submaximal strength test in healthy young adult males. Journal of Exercise Physiology, 5(3), 54-9.
García-Hermoso, A., Ramírez-Vélez, R., Ramírez-Campillo, R., Peterson, M. D., & Martínez-Vizcaíno, V. (2018). Concurrent aerobic plus resistance exercise versus aerobic exercise alone to improve health outcomes in paediatric obesity: a systematic review and meta-analysis. British Journal of Sports Medicine, 52(3), 161-166.
Ghahramanloo, E., Midgley, A. W., & Bentley, D. J. (2009). The effect of concurrent training on blood lipid profile and anthropometrical characteristics of previously untrained men. Journal of physical activity & health, 6(6), 760.
Glowacki, S. P., Martin, S. E., Maurer, A. N. N., Baek, W., Green, J. S., & Crouse, S. F. (2004). Effects of resistance, endurance, and concurrent exercise on training outcomes in men. Medicine and science in sports and exercise, 36, 2119-2127.
Goh, J., Lim, C. L., & Suzuki, K. (2019). Effects of endurance-, strength-, and concurrent training on cytokines and inflammation. In Concurrent aerobic and strength training (pp. 125-138). Springer, Cham.
Gondim, O. S., Camargo, V. T. N. D., Gutierrez, F. A., Martins, P. F. D. O., Passos, M. E. P., Momesso, C. M., ... & Cury-Boaventura, M. F. (2015). Benefits of regular exercise on inflammatory and cardiovascular risk markers in normal weight, overweight and obese adults. PloS one, 10(10), e0140596.
Ichikawa, T., Machida, N., Kaneko, H., Oi, I., & Fujino, M. A. (2019). C-reactive Protein Can Predict Patients with Cirrhosis at a High Risk of Early Mortality after Acute Esophageal Variceal Bleeding. Internal Medicine, 58(4), 487-495.
Ihalainen, J. K., Schumann, M., Eklund, D., Hämäläinen, M., Moilanen, E., Paulsen, G., ... & Mero, A. A. (2018). Combined aerobic and resistance training decreases inflammation markers in healthy men. Scandinavian journal of medicine & science in sports, 28(1), 40-47.
Jackson, A. S., Pollock, M. L., & Gettman, L. R. (1978). Intertester reliability of selected skinfold and circumference measurements and percent fat estimates. Research Quarterly. American Alliance for Health, Physical Education and Recreation, 49(4), 546-551.
Jorge, M. L. M. P., de Oliveira, V. N., Resende, N. M., Paraiso, L. F., Calixto, A., Diniz, A. L. D., ... & Geloneze, B. (2011). The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus. Metabolism, 60(9), 1244-1252.
LeMura, L. M., von Duvillard, S. P., Andreacci, J., Klebez, J. M., Chelland, S. A., & Russo, J. (2000). Lipid and lipoprotein profiles, cardiovascular fitness, body composition, and diet during and after resistance, aerobic and combination training in young women. European journal of applied physiology, 82(5), 451-458.
Libardi, C. A., De Souza, G. V., Cavaglieri, C. R., Madruga, V. A., & Chacon-Mikahil, M. (2012). Effect of resistance, endurance, and concurrent training on TNF-a, IL-6, and CRP. Med Sci Sports Exerc, 44(1), 50-6.
Libardi, C. A., Souza, G. V., Gaspari, A. F., Santos, C. F. D., Leite, S. T., Dias, R., ... & Chacon-Mikahil, M. P. (2011). Effects of concurrent training on interleukin-6, tumour necrosis factor-alpha and C-reactive protein in middle-aged men. Journal of sports sciences, 29(14), 1573-1581.
Lopes, W. A., Leite, N., da Silva, L. R., Brunelli, D. T., Gáspari, A. F., Radominski, R. B., ... & Cavaglieri, C. R. (2016). Effects of 12 weeks of combined training without caloric restriction on inflammatory markers in overweight girls. Journal of sports sciences, 34(20), 1902-1912.
Marta, C., Marinho, D. A., Barbosa, T. M., Izquierdo, M., & Marques, M. C. (2013). Effects of concurrent training on explosive strength and VO2max in prepubescent children. International journal of sports medicine, 34(10), 888-896.
Mirghani, S. J., Alinejad, H. A., Azarbayjani, M. A., Mazidi, A., & Mirghani, S. A. (2014). Influence of strength, endurance and concurrent training on the lipid profile and blood testosterone and cortisol response in young male wrestlers. Baltic Journal Of Health And Physical Activity, 6(1), 1.
Monteiro, P. A., Chen, K. Y., Lira, F. S., Saraiva, B. T. C., Antunes, B. M. M., Campos, E. Z., & Freitas, I. F. (2015). Concurrent and aerobic exercise training promote similar benefits in body composition and metabolic profiles in obese adolescents. Lipids in health and disease, 14(1), 1-9.
Murlasits, Z., Kneffel, Z., & Thalib, L. (2018). The physiological effects of concurrent strength and endurance training sequence: A systematic review and meta-analysis. Journal of sports sciences, 36(11), 1212-1219.
Olson, T. P., Dengel, D. R., Leon, A. S., & Schmitz, K. H. (2007). Changes in inflammatory biomarkers following one-year of moderate resistance training in overweight women. International journal of obesity, 31(6), 996-1003.
Pozza, C., & Isidori, A. M. (2018). What’s behind the obesity epidemic. In Imaging in bariatric surgery (pp. 1-8). Springer, Cham.
Rosa, C., Vilaça-Alves, J., Fernandes, H. M., Saavedra, F. J., Pinto, R. S., & dos Reis, V. M. (2015). Order effects of combined strength and endurance training on testosterone, cortisol, growth hormone, and IGF-1 binding protein 3 in concurrently trained men. The Journal of Strength & Conditioning Research, 29(1), 74-79.
Rossi, F. E., Diniz, T. A., Fortaleza, A. C., Neves, L. M., Picolo, M. R., Monteiro, P. A., ... & Freitas Jr, I. F. (2018). Concurrent training promoted sustained anti-atherogenic benefits in the fasting plasma triacylglycerolemia of postmenopausal women at 1-year follow-up. The Journal of Strength & Conditioning Research, 32(12), 3564-3573.
Salamat, K. M., Azarbayjani, M. A., Yusof, A., & Dehghan, F. (2016). The response of pre-inflammatory cytokines factors to different exercises (endurance, resistance, concurrent) in overweight men. Alexandria Journal of Medicine, 52(4), 367-370.
Sallam, N., & Laher, I. (2016). Exercise modulates oxidative stress and inflammation in aging and cardiovascular diseases. Oxidative medicine and cellular longevity, 2016.
Schwingshackl, L., Dias, S., Strasser, B., & Hoffmann, G. (2013). Impact of different training modalities on anthropometric and metabolic characteristics in overweight/obese subjects: a systematic review and network meta-analysis. PloS one, 8(12), e82853.
Shamim, B., Devlin, B. L., Timmins, R. G., Tofari, P., Lee Dow, C., Coffey, V. G., ... & Camera, D. M. (2018). Adaptations to concurrent training in combination with high protein availability: a comparative trial in healthy, recreationally active men. Sports Medicine, 48(12), 2869-2883.
Tseng, M. L., Ho, C. C., Chen, S. C., Huang, Y. C., Lai, C. H., & Liaw, Y. P. (2013). A simple method for increasing levels of high-density lipoprotein cholesterol: a pilot study of combination aerobic-and resistance-exercise training. International journal of sport nutrition and exercise metabolism, 23(3), 271-281.
Van Gaal, L. F., Mertens, I. L., & De Block, C. E. (2006). Mechanisms linking obesity with cardiovascular disease. Nature, 444(7121), 875-880.
Verney, J., Kadi, F., Charifi, N., Féasson, L., Saafi, M. A., Castells, J., ... & Denis, C. (2008). Effects of combined lower body endurance and upper body resistance training on the satellite cell pool in elderly subjects. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine, 38(3), 1147-1154.
Verney, J., Kadi, F., Saafi, M. A., Piehl-Aulin, K., & Denis, C. (2006). Combined lower body endurance and upper body resistance training improves performance and health parameters in healthy active elderly. European journal of applied physiology, 97(3), 288-297.
Vivian Heyward, A. G. (2014). Advanced Fitness Assessment and Exercise Prescription 7th Edition With Online Video. Environments, 552.
Wadhera, R. K., Steen, D. L., Khan, I., Giugliano, R. P., & Foody, J. M. (2016). A review of low-density lipoprotein cholesterol, treatment strategies, and its impact on cardiovascular disease morbidity and mortality. Journal of clinical lipidology, 10(3), 472-489.
WHO. (2018). Obesity and overweight. from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
Wilhelm, EN., & Pinto, RS. (2019). Concurrent Aerobic and Strength Training for Body Composition and Health. Concurrent Aerobic and Strength Training: Scientific Basics and Practical Applications. M. Schumann and B. R. Rønnestad. Cham, Springer International Publishing: 293-307.
