Evaluation of Exercise Programs at a Fitness Club in Female

13 Pages·2009·4.73 MB·English

Received: Jun. 1, 2009
Accepted: Aug. 13, 2009
Published online: Oct. 8, 2009
Original Article
Evaluation of Exercise Programs at a Fitness Club in Female Exercise Beginners
Using Anti-Aging Medical Indicators
Toshio Mochizuki 1), Yoko Amenomori 2), Ryo Miyazaki 1), Tsutomu Hasegawa 1),
Miwako Watanabe 3), Kazuhito Fukuike 4), Yoshikazu Yonei 1)
1) Anti-Aging Medical Research Center, Graduate School of Life and Medical Science, Doshisha University
2) Health fitness instructor, Excellcia LLC
3) Mareesia Garden Clinic
4) TIPNESS Limited
Abstract
Objective: Although the importance of exercise instruction in preventing metabolic syndrome and lifestyle-related diseases is
evident, there exists little knowledge regarding specific types of exercise which is easily accepted by exercise beginners and
provide strong motivation to continuing such exercise, and its expected effect. In the present open-label, comparative study, two
types of exercise program were compared in exercise beginners.
Methods: Twenty-three healthy premenopausal volunteer women aged between 35 (inclusive) and 45 (exclusive) years without
experience of exercise were randomly allocated to Group M, which was prescribed a composite exercise program with muscle
resistance training (n=12), or Group W, which was prescribed a simple exercise program with walking as a main component
(n=11). The participants were instructed to perform their assigned exercise program for 40 minutes at a time, three times a week
for 8 consecutive weeks at a fitness studio. After three withdrawals were excluded, 10 women (40.3 ± 1.9 years) in Group M and
10 (39.7 ± 2.7) in Group W were included in analyses of the following data obtained at baseline and after 8 weeks: examination
for subjective symptoms (using the Anti-Aging QOL Common Questionnaire (AAQol), the State Trait Anxiety Inventory (SATI)
for evaluation of anxiety, Young’s Symptom Distress Scale (SDS) for evaluation of depressed state, and the Kupperman
Menopausal Index (KMI) for evaluation of symptoms of climacteric disturbance), physical examination, vascular function tests
(cardio-ankle vascular index (CAVI), ankle brachial pressure index (ABI), and fingertip acceleration plethysmogram), blood tests
(including but not limited to IGF-I and DHEA-s), oxidative stress tests (with a biological antioxidant potential (BAP) test and
measurement of diacron-reactive oxygen metabolites (-ROMs), and skin image analysis.
Results: Evaluation with the AAQol revealed significant improvement after 8-week exercise period in the following symptoms:
“early satiety,” “headache” and “dizziness” in Group M; and “stiff shoulder,” “lethargy,” “lack of sense of wellness,”
“constipation,” “tinnitus,” “edematous,” “cold skin,” “no feeling of happiness,” “depressed,” and “a sense of tension.” in Group
W. Evaluation of anxiety with the STAI revealed that scores for both state anxiety and trait anxiety significantly improved in
Group M, while Group W showed no significant changes. Evaluation of depressed state with the SDS revealed no significant
changes in Group M and a significant improvement in the total score of Group W. The KKSI did not significantly change in
Group M, whereas in Group W, it improved in terms of both menopausal index and intensity. For physical examination, Group M
showed significant increases in body weight (+1.6%, p=0.016), estimated muscle mass (+2.1%, p=0.008) and bending forward,
and a significant reduction in abdominal circumference (– 6.0%, p=0.014). In Group W, percentage body fat and fat
amount (– 2.7%, p=0.026) significantly decreased, whereas systolic blood pressure significantly increased (baseline value of
106.1 ± 12.0, +8.0%, p=0.010). Blood tests revealed a significant decrease in urea nitrogen in Group M, and significant decreases
in TC (– 4.4%, p=0.027), LDL-C (– 8.2%, p=0.008), TG (– 13.8%, p=0.038), albumin and ALP in Group W. HDL-C was more
remarkably increased in Group M than in Group W. Endocrinology revealed significant increases in IGF-I (Group M: +17.0%,
p=0.045, Group W: +17.6%, p=0.035) and DHEA-s (Group M: +34.2%, p=0.001, Group W: +22.9%, p=0.043) in both groups.
Vascular function tests and oxidative stress tests showed no significant changes in either group. With regard to unfavorable
effects, a significant reduction in MCV was noted in Group M, and in erythrocyte count, hemoglobin, hematocrit, MCV and
MCHC in Group W, although these decreases were all within the range of physiological changes. The activity of NK cells was
significantly lowered in both groups. Skin image analysis revealed a significant increase in noticeable pores and pigmentation in
both groups.
Conclusion: The present study results suggest that in exercise beginners, slight muscle-resistance exercise may increase muscle
mass and improves HDL-C and anxiety, and walking exercise improves lipid metabolism and climacteric symptoms. In addition,
both types of exercise accelerated the secretion of IGF-I and DHEA-s, and relieved physical and mental symptoms according to
the contents of individual exercise programs.
KEY WORDS: exercise, IGF-I, DHEA-s, stress, climacteric symptoms
Anti-Aging Medicine 6 (8) : 66-78, 2009 Professor Yoshikazu Yonei,
(c) Japanese Society of Anti-Aging Medicine 66 Anti-Aging Medical Research Center, Graduate School of Life and Medical Science, Doshisha University
1-3 Tatara-Miyakodani, Kyotanabe, Kyoto 610-0321, Japan
Tel & Fax: [phone] / E-mail: [email protected]
Introduction The study period was from October 10, 2008 to December 5,
2008. Clinical tests and examinations were conducted at Mareesia
The objective of anti-aging medicine is to contribute to the Garden Clinic (Shinjuku-ku, Tokyo). The participants were
promotion of health in daily activities and improve quality of life instructed to drink no alcohol on the day before each prescribed
(QOL), resulting in the achievement of longevity coupled with visit to the clinic for tests and examinations, and to avoid an
health 1). Anti-aging medicine is categorized as preventive irregular way of living throughout the study period. They were
medicine. As its diagnostic tool, a comprehensive medical system also instructed to maintain the same level of quality and quantity
for determining the degree of senescence (i.e. an anti-aging human of sleep, diet, exercise, alcohol drinking and any other relevant
dock) exists and its treatment consists of lifestyle therapies such as lifestyle-related habits that they had experienced prior to the start
diet/exercise and medical therapies such as supplemental nutrition of the study.
and hormone replacement 2,3).
Lifestyle-related diseases such as metabolic syndrome and
Contents of exercise programs
type 2 diabetes, in which impaired metabolism play a primary role
in pathogenesis, have recently increased. The most probable cause
Group W was assigned a simple exercise program with
of this is an imbalance between calories taken in and the amount
walking as a main component (estimated caloric consumption
of physical activity. This is regarded as a risk factor for aging. To
from 200 – 220 kcal per lesson), and Group M a composite
date, we have focused on data accumulation for age-associated
exercise program requiring slight muscle resistance (estimated
changes in muscle mass of the body 4). For physical activity and
caloric consumption of about 180 – 200 kcal per lesson). The
exercise, we have also investigated the effects of muscle resistance
exercise program allocated to Group M is called the “Women’s
training 5) and walking 6) on issues related to aging through the use
Therapy Workout,” which was developed by Yoko Amenomori at
of various anti-aging medical indicators.
Excellcia LLC and provided by TIPNESS Limited in the present
Although the importance of exercise instruction in preventing
study. This exercise for Group M was intended to relieve stress,
lifestyle-related diseases such as metabolic syndrome is evident,
condition the physical status and control emotion, and focused on
little knowledge is available regarding specific types of exercise
the following: (1) adjustment of balance of the autonomous
which are easily accepted by exercise beginners and which
nervous system; (2) elaborativeness; (3) improvement in balancing
strongly motivate them to continue such exercise, and effects
ability; (4) improvement in dynamic flexibility; and (5)
expected from the exercise. Here, we performed the an open-label,
improvement in muscle balance and one’s figure balance.
comparative study to compare two types of exercise programs
In Group M, a sports mat with a pillow made of low-resilience
using anti-aging medical indicators including but not limited to
material (referred to as “Pillow” hereinafter) was used to stimulate
vascular elasticity, endocrinology and oxidative stress: (1) a
the sense of touch; that is, using the Pillow, the subjects confirmed
composite exercise program with muscle resistance training; and
how they felt about their body movements, sensed any difference
(2) a simple exercise program with walking as a main component.
they felt, set their own objectives and experienced a sense of
achievement. The Pillow was impregnated with clary sage
essential oil to simulate the sense of smell. The colors of the
Pillow (in which lots of pink and green colors are used) were
aimed at accelerating eye movement and stimulating the sense of
sight during exercise. Further, music was combined to stimulate
Methods the sense of hearing. The musical pieces used were included in
commercially available CDs entitled “Anti-Aging Music”
Subjects (B000RG14KC; Directed by Yoshikazu Yonei, Victor Entertainment
Inc., Minato-ku, Tokyo). In addition, popular musical pieces
Healthy premenopausal volunteer women aged between 35
accessible to the age and gender of the subjects were also used.
and 45 years without experience of exercise were recruited.
The exercise program for Group M consisted of the following
Twenty-three healthy volunteer women (mean age 40.1 ± 2.3 years
four parts, each of which persisted for 10 minutes:
old) who gave informed consent to participate in the present study
Part 1: With the colors and aroma of the Pillow, stimulation of the
were randomly allocated to Group M; a composite exercise
senses of sight and smell. Progression from shallow breathing
program with muscle resistance training (12 women), or Group W;
to deep breathing. With the Pillow, warming up of the neck
a simple exercise program with walking as a main component (11
circumference.
women). The participants were instructed to perform their assigned
Part 2: With the Pillow, stretching of the whole body.
exercise program for 40 minutes at a time, three times a week for 8
Part 3: With the Pillow, muscle-resistance training for the inner
consecutive weeks at a fitness studio (Shinjuku-ku, Tokyo). On the
and core muscles of the shoulder girdle, the pelvic muscle
day before study initiation and two days after completion of the
group, and skeletal muscle groups of limbs.
8-week study, examinations for subjective symptoms, blood
Part 4: With the Pillow, stretching and cooling down.
biochemistry, tests with oxidative stress markers, vascular function
tests, and skin tests were performed. During the study period, two
women in Group M and one in Group W withdrew from the study, Examination for subjective symptoms
leaving 10 women (40.3 ± 1.9 years old) in Group M and 10 (39.7
± 2.7 years old) in Group W for inclusion in the analyses For the purpose of evaluating subjective symptoms, Subjects
(withdrawal rate: 13.0%). In Group M, the first withdrawal were divided into two categories, i.e. “physical symptoms” and
stopped participation because she caught a common cold during “mental symptoms.” As described in our previous study 7), the
the study period and was unable to continue to prescribed exercise Anti-Aging QOL Common Questionnaire (AAQol) was used to
program, while the second failed to obtain her family members’ rate individual symptoms according to a 5-grade scale ranging
consent for her participation in the post-study tests and from 1 to 5 points. This questionnaire was downloaded from the
examinations. For the one withdrawal in Group W, performance of Web site of the Japanese Society of Anti-Aging Medicine
the study did not fit into her schedule. (http://www.anti-aging.gr.jp/anti/clinical.html). Effects on the
67
Evaluation of Fitness Exercise Programs in Female Exercise Beginners
subject’s anxiety, stress, depressed mood and climacteric Ethical considerations
disturbance-like symptoms were evaluated. For the degree of
Prior to study initiation, an ethical committee was organized
anxiety, the State Trait Anxiety Inventory (STAI) 8) was used to
in Medical Urban Clinic Koroen (Nishinomiya-city, Hyogo). The
evaluate state anxiety and trait anxiety. The Young’s Symptom
present study was performed after it had obtained the approval of
Distress Scale (SDS) 9) was used to evaluate depressed state. The
theethical committee, in compliance with ethical principles
KKSI (Kupperman Konenki Shogai Index), a modified
prescribed by the study protocol, the Declaration of Helsinki
Kupperman’s Menopausal Index adapted for use by Japanese
(modified at the General Assembly in Edinburgh in the year 2000)
women by Tetsuro Abe 10,11) was used to evaluate symptoms of
and the Ethical Guidelines for Epidemiological Research issued by
climacteric disturbance. This Japanese version of modified
the Ministry of Labour, Health and Welfare and the Ministry of
Kupperman’s Index consists of the 11 symptoms included in the
Education, Science and Culture (http://www.mhlw.go.jp/general/
original index and additional symptoms unique to Japanese
seido/kousei/i-kenkyu/sisin2.html).
women; that is, 17 symptoms in total.
Statistical analysis
Anthropometry
Statistical analyses were performed using statistical analysis
Anthropometry included height (cm), body weight (kg), body
applications Dr.SPSSII (SPSS Japan Inc., Shibuya-ku, Tokyo) and
muscle mass (kg), lean body mass (kg), body fat percentage (%),
Excel Tokei (Social Survey Research Information Co., Ltd.,
BMI, basal metabolism (kcal), bending forward (cm), grip strength
Shinjuku-ku, Tokyo). Paired t-test was applied to compare those
(kg), abdominal circumference (cm), blood pressure (mmHg) and
who used the product under study with those who did not, with a
pulse rate (per minute). Body composition was measured with an
significance level of <0.05 on two-sides. For between-group
InBody 520 (BIOSPACE Co., Ltd., Seoul, Korea) 12), a body
analysis, differences before and after the study as well as percent
composition analyzer which uses the bioelectrical impedance
change from baseline were compared between groups using
method.
parametric and nonparametric tests.
Blood biochemistry and oxidative stress markers
Blood chemistry tests, hematology tests and urinalysis were
performed in the morning before breakfast, and measured at
Mitsubishi Chemical Medience Corporation (Minato-ku, Tokyo).
Results
For antioxidant capacity and oxidative stress status of the body, as

described in our previous report, the Free Radical Analysis System
Examination for subjective symptoms
4 (FRAS4) (Wismerll Co., Ltd., Bunkyo-ku, Tokyo) was used to
perform the biological anti-oxidant potential (BAP) test and to The results of evaluation of subjective symptoms using the
measure Diacron-reactive oxygen metabolites (d-ROMs) 13,14). AAQol were compared before and after the 8-week exercise
program (Table 1). In Group M; a composite exercise program
with muscle resistance training was also performed, 3 of the 33
Vascular function tests physical symptoms showed significant changes: “early satiety”,
“headache” and “dizziness”. No significant changes were noted in
As parameters for diagnosis of arteriosclerosis, the
cardio-ankle vascular index (CAVI) 15), which is a blood any of the mental symptoms. For lifestyle-related habits, “the
number of days on which they took exercise, per week”
pressure-independent indicator of arterial wall stiffness and
tension, and the ankle brachial pressure index (ABI) 16), which significantly increased, while “sleeping hours” significantly
decreased (– 8.8%).
indicates stenosis and occlusion of the arteries of lower limbs,
In Group W; a simple exercise program with walking as a
were measured with VaSeraVS-100 (Fukuda Denshi Co., Ltd.,
main component, 7 of the 33 physical symptoms showed
Bunkyo-ku, Tokyo). Fingertip acceleration plethysmography was
performed to evaluate vascular dynamics and hemodynamics 17-19). significant changes: “stiff shoulders”, “lethargy”, “lack of sense of
wellness”, “constipation”, “tinnitus”, “edematous” and “cold skin”.
Namely, fingertip acceleration plethysmogram detected a pulse
Three of the 21 mental symptoms showed significant changes: “no
wave of the fingertip (a minor change in pulse pressure at the
feeling of happiness”, “depressed” and “a sense of tension”. For
fingertip), on the basis of which the degree of arteriosclerosis was
lifestyle-related habits, “daily consumption of alcohol (expressed
evaluated. For the measurement, an acceleration plethysmogram
using a measuring unit for Japanese Sake)” significantly changed.
Blood Circulation Checker (Future Wave, Inc., Nerima-ku, Tokyo)
The physical symptom of “tendency to gain weight” differed
was used and results were expressed in terms of vascular age.
between groups, showing a tendency to increase in Group M and
decrease in Group W. The mental symptom of “depressed” showed
Skin tests a significant tendency to improve in Group W.
Evaluation of the degree of anxiety using the STAI revealed
According to a previously reported method 20), facial skin was significant improvement in the total score of state anxiety (42.2 ±
examined for oil and moisture content and evaluated with an 13.3 to 35.7 ± 10.2, p=0.041) and the frequency rating of trait
image analyzer. For the facial image analysis, with her head fixed, anxiety (3.7 ± 1.1 to 3.0 ± 0.9, p=0.025) in Group M, whereas no
the subject’s face was photographed with a Robo Skin Analyzer significant differences were noted in Group W (Table 2). Two
CS50 (Niic Co., Ltd., Setagaya-ku, Tokyo), and the data obtained statements significantly improved: “I worry too much over
were rated according to the predetermined scoring systems for something that really doesn’t matter”, and “I lack self-confidence.”
individual parameters 21). Oil and moisture levels of the skin were Three statements, “I feel pleasant,” “I cannot make up my mind
measured with an oil/moisture analyzer WSK-P500 (Wavecyber immediately and am apt to miss an opportunity” and “I feel secure,”
Co., Ltd., Saitama-city, Saitama). were significantly worsened.
68
Table 1 Changes in scores for symptoms on the Anti-Aging QOL Common Questionnaire : AAQol
Between-group
Group M Group W
comparison
Physical symptoms Baseline After 8 weeks p value Baseline After 8 weeks p value p value
Tired eyes 3.40 ±1.07 3.40 ±1.43 1.000 3.10 ±1.29 2.50 ±0.97 0.193 0.920
Blurry eyes 2.40 ±1.17 2.30 ±1.49 0.758 2.30 ±1.42 1.90 ±0.99 0.309 0.866
Eye pain 2.30 ±0.95 1.80 ±1.14 0.213 1.90 ±0.74 1.40 ±0.52 0.096 0.893
Stiff shoulders 3.30 ±1.25 2.80 ±1.62 0.299 4.00 ±0.94 3.10 ±0.74 0.010 0.641
Muscular pain/stiffness 2.40 ±1.07 2.50 ±1.65 0.726 2.80 ±1.03 1.90 ±0.88 0.054 0.317
Palpitations 1.40 ±0.70 1.50 ±0.85 0.726 1.20 ±0.42 1.10 ±0.32 0.343 0.359
Shortness of breath 1.50 ±0.85 1.70 ±0.95 0.619 1.30 ±0.48 1.10 ±0.32 0.168 0.150
Tendency to gain weight 3.40 ±1.58 3.90 ±0.99 0.244 3.30 ±1.42 2.40 ±1.07 0.019 0.042
Weight loss; thin 1.40 ±0.70 1.30 ±0.67 0.343 1.10 ±0.32 1.20 ±0.42 0.591 0.232
Lethargy 2.60 ±1.51 2.20 ±1.23 0.309 2.90 ±1.37 1.80 ±0.79 0.048 0.404
Lack of sense of wellness 2.40 ±1.35 2.00 ±0.82 0.168 2.60 ±1.07 1.70 ±0.82 0.019 0.119
Thirst 2.80 ±1.32 2.70 ±1.25 0.823 1.70 ±1.16 2.00 ±0.94 0.279 0.497
Skin problems 3.00 ±1.33 3.20 ±0.79 0.591 2.70 ±1.16 2.20 ±0.79 0.177 0.278
Anorexia 1.40 ±0.70 1.20 ±0.42 0.168 1.50 ±0.71 1.60 ±0.70 0.678 0.171
Early satiety 2.30 ±1.34 1.90 ±1.29 0.037 1.50 ±0.71 1.20 ±0.42 0.081 0.801
Epigastralgia 2.20 ±1.23 1.70 ±1.16 0.052 1.70 ±0.82 1.20 ±0.42 0.096 0.948
Liable to catch colds 2.10 ±1.10 2.30 ±1.06 0.443 2.40 ±1.35 1.80 ±0.79 0.081 0.185
Coughing and sputum 1.90 ±1.10 2.10 ±1.20 0.443 1.90 ±1.29 1.70 ±1.06 0.343 0.204
Diarrhea 2.40 ±1.35 1.90 ±0.99 0.138 1.30 ±0.48 1.50 ±0.85 0.168 0.082
Constipation 2.10 ±0.99 2.50 ±1.58 0.343 2.90 ±1.37 2.10 ±1.20 0.037 0.087
Hair loss 2.30 ±1.16 2.50 ±1.27 0.509 2.40 ±0.97 1.90 ±0.88 0.213 0.452
Gray hair 3.50 ±1.18 3.50 ±1.18 1.000 2.90 ±1.45 2.50 ±1.35 0.104 0.459
Headache 2.80 ±1.32 2.30 ±1.25 0.015 2.50 ±1.27 1.80 ±0.63 0.153 0.570
Dizziness 2.60 ±1.51 1.90 ±1.10 0.010 1.50 ±0.71 1.10 ±0.32 0.104 0.635
Tinnitus 1.80 ±1.23 1.50 ±1.27 0.081 1.70 ±0.82 1.20 ±0.42 0.015 0.541
Lumbago 2.70 ±1.57 2.60 ±1.26 0.591 2.30 ±1.06 1.60 ±0.84 0.111 0.363
Arthralgia 1.70 ±0.82 1.90 ±1.37 0.726 1.50 ±0.71 1.30 ±0.67 0.168 0.269
Edematous 2.90 ±1.10 2.40 ±1.43 0.299 2.70 ±1.34 1.70 ±0.95 0.004 0.349
Easily breaking into a sweat 2.10 ±1.29 2.90 ±1.20 0.053 2.00 ±0.94 2.00 ±1.05 1.000 0.155
Frequent urination 1.50 ±0.85 1.50 ±0.97 1.000 1.90 ±0.99 1.70 ±0.95 0.591 0.846
Hot flashes 1.70 ±0.67 1.80 ±0.79 0.678 1.40 ±0.52 1.20 ±0.42 0.168 0.182
Cold skin 3.30 ±1.34 3.40 ±1.35 0.832 3.70 ±1.16 2.60 ±1.17 0.001 0.061
Mental symptoms Baseline After 8 weeks p value Baseline After 8 weeks p value p value
Irritability 2.90 ±1.45 2.70 ±0.82 0.619 2.80 ±1.03 2.00 ±0.94 0.070 0.171
Easily angered 2.70 ±1.42 2.40 ±0.84 0.394 2.50 ±0.85 2.00 ±1.05 0.177 0.359
Loss of motivation 2.50 ±1.35 2.30 ±1.06 0.343 2.40 ±0.97 1.80 ±0.79 0.051 0.163
No feeling of happiness 2.40 ±1.26 1.90 ±0.99 0.138 2.30 ±0.95 1.60 ±0.70 0.045 0.439
Nothing to look forward to in life 2.10 ±1.20 2.00 ±1.15 0.591 2.10 ±0.99 1.80 ±0.63 0.343 0.715
Daily life is not enjoyable 2.20 ±1.14 1.90 ±0.99 0.193 2.20 ±1.03 1.80 ±0.63 0.269 0.720
Lose confidence 2.50 ±1.43 2.40 ±1.17 0.591 2.10 ±1.10 1.70 ±0.48 0.309 0.920
Reluctance to talk with others 2.30 ±1.25 2.20 ±0.92 0.678 1.80 ±0.79 1.50 ±0.53 0.193 0.496
Depressed 2.10 ±1.29 2.00 ±1.05 0.591 2.00 ±0.67 1.30 ±0.48 0.001 0.025
Feeling of uselessness 2.30 ±1.16 2.00 ±0.94 0.193 1.70 ±0.82 1.50 ±0.53 0.443 0.532
Shallow sleep 2.40 ±1.90 2.50 ±1.35 0.876 1.80 ±0.92 1.10 ±0.32 0.066 0.119
Difficulty in falling asleep 1.60 ±1.35 1.60 ±0.84 1.000 1.90 ±1.20 1.20 ±0.42 0.132 0.134
Pessimism 2.30 ±1.25 2.00 ±0.82 0.279 2.00 ±0.67 1.60 ±0.52 0.168 0.571
Lapse of memory 3.00 ±1.49 3.30 ±1.25 0.193 2.40 ±0.97 2.20 ±0.79 0.443 0.106
Inability to concentrate 2.60 ±1.43 2.30 ±1.34 0.081 2.40 ±0.97 1.70 ±0.82 0.089 0.444
Inability to solve problems 2.50 ±1.27 2.20 ±1.14 0.081 1.80 ±0.79 1.70 ±0.67 0.591 0.392
Inability to make judgments readily 2.40 ±1.35 2.20 ±1.03 0.343 2.00 ±0.94 1.70 ±0.67 0.193 0.472
Inability to sleep because of worries 1.70 ±1.34 1.50 ±0.85 0.443 1.40 ±0.52 1.40 ±0.52 1.000 0.818
A sense of tension 2.20 ±1.40 2.00 ±1.05 0.591 2.00 ±0.82 1.50 ±0.71 0.015 0.212
Feeling of anxiety for no special reason 2.40 ±1.51 2.00 ±1.05 0.168 1.90 ±0.74 1.60 ±0.52 0.279 0.980
Vague feeling of fear 2.00 ±1.25 1.80 ±1.14 0.443 1.70 ±0.67 1.30 ±0.67 0.104 0.389
Lifestyle-related habits Baseline After 8 weeks p value Baseline After 8 weeks p value p value
Tobacco smoking cigarettes/day 0.00 ±0.00 0.00 ±0.00 ND 0.00 ±0.00 0.00 ±0.00 ND ND
Alcohol consumption go/day 0.86 ±0.70 0.78 ±0.59 0.757 0.92 ±0.67 0.64 ±0.40 0.026 0.240
Exercise times/ week 2.90 ±2.39 3.45 ±2.49 0.483 3.10 ±2.44 3.20 ±2.85 0.846 0.168
days/ week 1.00 ±0.97 2.10 ±1.37 0.016 1.40 ±1.26 2.65 ±1.97 0.104 0.522
Sleeping hours hours/ day 6.80 ±0.79 6.20 ±0.59 0.009 6.60 ±1.07 6.45 ±0.76 0.434 0.083
Water consumption L/day 1.65 ±0.94 1.21 ±0.46 0.205 1.30 ±0.54 1.25 ±0.54 0.758 0.283
ND: not determined.
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Evaluation of Fitness Exercise Programs in Female Exercise Beginners
Table 2 Evaluation of anxiety with STAI
Between-group
Group M Group W
comparison
Baseline After 8 weeks p value Baseline After 8 weeks p value p value
Lifestyle assessment /100 points 58.40 8.80 54.90 7.62 0.260 55.90 9.94 59.80 12.88 0.271 0.154
I feel calm 2.50 ±1.18 3.00 ±1.41 0.177 3.20 ±1.03 3.70 ±0.48 0.138 0.982
I feel secure 2.70 ±0.82 3.20 ±1.14 0.177 3.00 ±0.94 3.50 ±0.53 0.177 0.643
I am tense 2.30 ±1.06 1.60 ±0.52 0.089 1.80 ±0.79 1.70 ±0.67 0.758 0.465
I am fretting 1.40 ±0.97 1.50 ±0.97 0.798 1.20 ±0.42 1.30 ±0.48 0.591 0.776
I feel at ease 2.70 ±0.95 3.20 ±0.79 0.052 2.60 ±1.07 3.10 ±0.74 0.138 0.693
I feel upset 1.10 ±0.32 1.30 ±0.67 0.343 1.00 ±0.00 1.00 ±0.00 ND 0.343
I am presently worrying over possible 1.50 ±0.85 1.30 ±0.48 0.168 1.40 ±0.52 1.30 ±0.48 0.343 0.806
misfortunes
I feel rested 2.70 ±0.95 2.90 ±1.29 0.591 2.90 ±0.99 3.60 ±0.52 0.089 0.281
There is something that has been worrying me 1.50 ±0.71 1.60 ±0.97 0.780 1.60 ±0.97 1.70 ±0.67 0.811 0.790
I feel comfortable 2.60 ±0.97 3.30 ±0.95 0.025 2.80 ±0.92 3.10 ±0.74 0.343 0.505
I feel self-confident 1.90 ±1.10 2.30 ±0.82 0.104 2.60 ±0.70 2.80 ±0.63 0.343 0.143
I am jittery 1.80 ±1.23 1.50 ±0.71 0.434 1.80 ±0.92 1.20 ±0.42 0.081 0.194
I feel nervous and restless 1.50 ±0.97 1.00 ±0.00 0.138 1.50 ±0.71 1.20 ±0.42 0.081 0.722
I feel strained 1.50 ±0.53 1.20 ±0.42 0.081 1.50 ±0.71 1.10 ±0.32 0.168 0.847
I am relaxed 2.40 ±1.17 3.00 ±1.05 0.217 2.80 ±1.14 3.10 ±0.99 0.541 0.805
I am content 2.00 ±1.15 2.50 ±0.53 0.177 2.50 ±1.08 2.90 ±0.74 0.343 0.800
I am worried 2.20 ±1.32 1.90 ±0.88 0.496 2.40 ±0.97 1.80 ±0.79 0.168 0.272
I get so excited that I feel as if I were in a 1.30 ±0.95 1.20 ±0.63 0.343 1.00 ±0.00 1.00 ±0.00 ND 0.343
tremble
I am in a joyful mood without knowing why 2.00 ±0.82 2.30 ±0.95 0.279 2.40 ±1.07 2.50 ±0.53 0.780 0.930
I feel pleasant 2.40 ±0.97 2.60 ±0.84 0.443 2.50 ±0.97 3.00 ±0.67 0.096 0.630
State anxiety Total 42.20 ±13.34 35.70 ±10.17 0.041 37.80 ±11.94 32.20 ±6.61 0.184 0.707
Frequency rating 3.40 ± 0.97 2.90 ± 0.99 0.177 3.20 ± 1.23 2.50 ±0.85 0.153 0.837
I feel pleasant 2.70 ±0.82 2.90 ±0.88 0.555 2.40 ±0.52 3.10 ±0.74 0.025 0.301
I easily get tired 2.60 ±0.84 2.40 ±0.70 0.555 3.10 ±0.74 2.10 ±0.57 0.015 0.097
I feel like crying 1.90 ±0.88 1.80 ±0.92 0.726 2.10 ±0.74 1.50 ±0.53 0.024 0.133
I wish I could be as happy as others seem to be 1.90 ±0.88 1.70 ±0.95 0.509 1.90 ±0.74 1.80 ±0.63 0.591 1.000
I cannot make up my mind immediately 1.60 ±0.84 2.00 ±1.05 0.037 1.60 ±0.84 1.50 ±0.53 0.678 0.354
and am apt to miss an opportunity
I feel rested 2.40 ±1.17 3.10 ±1.10 0.111 2.80 ±0.79 3.20 ±0.79 0.168 0.285
I am calm, cool, and collected 2.20 ±0.79 2.40 ±0.97 0.343 3.00 ±0.82 3.10 ±0.74 0.678 0.727
I feel that difficulties are piling up so that 1.80 ±0.79 1.70 ±0.67 0.678 2.00 ±1.05 1.40 ±0.52 0.168 0.660
I cannot overcome them
I worry too much over something that 2.00 ±0.94 1.60 ±0.70 0.037 1.70 ±0.48 1.50 ±0.53 0.343 0.523
really doesn’t matter
I am happy 2.90 ±0.88 2.70 ±1.06 0.443 2.50 ±0.85 3.00 ±0.67 0.052 0.030
I am apt to take things too seriously 2.10 ±0.99 2.00 ±0.94 0.678 1.80 ±0.63 1.70 ±0.82 0.678 0.711
I feel lacking self-confidence 2.40 ±0.70 2.00 ±0.67 0.037 2.10 ±0.57 1.80 ±0.42 0.081 0.709
I feel secure 2.60 ±0.97 3.20 ±0.92 0.024 2.80 ±0.79 3.20 ±0.63 0.223 0.665
I am apt to keep away from danger or difficulty 2.70 ±1.16 2.80 ±1.03 0.798 2.30 ±0.67 2.30 ±0.95 1.000 0.464
I feel depressed 2.30 ±0.95 1.80 ±0.79 0.052 2.10 ±0.57 1.60 ±0.70 0.096 0.904
I feel content 2.80 ±0.92 3.10 ±0.99 0.520 2.30 ±0.48 2.80 ±0.63 0.015 0.813
Some unimportant thought runs through 2.10 ±1.10 1.70 ±0.67 0.104 1.80 ±0.63 1.30 ±0.48 0.096 0.770
my mind and bothers me
I take disappointments so keenly that 2.10 ±1.10 1.70 ±0.67 0.168 1.90 ±0.88 1.60 ±0.70 0.343 0.937
I can’t put them out of my mind
I am a steady person 2.40 ±0.84 2.50 ±1.08 0.591 2.70 ±0.82 2.90 ±0.74 0.168 0.535
I get in a state of tension or turmoil as I think 2.20 ±1.32 1.90 ±0.88 0.193 1.90 ±0.57 1.70 ±0.67 0.443 0.933
about my recent concerns and interests
State anxiety Total 45.30 ±13.96 40.20 ±12.86 0.100 42.60 ±7.75 35.50 ±8.14 0.039 0.507
Frequency rating 3.70 ± 1.06 3.00 ±0.94 0.025 3.20 ±0.79 2.70 ±0.95 0.138 0.781
STAI: state trait anxiety inventory.
Score: 1=Not at all, 2=Somewhat, 3=Moderately so, 4= Very much so.
Rating: Frequency 1=Almost never, 2=Sometimes, 3=Average, 4= Often, 5= Almost always.
ND: not determined.
70
Table 3 Evaluation of depressed state with SDS
Between-group
Group M Group W
comparison
Baseline After 8 weeks p value Baseline After 8 weeks p value p value
I am depressed and melancholy 1.60 ±0.70 1.50 ±0.71 0.343 1.80 ±0.63 1.10 ±0.32 0.010 0.019
I feel most pleasant in the morning 2.10 ±1.37 1.80 ±1.23 0.576 2.30 ±1.16 2.10 ±1.20 0.509 0.684
I actually cry or feel like crying 1.60 ±0.52 1.70 ±0.95 0.678 1.70 ±0.67 1.20 ±0.42 0.138 0.481
I cannot sleep well at night 1.40 ±0.97 1.20 ±0.63 0.555 1.50 ±0.71 1.00 ±0.00 0.052 0.159
I have an average appetite 2.60 ±1.35 3.20 ±1.03 0.239 3.70 ±0.67 3.50 ±0.71 0.509 0.141
I still have libido (I have interest in the 2.60 ±1.07 2.60 ±1.17 1.000 1.70 ±0.67 1.90 ±0.57 0.343 0.433
opposite gender)
I notice that I have lost weight 1.10 ±0.32 1.20 ±0.42 0.591 1.00 ±0.00 1.50 ±0.85 0.096 0.274
I suffer from constipation 1.50 ±0.71 1.70 ±0.95 0.343 1.90 ±0.74 2.00 ±0.82 0.726 0.817
I have more palpitations than usual 1.10 ±0.32 1.20 ±0.42 0.591 1.00 ±0.00 1.00 ±0.00 ND 0.343
I am tired without knowing why 2.70 ±1.16 1.90 ±0.74 0.037 2.30 ±0.82 1.40 ±0.52 0.029 0.801
I always feel refreshed 2.90 ±1.20 2.60 ±0.84 0.193 2.20 ±0.63 3.30 ±0.82 0.003 0.049
I can do my job as usual 2.80 ±0.79 3.10 ±0.74 0.279 3.20 ±0.79 3.60 ±0.70 0.309 0.760
I feel nervous and restless 1.50 ±0.71 1.40 ±0.70 0.591 1.30 ±0.48 1.30 ±0.67 1.000 1.000
I have hope in the future 2.30 ±0.82 2.60 ±1.17 0.434 2.30 ±1.06 2.50 ±0.71 0.343 0.849
I get more greatly irritated than usual 1.70 ±0.82 1.60 ±0.70 0.678 2.10 ±0.88 1.40 ±0.52 0.045 0.232
I can easily make decision 2.50 ±0.97 2.60 ±1.17 0.780 2.60 ±1.17 3.00 ±0.94 0.168 0.439
I think that I am useful and competent 2.50 ±0.97 2.40 ±0.97 0.678 2.90 ±0.88 2.80 ±0.79 0.591 1.000
I live a substantially full life 2.80 ±0.92 2.80 ±1.23 1.000 2.50 ±0.85 3.10 ±0.57 0.024 0.134
I think that if I should die, the others would 1.20 ±0.42 1.20 ±0.42 ND 1.00 ±0.00 1.00 ±0.00 ND ND
live in ease.
I am satisfied with what I am doing everyday 2.50 ±1.18 2.60 ±1.07 0.853 2.50 ±0.71 2.80 ±0.92 0.343 0.622
Total score 39.80 ±9.02 38.30 ±9.46 0.322 39.70 ±6.07 34.30 ±4.81 0.028 0.163
SDS: Young’s symptom distress scale.
Score: 1=Not at all or very infrequently, 2=Sometimes, 3=Very frequently, 4=Almost always.
Rating: Normal=23-47 points, Neurosis=39-59 points, Depression=53-67 points.
ND: not determined.
Evaluation of depressed state using the SDS revealed that in Body weight and BMI provided between-group differences as
Group W, the total score significantly improved from 39.7 ± 6.1 they showed a tendency to increase in Group M and a tendency to
points before the study to 34.3 ± 4.8 after the 8-week exercise decrease in Group W.
period (p=0.028), while Group M showed no significant difference
(Table 3). In Group W, two statements, “I am depressed and
Blood biochemistry
melancholy” and “I am tired without knowing why,” significantly
improved, whereas significant worsening was noted in the two In Group M, two blood biochemistry parameters, MCV (– 1.8%)
statements “I always feel refreshed” and “I live a substantially full life.” and urea nitrogen (– 11.5%) showed significant changes (Table 6),
Evaluation with the KMI revealed that Group W improved although these changes were all within the standard reference range.
both menopausal index (22.7 ± 7.8 to 12.5 ± 11.2, p=0.038) and In Group W, the following 12 parameters showed significant
intensity (2.5 ± 0.7 to 1.6 ± 1.0, p=0.019), whereas Group M changes before and after the study, although they were all within
showed no significant difference (Table 4). The results of intensity the standard reference range: erythrocyte count (– 4.0%),
evaluation showed a significant difference between the two groups hemoglobin (– 5.1%), hematocrit (– 6.9%), MCV (– 2.9%), MCHC
(p=0.006). In Group W, significant improvement was noted in four (+2.0%), albumin (– 3.4%), ALP (– 10.8%), triglyceride (– 13.8%),
symptoms, “I am nervous,” “I easily get tired,” “I have stiff total cholesterol (– 4.4%), LDL-C (– 8.2%), Na (– 1.1%) and K
shoulders, lumber pain and pain in the joints” and “I have (+3.4%).Between-group differences were noted in three
headaches,” while no symptoms significantly worsened. parameters: ALP (2.0% for Group M, – 10.9% for Group W),
creatinine (– 3.7% for Group M, +4.1% for Group G) and HDL-C
(+7.0% for Group M, – 4.0% for Group W).
Anthropometry
Qualitative urine analysis revealed no significant changes in
In Group M, the following anthropometric parameters showed either group. Endocrinology indicated a similar degree of
significant changes before and after the study: body weight significant increases in IGF-I in Groups M (+17.0%) and W
(+1.6%), lean body mass (+1.9%), body water content (+2.0%), (+17.6%) (Table 6). DHEA-s significantly increased in both
BMI (+1.7%), estimated muscle mass (+2.1%), abdominal Groups M (+34.2%) and W (+22.8%). Significant increases were
circumference (– 3.8%), bending forward (+57.5%) and basal also noted in adrenaline (+100.0%) and noradrenaline (+89.5%) in
metabolism (+1.8%) (Table 5). No significant changes were noted Group M, and in noradrenaline (+105.4%) in Group W.
in grip strength and blood pressure. Immunological tests revealed significant reduction in NK cell
In Group W, percentage body fat (– 2.2%) and fat amount activity in both Groups M (– 27.8%) and W (– 25.3%).
(– 2.7%) showed significant changes before and after the study.
Systolic blood pressure (mmHg) significantly increased from the Oxidative stress markers
baseline value of 106.1 ± 12.0 to the post-8-week study value of
114.6 ± 8.6 (+8.0%), partly because three subjects whose blood For tests with oxidative stress markers, the measurement of
pressure had been in the range (90 to 113, 96 to 108, and 92 to d-ROMs and the BAP test showed no significant changes (Table 6).
108) indicating a tendency to hypotension before the study
returned to the normal range after the study.
71
Evaluation of Fitness Exercise Programs in Female Exercise Beginners
Table 4 Kupperman Menopausal Index
Between-group
Group M Group W
comparison
Baseline After 8 weeks p value Baseline After 8 weeks p value p value
My face is flushed 1.40 ±0.70 1.40 ±0.52 1.000 1.30 ±0.48 1.30 ±0.48 1.000 0.867
I easily perspire 1.80 ±1.14 2.00 ±0.67 0.555 1.80 ±0.79 1.80 ±0.92 1.000 0.507
My feet and lower back are cold 2.10 ±1.37 2.90 ±0.99 0.104 2.60 ±0.97 2.00 ±0.82 0.051 0.017
I get out of breath 1.40 ±0.70 1.40 ±0.52 1.000 1.40 ±0.70 1.10 ±0.32 0.193 0.207
My hands and feet are numb 1.30 ±0.95 1.40 ±0.97 0.343 1.20 ±0.42 1.10 ±0.32 0.591 0.548
I have little feeling in my hands and feet 1.20 ±0.63 1.40 ±0.70 0.168 1.00 ±0.00 1.10 ±0.32 0.343 0.557
I cannot get to sleep for a long time at night 1.40 ±0.70 1.40 ±0.70 1.000 1.40 ±0.52 1.10 ±0.32 0.193 0.432
I easily wake up at night even though I sleep 1.40 ±0.70 2.10 ±1.10 0.045 1.50 ±0.53 1.20 ±0.42 0.193 0.046
I easily get excited 1.50 ±0.97 2.00 ±1.05 0.052 1.60 ±0.70 1.20 ±0.63 0.168 0.025
I am nervous 1.60 ±0.84 1.90 ±0.74 0.081 1.90 ±0.57 1.20 ±0.63 0.025 0.005
I fret over unimportant things 1.80 ±1.03 1.70 ±0.82 0.591 1.80 ±0.63 1.40 ±0.70 0.168 0.263
(I frequently get depressed)
I suffer from dizziness or nausea 1.70 ±0.95 1.60 ±0.84 0.726 1.10 ±0.32 1.20 ±0.42 0.343 0.776
I easily get tired 2.40 ±0.97 2.00 ±0.82 0.104 2.40 ±0.52 1.40 ±0.52 0.004 0.058
I have stiff shoulders, lumber pain and 2.50 ±1.27 2.00 ±0.94 0.138 2.80 ±1.14 1.70 ±0.67 0.012 0.112
pain in joints
I have headaches 2.10 ±1.10 1.80 ±0.79 0.279 1.90 ±0.99 1.20 ±0.63 0.045 0.201
My heart palpitates 1.20 ±0.42 1.20 ±0.42 1.000 1.10 ±0.32 1.00 ±0.00 0.343 0.446
I have a sensation like insects crawling 1.20 ±0.42 1.30 ±0.67 0.591 1.00 ±0.00 1.00 ±0.00 ND 0.443
over the skin
Menopausal index 21.50 ±17.58 27.80 ±12.95 0.134 22.70 ±7.83 12.50 ±11.16 0.038 0.343
Intensity 2.40 ± 1.58 3.10 ± 1.45 0.089 2.50 ±0.71 1.60 ± 0.97 0.019 0.006
Kupperman Menopausal Index: 1=None, 2=Slight, 3=Moderate, 4=Marked.
Rating: Intensity 1=Mild I, 2= Mild II, 3=Moderate, 4=Serious IV, 5=Serious V.
ND: not determined.
Table 5 Anthropometry
Between-group
Group M Group W
comparison
Baseline After 8 weeks p value Baseline After 8 weeks p value p value
Height cm 160.48 ±4.14 160.48 ±4.14 – 158.35 ±4.19 158.35 ±4.19 – –
Body weight kg 54.10 ±4.99 54.97 ±4.76 0.016 53.04 ±6.12 52.84 ±5.76 0.470 0.020
Percentage body fat % 28.99 ±5.69 28.85 ±5.08 0.792 28.04 ±4.74 27.42 ±4.74 0.026 0.316
Fat amount kg 15.88 ±4.20 16.01 ±3.88 0.699 15.12 ±4.07 14.71 ±3.94 0.026 0.124
Lean body mass kg 38.23 ±2.49 38.97 ±2.70 0.010 37.93 ±2.47 38.14 ±2.20 0.346 0.131
Body water content kg 27.98 ±1.83 28.53 ±2.00 0.007 27.79 ±1.82 27.92 ±1.60 0.448 0.105
Basal metabolism kcal 1077.0 ±69.0 1096.9 ±74.1 0.007 1068.6 ±71.3 1072.9 ±63.3 0.463 0.086
BMI 20.97 ±1.67 21.33 ±1.60 0.020 21.09 ±1.88 21.04 ±1.74 0.665 0.030
Estimated muscle mass kg 35.49 ±2.30 36.22 ±2.49 0.008 35.25 ±2.29 35.41 ±2.01 0.437 0.084
Systolic blood pressure mmHg 106.10 ±9.02 111.60 ±12.59 0.230 106.10 ±11.95 114.60 ±8.64 0.010 0.561
Diastolic blood pressure mmHg 70.90 ±5.04 67.40 ±11.38 0.328 65.80 ±10.12 69.30 ±6.67 0.346 0.127
Pulse rate bpm 74.20 ±13.05 72.30 ±8.73 0.680 80.90 ±10.15 79.00 ±10.43 0.551 0.850
Abdominal circumference cm 77.53 ±6.06 74.59 ±3.75 0.014 74.71 ±4.57 73.05 ±5.36 0.199 0.591
Bending forward cm 5.97 ±10.54 9.40 ±9.54 0.000 2.47 ±8.53 9.14 ±21.39 0.304 0.746
Grip strength: right kg 25.00 ±4.22 25.65 ±4.99 0.459 25.45 ±3.63 26.05 ±3.55 0.565 0.966
Grip strength: left kg 23.70 ±3.92 23.70 ±5.09 1.000 22.90 ±2.91 22.95 ±2.35 0.944 0.503
Oxygen amount 172.00 ±16.30 179.90 ±14.96 0.240 156.90 ±23.67 166.00 ±13.42 0.184 0.921
72
Table 6 Blood biochemistry
Between-group
Group M Group W
comparison
Baseline After 8 weeks p value Baseline After 8 weeks p value p value
Leukocyte count /µL 5830.0 ±1589.6 6060.0 ±2238.7 0.726 5400.0 ±1659.3 4860.0 ±1668.1 0.343 0.435
Erythrocyte count ×104/µL 439.40 ±38.51 429.00 ±31.65 0.168 410.60 ±30.16 394.00 ±24.89 0.007 0.375
Hemoglobin g/dL 12.39 ±1.93 12.03 ±1.74 0.120 12.47 ±1.60 11.84 ±1.46 0.003 0.259
Hematocrit % 39.91 ±4.30 38.30 ±3.66 0.070 39.68 ±4.33 36.95 ±3.58 0.000 0.190
Platelet count ×104/µL 24.41 ±3.70 25.50 ±5.29 0.258 24.76 ±4.60 24.81 ±5.58 0.961 0.508
MCV fL 91.20 ±10.32 89.60 ±9.44 0.013 96.50 ±6.85 93.70 ±7.42 0.001 0.135
MCH pg 28.33 ±4.58 28.17 ±4.40 0.172 30.28 ±2.62 30.02 ±3.02 0.247 0.541
MCHC % 30.87 ±2.14 31.26 ±2.36 0.089 31.35 ±0.77 31.97 ±1.06 0.003 0.382
Neutrophils % 60.24 ±7.67 63.40 ±11.07 0.424 59.89 ±8.86 59.22 ±9.32 0.752 0.327
Lymphocytes % 30.50 ±7.08 28.46 ±10.34 0.609 31.45 ±7.80 32.13 ±8.73 0.708 0.793
Monocytes % 5.42 ±1.37 5.11 ±1.25 0.292 5.05 ±1.25 4.90 ±1.42 0.669 0.791
Eosinophils % 3.20 ±2.46 2.50 ±2.11 0.189 2.90 ±1.43 2.98 ±1.67 0.822 0.470
Basophils % 0.64 ±0.20 0.53 ±0.29 0.234 0.71 ±0.55 0.77 ±0.44 0.443 0.099
Total protein g/dL 7.12 ±0.49 7.08 ±0.35 0.759 7.30 ±0.43 7.09 ±0.41 0.054 0.272
Albumin g/dL 4.37 ±0.18 4.33 ±0.21 0.522 4.44 ±0.30 4.29 ±0.20 0.048 0.249
A/G ratio 1.64 ±0.28 1.58 ±0.21 0.343 1.56 ±0.13 1.54 ±0.20 0.642 0.817
CK IU/L 74.30 ±38.79 84.70 ±26.68 0.249 66.90 ±21.17 78.00 ±39.02 0.264 0.545
AST IU/L 16.70 ±4.72 16.70 ±3.33 1.000 16.80 ±2.35 16.70 ±3.27 0.895 0.575
ALT IU/L 14.30 ±6.86 13.60 ±3.44 0.757 11.70 ±2.71 10.30 ±1.95 0.083 0.219
LDH IU/L 155.80 ±25.62 158.50 ±21.94 0.719 154.80 ±15.36 146.50 ±15.59 0.142 0.175
ALP IU/L 157.50 ±35.98 161.10 ±51.63 0.724 170.90 ±37.40 152.40 ±33.96 0.000 0.041
γ-GTP IU/L 15.90 ±8.14 15.40 ±7.04 0.618 14.20 ±5.55 12.90 ±4.23 0.158 0.531
Creatinine mg/dL 0.60 ±0.07 0.58 ±0.07 0.131 0.63 ±0.05 0.66 ±0.03 0.125 0.032
Uric acid mg/dL 3.66 ±1.20 3.37 ±1.13 0.123 4.02 ±0.56 3.87 ±0.54 0.096 0.854
Urea nitrogen mg/dL 11.54 ±2.70 10.21 ±2.42 0.049 10.96 ±2.51 10.24 ±2.14 0.422 0.473
Blood glucose mg/dL 88.10 ±7.32 89.00 ±9.83 0.680 83.30 ±5.03 82.30 ±6.29 0.540 0.487
HbA1c % 4.88 ±0.24 4.85 ±0.22 0.394 4.72 ±0.12 4.77 ±0.16 0.138 0.102
Triglyceride mg/dL 85.40 ±40.96 69.70 ±26.45 0.189 63.60 ±17.50 54.80 ±15.41 0.038 0.739
Total cholesterol mg/dL 186.90 ±41.50 187.40 ±43.27 0.929 188.10 ±26.35 179.80 ±26.95 0.027 0.169
HDL cholesterol mg/dL 64.00 ±13.32 68.00 ±12.89 0.088 69.60 ±10.66 66.80 ±11.16 0.068 0.015
LDL cholesterol mg/dL 105.90 ±31.99 103.70 ±34.58 0.627 104.80 ±18.90 96.20 ±18.71 0.008 0.291
Sodium mEq/L 140.00 ±1.83 138.60 ±2.17 0.061 140.10 ±1.10 138.60 ±1.17 0.015 0.904
Potassium mEq/L 4.00 ±0.23 3.99 ±0.21 0.916 3.82 ±0.20 3.95 ±0.26 0.022 0.217
Chlorine mEq/L 103.30 ±1.89 102.70 ±1.95 0.475 104.40 ±1.65 103.80 ±1.69 0.425 1.000
IGF-I ng/mL 170.76 ±50.27 199.80 ±38.46 0.045 166.40 ±44.75 195.70 ±54.17 0.035 0.816
TSH µIU/mL 1.80 ±1.09 1.61 ±0.95 0.526 1.87 ±1.51 3.94 ±7.83 0.333 0.202
FT3 pg/mL 3.16 ±0.31 3.17 ±0.38 0.915 3.00 ±0.29 3.07 ±0.34 0.523 0.633
FT4 ng/dL 1.27 ±0.12 1.27 ±0.18 1.000 1.24 ±0.21 1.23 ±0.21 0.726 0.831
Cortisol µg/dL 8.67 ±2.71 9.94 ±3.13 0.422 8.51 ±2.52 8.26 ±2.91 0.831 0.315
DHEA-s µg/dL 96.10 ±43.19 129.00 ±60.66 0.001 110.30 ±60.36 135.50 ±92.34 0.043 0.055
Adrenaline *1 ng/mL 0.01 ±0.00 0.02 ±0.01 0.004 0.02 ±0.01 0.02 ±0.01 0.052 ND
Noradrenaline ng/mL 0.13 ±0.07 0.25 ±0.09 0.000 0.11 ±0.04 0.23 ±0.06 0.000 0.751
Dopamine *2 ng/mL 0.04 ±0.06 0.02 ±0.00 0.237 0.02 ±0.00 0.02 ±0.00 1.000 ND
Insulin µU/mL 3.88 ±1.26 3.25 ±1.45 0.229 3.11 ±0.91 3.25 ±1.06 0.712 0.145
CRP mg/dL 0.07 ±0.14 0.06 ±0.13 0.983 0.05 ±0.06 0.07 ±0.14 0.464 0.392
NK cell activity % 29.60 ±16.78 21.38 ±17.53 0.029 33.45 ±14.04 25.00 ±11.97 0.025 0.378
BAP test uMol/L 2480.0 ±212.2 2422.5 ±273.4 0.344 2513.9 ±165.5 2335.4 ±203.6 0.085 0.337
d-ROMs UCARR 342.60 ±72.58 328.50 ±51.68 0.600 348.10 ±47.57 352.30 ±87.20 0.875 0.775
*1 Upon analysis, <0.01 was regarded as 0.01.
*2 Upon analysis, <0.02 was regarded as 0.02.
BAP: biological anti-oxident potential. d-ROM: diacron-reactive oxygen metabolites.
Table 7 Vascular elasticity tests
Between-group
Group M Group W
comparison
Baseline After 8 weeks p value Baseline After 8 weeks p value p value
CAVI : right 6.58 ±0.48 6.86 ±0.59 0.111 6.30 ±0.36 6.54 ±0.80 0.386 0.940
CAVI : left 6.60 ±0.50 6.96 ±0.60 0.053 6.39 ±0.33 6.69 ±0.86 0.313 0.883
ABI : right 1.08 ±0.06 1.08 ±0.06 0.727 1.04 ±0.05 1.06 ±0.06 0.626 0.533
ABI : left 1.07 ±0.06 1.07 ±0.06 0.827 1.07 ±0.05 1.08 ±0.08 0.745 0.735
Accelerated plethysmography years old 41.10 ±4.98 39.90 ±4.31 0.493 44.20 ±7.79 45.20 ±7.74 0.705 0.446
CAVI : cardio ankle vascular index. ABI : ankle brachial pressure index.
73
Evaluation of Fitness Exercise Programs in Female Exercise Beginners
Table 8 Skin tests
Between-group
Group M Group W
comparison
Baseline After 8 weeks p value Baseline After 8 weeks p value p value
(Frontal view)
Noticeable pores number 948.2 ±428.7 1443.0 ±572.3 0.004 798.0 ±363.9 1241.2 ±645.2 0.020 0.814
Large noticeable pores number 45.90 ±44.63 101.90 ±95.56 0.034 33.30 ±21.47 86.90 ±69.81 0.021 0.993
Dusky noticeable pores number 421.20 ±246.16 730.90 ±382.03 0.005 327.30 ±189.06 619.30 ±400.47 0.021 0.997
Pigmentation (small) number 25.50 ±7.79 31.10 ±8.77 0.016 27.40 ±8.63 37.40 ±10.62 0.005 0.261
mm2 18.60 ±5.80 22.70 ±6.29 0.030 19.50 ±6.22 27.50 ±7.95 0.002 0.211
Pigmentation (big) number 53.80 ±18.12 69.90 ±26.66 0.004 61.00 ±28.80 79.80 ±30.77 0.006 0.458
mm2 200.00 ±113.37 253.60 ±152.81 0.013 215.80 ±111.98 310.10 ±118.77 0.031 0.222
Wrinkles under the right eye number 3.10 ±2.23 2.80 ±1.55 0.591 3.70 ±1.34 4.40 ±2.80 0.454 0.391
Wrinkles under the left eye number 3.40 ±2.59 3.20 ±1.75 0.619 3.50 ±1.18 4.60 ±2.37 0.162 0.128
Skin color tone (0-360) score 55.34 ±3.90 52.89 ±4.67 0.044 55.23 ±3.62 54.33 ±3.52 0.088 0.202
Skin clearness (0-100) score 43.85 ±4.18 42.16 ±4.13 0.008 45.11 ±7.45 43.66 ±7.06 0.014 0.653
Skin lightning (0-100) score 64.28 ±0.85 63.35 ±1.53 0.086 63.47 ±1.99 63.32 ±1.52 0.758 0.251
Moisture level (0-100) score 81.90 ±4.72 77.40 ±6.04 0.137 82.00 ±6.46 77.30 ±5.50 0.043 0.937
Oil level (0-100) score 31.50 ±5.99 26.10 ±10.18 0.100 36.60 ±9.49 30.00 ±7.33 0.082 0.751
Delicateness (0-100) score 13.80 ±4.78 17.80 ±7.21 0.066 14.50 ±6.65 14.40 ±7.65 0.971 0.934

(Right-lateral view)
Noticeable pores number 556.30 ±247.27 662.20 ±387.07 0.142 479.00 ±337.05 696.10 ±573.21 0.156 0.145
Large noticeable pores number 6.90 ±3.60 10.60 ±9.95 0.172 4.00 ±2.40 9.70 ±10.76 0.097 0.369
Dusky noticeable pores number 232.20 ±131.90 295.90 ±208.89 0.109 201.30 ±168.18 330.10 ±360.02 0.180 0.201
Pigmentation (small) number 53.40 ±8.54 62.60 ±17.81 0.070 62.50 ±15.59 67.40 ±11.13 0.340 0.745
mm2 21.50 ±5.21 26.10 ±7.02 0.006 26.60 ±8.62 27.50 ±6.67 0.720 0.422
Pigmentation (big) number 55.30 ±23.51 56.20 ±21.75 0.812 55.80 ±20.98 64.90 ±19.69 0.040 0.176
mm2 319.30 ±149.21 329.10 ±218.94 0.738 345.80 ±139.09 349.40 ±86.79 0.894 0.276
Wrinkles under the left eye number 1.40 ±0.70 1.60 ±0.84 0.555 2.10 ±1.10 1.90 ±1.73 0.693 0.343
Wrinkles at the corner of
the eye (length) mm 30.00 ±15.88 25.90 ±11.18 0.372 40.90 ±28.83 41.80 ±20.05 0.905 0.343
(area) mm2 54.10 ±29.93 50.00 ±26.85 0.429 55.30 ±32.61 63.10 ±29.49 0.377 0.343
(Left-lateral view)
Noticeable pores number 555.80 ±228.33 673.50 ±465.90 0.283 426.30 ±210.46 597.70 ±325.02 0.066 0.285
Large noticeable pores number 5.20 ±3.43 10.00 ±10.88 0.147 3.40 ±3.13 10.40 ±9.94 0.072 0.242
Dusky noticeable pores number 222.00 ±124.02 305.30 ±281.13 0.222 159.20 ±92.81 260.40 ±192.12 0.059 0.389
Pigmentation (small) number 66.40 ±18.81 65.30 ±15.66 0.814 59.20 ±12.85 64.90 ±16.35 0.153 0.289
mm2 26.30 ±7.02 28.00 ±9.27 0.553 24.30 ±4.72 27.20 ±7.79 0.162 0.817
Pigmentation (big) number 60.30 ±22.86 62.40 ±23.07 0.585 61.80 ±24.42 63.30 ±20.55 0.813 0.850
mm2 332.20 ±106.68 307.80 ±118.42 0.464 355.90 ±124.20 351.90 ±116.36 0.921 0.359
Wrinkles under the left eye number 2.00 ±1.15 1.80 ±0.79 0.591 1.70 ±1.16 2.00 ±1.33 0.576 1.000
Wrinkles at the corner of
the eye (length) mm 35.70 ±15.52 36.70 ±11.38 0.842 41.80 ±16.31 25.50 ±14.25 0.043 0.023
(area) mm2 64.10 ±18.13 67.50 ±14.68 0.531 65.40 ±23.98 40.20 ±22.86 0.068 0.043
Vascular function test Discussion

Table 7 shows results of vascular elasticity tests, indicating
Physical exercise and endocrinology
vascular age and degree of arteriosclerosis. Groups M and W
provided no significant changes in CAVI, ABI or fingertip In 20 healthy Japanese subjects (10 men and 10 women; mean
acceleration plethysmogram. age of 37.0 ± 5.9 years) who performed a 15-minute dumbbell
exercise in our previously reported study, secretion of growth
hormone was promoted after the exercise, whereas IGF-I did not
Skin test
change for the post-exercise 2-hour period 5). In our subsequent
Upon skin image analysis, neither of the two groups showed study, 31 healthy Japanese subjects (17 men and 14 women with a
significant changes in “wrinkles under the eyes” in the frontal view mean age of 59.1 ± 5.0 years) took walking exercise for 45
and “wrinkles at the corner of the eye” in the right-lateral view. In minutes at a time, 5 times a week for 8 weeks. After the study,
Group W, however, “wrinkles at the corner of the eye” in the systolic blood pressure decreased by 3.7% (from a baseline value
left-lateral view tended to improve, giving a significant of 140.2 ± 23.2 mmHg) and estrogen secretion increased in the
between-group difference (Table 8). The number of noticeable pores women, while IGF-I and DHEA-s did not significantly change 6).
and the measured parameters for pigmentation increased significantly Eighty-eight elderly male athletes (mean age of 56.8 ± 10.8 years)
in the frontal view of the face, although these parameters did not gave smaller scores for symptoms on the AAQol 22). Regarding the
provide remarkable results in the right- and left-lateral views. A relationship between exercise and secretion of monoamines, a
significant reduction was noted in “skin color tone” and “skin post-exercise increase in noradrenaline 23) and reduction in
clearness” in Group M, and in “skin clearness” in Group W. noradrenaline immediately after triathlon 24) have been reported to
Moisture level measurement revealed no significant changes date.
in Group M and a significant reduction (p=0.043) in Group W. Oil In the present study, IGF-I and DHEA-s increased after
level measurement showed no significant changes in either group. performance of the prescribed exercise programs. Our study
74
differs from these previously reported studies in that the subjects that is, it contributes to the maintenance of homeostasis.
were relatively young women (35 to 45 years old) with little
experience of undertaking exercise. The subjects had the potential
for hormone secretion but had failed to exert this potential ability Effects on the psychoneurologic system
since they had not made a habit of taking exercise. Their
Exercise is known to exert a variety of favorable effects on
participation in our study made them exercise, resulting in
mental variables. In the present study, evaluation of mental
demonstration of their ability to secrete GH/IGF-I and DHEA.
symptoms revealed that Group M was characterized by the
exercise-induced improvement of anxiety, and Group W by
the anti-depression effect of exercise and exercise-related
Effects on body composition and lipid metabolism
improvement of climacteric symptoms.
In the present study, Group M; a composite exercise program As indicated by the fact that serotonin 1A (5-HT1A) agonists
with muscle resistance training, and Group W; a simple exercise play a greater role among anti-anxiety drugs in the management of
program with walking as a main component, produced changes in anxiety symptoms, metabolism of monoamines such as serotonin
body composition after the 8-week exercise period which accorded in the brain is involved in anxiety symptoms. Selective serotonin
with the contents of the individual program. That is, Group M was reuptake inhibitors exhibit anti-anxiety effects, and serotonin
characterized by increases in estimated muscle mass and lean body release may control anxiety in a suppressive manner 31). After
mass, whereas Group M was characterized by decreased fat learning in the context of fear conditioning, fear responses to
amount. In Group M, due to the increased muscle mass, body conditional stimulation are associated with the expression of
weight and BMI increased and these increases were significantly transcription factors in the amygdaloid body and hippocampus.
different when compared with Group W. As the result of this, the Exercise in combination with music has been reported to exert
scores for the subjective symptom “tendency to gain weight” anti-anxiety and relaxing effects, although evaluation with the
increased in Group M. Since increased muscle mass is associated STAI indicated no significant differences 32). The exercise program
with intensified basal metabolism and increased secretion of IGF-I of Group M in the present study included aromatherapy and music
and DHEA-s, these changes in body composition in Group M may therapy as components, and thus represented a comprehensive
have had favorable effects on the subjects of this group. Increased approach to the pursuit of sensory comfort. Aromatherapy has
skeletal muscle mass improves insulin resistance, accelerates fat been reported to display anti-anxiety effects in various clinical
decomposition in fat cells and reduces fat retention 25). Increasing settings 33). Although we cannot conclusively determine that many
the amount of physical activity by the methods used in the present of the published studies regarding music therapy would stand up to
study is greatly significant, since decreased physical activity more stringent medical verification, some investigators have reported
strongly contributes to the increased prevalence of metabolic that listening to music in an intensive care unit suppressed anxiety
syndrome in modern society than increased dietary caloric intake 26). and intensified the effect of analgesic medication, resulting in the
Evaluation of lipid metabolism revealed that in Group W, smaller consumption of analgesics 34). In the present study, the
significantly lowered triglyceride, total cholesterol and approach through comprehensive exercise therapy might have
LDL-cholesterol and decreased. In Group M, triglyceride and promoted serotonin secretion in the brain, leading to the demonstration
LDL-C tended to decrease, although not significantly, while of anti-anxiety effects. Measurement of changes in cerebral
HDL-C tended to increase, and this tendency to increase was serotonin levels for the purpose of evaluating the degree of anxiety
significantly different when compared with Group W. This may be in humans is desirable, although a practical method for such
explained by the fact that Group W performed aerobic exercise measurement has not been developed.
with walking as its primary component. Generally, lack of exercise Cerebral monoamines, adrenomedullary hormones and
inactivates β-oxidation of fatty acids and hampers the utilization of adrenocortical hormones are involved in the development of stress
these fatty acids as an energy source. Habitual aerobic exercise symptoms. In highly stressed individuals, levels of cortisol in
accelerates the secretion of growth hormone, cortisol, adrenaline, blood, urine and saliva, and adrenaline and noradrenaline in urine
noradrenaline and other relevant substances, and promotes the samples are high. Lack of exercise or insufficient sleeping
metabolism of fat. It was considered that these mechanisms facilitates the development of stress symptoms 35). For cortisol,
occurred in Group W of the present study, leading to the decreases investigators have reported that jogging for one hour at a time,
in blood lipids as well as in body fat and fat amount. We could not three times a week for 8 weeks induced a reduction in urinary
clarify the mechanism that exercise elevated the LDL-C level. cortisol levels 36), climbing up and down a step lowered cortisol
levels in saliva 37), but that 20-minute exercise using a bicycle
ergometer induced no change in salivary cortisol concentrations 38)
Association with blood pressure and that a transient water exercise induced no change in salivary
cortisol concentrations 39). In the present study, serum cortisol
A suitable amount of aerobic exercise such as walking is
levels tended to be lower in Group W than in Group M but not
known to reduce blood pressure, and is recommended by the
statically significant, indicating that this finding might have been
Japanese Society of Hypertension. This has also been incorporated
related to the anti-depression effect noted in Group W.
in a variety of forms into clinical practice provided by healthcare
Accordingly, the present study supports the previously reported
professionals 6,27-29). Study subjects in our previous study had
effectiveness of moderate aerobic exercise such as walking in the
borderline hypertension, and achieved a significant reduction in
management of stress. This study, which did not evaluate estrogen,
blood pressure by exercise 6). However, the subjects of present
also indicated the possibility that walking (Group W) might have
study included some women who showed a tendency towards
increased blood flow in the lower part of the body including the
hypotension, thus exercise did not cause any significant change in
region of the pelvic organs, activating ovarian function and
blood pressure. We should interpret these results as follows: a
accelerating the secretion of estrogen, which might then have
proper amount of aerobic exercise stabilizes the autonomic
contributed to the improvement of climacteric symptoms.
nervous system 30), and thereby increases blood pressure in those
with a tendency to lower blood pressure and decreases
bloodpressure in those with a tendency to higher blood pressure;
75