Battle of the sexes: Which is better for you, high- or low-intensity exercise?

Cardiovascular disease (CVD) accounts for more than 17 million deaths per year; however, morbidity statistics alone underestimate the scale of the problem because a significant proportion of the population live with CVD. Obesity and type 2 diabetes mellitus (T2DM) have significant influence on CVD initiation and progression, and obesity is independently associated with CVD, particularly among women. Obesity levels are rising rapidly in adults, but of particular concern is its swift rise in children and adolescents, who are at risk of remaining overweight into adult life in which long-term health consequences are most likely to manifest. In its simplest form, obesity arises because of an imbalance between energy intake and energy expenditure, with excess triglycerides being stored in adipocytes, which can increase in both size and number. Obesity results in numerous potential adverse effects such as sleep apnea, increased incidence of osteoarthritis, and psychological impact, but adipocytes also act as an endocrine organ secreting hormones and cytokines such as retinol-binding protein 4 (RBP-4) and adiponectin. In obesity, adiponectin levels decrease and RBP-4 levels increase, the effects of which enhance insulin resistance, thus increasing T2DM risk. Individuals with T2DM have a several-fold increased risk of CVD, and many of the risk factors for obesity, T2DM, and CVD overlap highlighting the interlinking complexity of these pathologic processes: poor diet, age, gender, ethnicity, smoking, dyslipidemia, hypertension, and physical inactivity, to name a few.