Muscular Adaptations to Concurrent Resistance Training and High-Intensity Interval Training in Adults with Type 2 Diabetes: A Pilot Study

This pilot study aimed to compare the effects of eight weeks of concurrent resistance training (RT) and high-intensity interval training (HIIT) vs. RT alone on muscle performance, mass and quality in adults with type 2 diabetes (T2DM). Twelve T2DM adults were randomly allocated to the RT + HIIT (n = 5) or RT (n = 7) group. Before and after training, maximal oxygen uptake (VO2max), muscle strength and power were evaluated by calorimetry, dynamometry and one-repetition maximum (1RM) test. Quadriceps muscle volume was determined by MRI, and muscle quality was estimated. After RT, VO2max (+12%), knee muscle power (+20%), quadriceps muscle volume (+5.9%) and quality (leg extension, +65.4%; leg step-up, +223%) and 1RM at leg extension (+66.4%), leg step-up (+267%), lat pulldown (+60.9%) and chest press (+61.2%) significantly increased. The RT + HIIT group improved on VO2max (+27%), muscle volume (+6%), muscle power (+9%) and 1RM at lat pulldown (+47%). No other differences were detected. Among groups, changes in muscle quality at leg step-up and leg extension and VO2max were significantly different. The combination of RT and HIIT effectively improves muscle function and size and increases cardiorespiratory fitness in adults with T2DM. However, HIIT combined with RT may interfere with the development of muscle quality.

Lower volume throughout the taper and higher intensity in the last interval session prior to a 1,500 m time trial improves performance

Eight highly-trained middle-distance runners (1,500 m personal best 4:01.4 ± 0:09.2 min) completed two 7-day tapers, separated by at least 3 weeks of regular training: (i) prescribed using prediction models from elite middle-distance runners, where continuous running volume was reduced by 30% and interval intensity was equal to 1,500 m race pace (RP); and (ii) continuous running volume was reduced by 60% and intensity of the final interval session was completed at 110% of 1,500 m race pace (HI). Performance was assessed using 1,500 m time trials on an indoor 200 m track one day before, and one day after each taper. Performance time was improved after HI by 5.2 ± 3.7 s (mean ± 90% confidence limits, p = 0.03) and by 3.2 ± 3.8 s after RP (p = 0.15). The first and second 300-m segments of the 1,500 m time trial were faster post-taper in RP (p = 0.012 and p = 0.017, respectively) and HI (both p = 0.012). Running faster than race pace late in a low-volume taper is recommended to improve 1,500 m track performance. A positive pacing strategy is adopted after tapering, although care should be taken to avoid an over-fast start. Novel Findings • A large reduction in volume during tapering and an increase in final interval session intensity improves running performance • Athletes adopt a negative pacing strategy before tapering and a positive-pacing strategy after tapering.

Effects of an increase in intensity during tapering on 1500-m running performance

We examined the effect of completing the final interval training session during a taper at either (i) race pace (RP) or (ii) faster than RP on 1500-m running performance and neuromuscular performance. Ten trained runners (age, 21.7 ± 3.0 years; height, 182.9 ± 7.0 cm; body mass, 73.4 ± 6.8 kg; and personal best 1500-m time, 4:17.5 ± 0:26.9 min) completed 2 conditions consisting of 7 days of regular training and a 7-day taper, separated by 3 weeks of training. In 1 condition, the taper was prescribed using prediction models based on the practices of elite British middle-distance runners, with the intensity of the final interval session being equal to 1500-m RP. The taper was repeated in the high-intensity (HI) condition, with the exception that the final interval session was completed at 115% of 1500-m RP. A 1500-m treadmill time trial and measures of maximal voluntary contraction (MVC) and rate of force development (RFD) were completed before and after regular training and tapering. Performance was most likely improved after RP (mean ± 90% confidence limits, 10.1 ± 1.6 s), and possibly beneficial after HI (4.2 ± 12.0 s). Both MVC force (p = 0.002) and RFD (p = 0.02) were improved after tapering, without differences between conditions. An RP taper based on the practices of elite middle-distance runners is recommended to improve performance in young, subelite runners. The effect of this strategy with an increase in interval intensity is highly variable and should be implemented with caution.

The effect of exercise training on intrahepatic triglyceride and hepatic insulin sensitivity: a systematic review and meta-analysis

This systematic review and meta-analysis determined the impact of structured exercise training, and the influence of associated weight loss, on intrahepatic triglyceride (IHTG) in individuals with non-alcoholic fatty liver disease (NAFLD). It also examined its effect on hepatic insulin sensitivity in individuals with or at increased risk of NAFLD. Analyses were restricted to studies using magnetic resonance spectroscopy or liver biopsy for the measurement of IHTG and isotope-labelled glucose tracer for assessment of hepatic insulin sensitivity. Pooling data from 17 studies (373 exercising participants), exercise training for one to 24 weeks (mode: 12 weeks) elicits an absolute reduction in IHTG of 3.31% (95% CI: -4.41 to -2.22%). Exercise reduces IHTG independent of significant weight change (-2.16 [-2.87 to -1.44]%), but benefits are substantially greater when weight loss occurs (-4.87 [-6.64 to -3.11]%). Furthermore, meta-regression identified a positive association between percentage weight loss and absolute reduction in IHTG (β = 0.99 [0.62 to 1.36], P < 0.001). Pooling of six studies (94 participants) suggests that exercise training also improves basal hepatic insulin sensitivity (mean change in hepatic insulin sensitivity index: 0.13 [0.05 to 0.21] mg m^-2  min^-1 per μU mL^-1 ), but available evidence is limited, and the impact of exercise on insulin-stimulated hepatic insulin sensitivity remains unclear.

The influence of adiposity and acute exercise on circulating hepatokines in normal-weight and overweight/obese men

Hepatokines are liver-secreted proteins with potential to influence glucose regulation and other metabolic parameters. This study investigated differences in adiposity status on 5 novel hepatokines and characterised their response to acute moderate-intensity exercise in groups of normal-weight and overweight/obese men. Twenty-two men were recruited into normal-weight and overweight/obese groups (body mass index: 18.5 to 24.9 and 25.0 to 34.9 kg·m^-2). Each completed 2 experimental trials, exercise and control. During exercise trials, participants performed 60 min of moderate-intensity treadmill exercise (∼60% peak oxygen uptake) and then rested for 6 h. Participants rested throughout control trials. Circulating fibroblast growth factor-21 (FGF21), follistatin, leukocyte cell-derived chemotaxin 2 (LECT2), fetuin-A, and selenoprotein-P (SeP) were measured throughout. Fasted (resting) FGF21 and LECT2 were higher in overweight/obese individuals (129% and 55%; P ≤ 0.01) and correlated with indices of adiposity and insulin resistance; whereas circulating follistatin was lower in overweight/obese individuals throughout trial days (17%, P < 0.05). In both groups, circulating concentrations of FGF21 and follistatin were transiently elevated after exercise for up to 6 h (P ≤ 0.02). Circulating fetuin-A and SeP were no different between groups (P ≥ 0.19) and, along with LECT2, were unaffected by exercise (P ≥ 0.06). These findings show that increased adiposity is associated with a modified hepatokine profile, which may represent a novel mechanism linking excess adiposity to metabolic health. Furthermore, acute perturbations in circulating FGF21 and follistatin after exercise may contribute to the health benefits of an active lifestyle.

Satellite cell response to concurrent resistance exercise and high-intensity interval training in sedentary, overweight/obese, middle-aged individuals

Purpose

Sarcopenia can begin from the 4–5th decade of life and is exacerbated by obesity and inactivity. A combination of resistance exercise (RE) and endurance exercise is recommended to combat rising obesity and inactivity levels. However, work continues to elucidate whether interference in adaptive outcomes occur when RE and endurance exercise are performed concurrently. This study examined whether a single bout of concurrent RE and high-intensity interval training (HIIT) alters the satellite cell response following exercise compared to RE alone.

Methods

Eight sedentary, overweight/obese, middle-aged individuals performed RE only (8 × 8 leg extensions at 70% 1RM), or RE + HIIT (10 × 1 min at 90% HR_max on a cycle ergometer). Muscle biopsies were collected from the vastus lateralis before and 96 h after the RE component to determine muscle fiber type-specific total (Pax7⁺ cells) and active (MyoD⁺ cells) satellite cell number using immunofluorescence microscopy.

Results

Type-I-specific Pax7⁺ (P = 0.001) cell number increased after both exercise trials. Type-I-specific MyoD⁺ (P = 0.001) cell number increased after RE only. However, an elevated baseline value in RE + HIIT compared to RE (P = 0.046) was observed, with no differences between exercise trials at 96 h (P = 0.21). Type-II-specific Pax7⁺ and MyoD⁺ cell number remained unchanged after both exercise trials (all P ≥ 0.13).

Conclusion

Combining a HIIT session after a single bout of RE does not interfere with the increase in type-I-specific total, and possibly active, satellite cell number, compared to RE only. Concurrent RE + HIIT may offer a time-efficient way to maximise the physiological benefits from a single bout of exercise in sedentary, overweight/obese, middle-aged individuals.

Cross-sectional surveillance study to phenotype lorry drivers' sedentary behaviours, physical activity and cardio-metabolic health

OBJECTIVES

Elevated risk factors for a number of chronic diseases have been identified in lorry drivers. Unhealthy lifestyle behaviours such as a lack of physical activity (PA) and high levels of sedentary behaviour (sitting) likely contribute to this elevated risk. This study behaviourally phenotyped UK lorry drivers' sedentary and non-sedentary behaviours during workdays and non-workdays and examined markers of drivers cardio-metabolic health.

SETTING

A transport company from the East Midlands, UK.

PARTICIPANTS

A sample of 159 male heavy goods vehicle drivers (91% white European; (median (range)) age: 50 (24, 67) years) completed the health assessments. 87 (age: 50.0 (25.0, 65.0); body mass index (BMI): 27.7 (19.6, 43.4) kg/m²) provided objective information on sedentary and non-sedentary time.

OUTCOMES

Participants self-reported their sociodemographic information. Primary outcomes: sedentary behaviour and PA, assessed over 7 days using an activPAL3 inclinometer. Cardio-metabolic markers included: blood pressure (BP), heart rate, waist circumference (WC), hip circumference, body composition and fasted capillary blood glucose, triglycerides, high-density lipopreotein cholesterol, low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) levels. These cardio-metabolic markers were treated as secondary outcomes.

RESULTS

Lorry drivers presented an unhealthy cardio-metabolic health profile (median (IQR) systolic BP: 129 (108.5, 164) mm Hg; diastolic BP: 81 (63, 104) mm Hg; BMI: 29 (20, 47) kg/m²; WC: 102 (77.5, 146.5) cm; LDL-C: 3 (1, 6) mmol/L; TC: 4.9 (3, 7.5) mmol/L). 84% were overweight or obese, 43% had type 2 diabetes or prediabetes and 34% had the metabolic syndrome. The subsample of lorry drivers with objective postural data (n=87) accumulated 13 hours/day and 8 hours/day of sedentary behaviour on workdays and non-workdays (p<0.001), respectively. On average, drivers accrued 12 min/day on workdays and 6 min/day on non-workdays of moderate-to-vigorous PA (MVPA).

CONCLUSION

Lorry drivers demonstrate a high-risk cardio-metabolic profile and are highly sedentary and physically inactive. Interventions to reduce sitting and increase MVPA during breaks and leisure time to improve cardio-metabolic health are urgently needed. Educational programmes to raise awareness about diet and exercise are recommended.

An evaluation of low volume high-intensity intermittent training (HIIT) for health risk reduction in overweight and obese men

ᅟ

Both sprint interval training (SIT) and high-intensity intermittent training (HIIT) have been described as time-efficient strategies for inducing favourable metabolic and cardiorespiratory adaptations in healthy and diseased participants.

Background

To date, little attention has been given to profiling the potential health benefits of HIIT or modified HIIT training within overweight and obese cohorts with particular focus on inflammation. Within this pilot trial, we tested the hypothesis that 6 sessions of HIIT performed over 2 weeks with 1–2 days’ rest would improve aerobic capacity, glucose metabolism and inflammatory profile in an overweight and obese male cohort. Additionally, we profiled the potential health benefits of 4 HIIT sessions performed over the same period.

Methods

18 overweight or obese males (BMI = 31.2 ± 3.6; V̇O₂ = 30.3 ± 4.4 ml.kg.min^-1) were studied before and 72 h after HIIT. Training sessions consisted of 10 x 1 min intervals at 90% HR_peak separated by 1 min recovery periods. Exercise was performed either 6 (group 1, n = 8) or 4 (group 2, n = 10) times over a 2 week period.

Results

After training no changes were detected from baseline for body composition, aerobic capacity, glucose metabolism or inflammatory profile (p > 0.05) in either group.

Conclusion

Both 6 and 4 sessions of HIIT performed over a 2-week period are ineffective in improving selected health markers within an overweight and obese cohort.

Trial registration

This trial reports data from human participants and was retrospectively registered on 22/02/2017 with the ISRCTN registry, trial number ISRCTN90672085.

Reducing sedentary time in adults at risk of type 2 diabetes: process evaluation of the STAND (Sedentary Time ANd Diabetes) RCT

Background

Reducing sedentary behaviour may have important health implications. This study evaluated the potential enablers and barriers for outcomes of a randomised controlled trial (RCT) designed to evaluate a pragmatic education based intervention designed to reduce sedentary (sitting) behaviour in young adults at high risk of type 2 diabetes.

Methods

Data were collected from participants in the intervention group immediately after an educational workshop addressing sedentary time and diabetes risk (n = 71), through phone interviews 6 weeks (n = 45) after the workshop, and at the conclusion of the 12-month trial (n = 10). The two education session facilitators were also interviewed about the intervention.

Results

The RCT showed no difference in sedentary time at 12 months between intervention and control arms. The lack of behaviour change appeared not to be attributed to the workshops, which were well led and very favourably received according to feedback. However, factors contributing to this lack of behaviour change include lack of perceived health risk from baseline measures feedback; the preference to adopt physically active behaviours rather than to sit less; certain barriers to sitting less; motivational drift after the 3-month follow-up measurements where participants had no contact for a further 9 months; and, for some, unreliability of the self-monitoring tool.

Conclusions

The workshop was well led and well received by the attendees but future interventions need to consider more contact with participants, discuss any specific benefits around simply standing to reduce sitting time, address the barriers to sitting less, and provide a more user-friendly and reliable self-monitoring tool.

Trial registration

Current controlled trials ISRCTN08434554, MRC project 91409. Registered retrospectively on 22 February 2011.

Understanding the health of lorry drivers in context: A critical discourse analysis

This article moves beyond previous attempts to understand health problems in the lives of professional lorry drivers by placing the study of drivers' health in a wider social and cultural context. A combination of methods including focus groups, interviews and observations were used to collect data from a group of 24 lorry drivers working at a large transport company in the United Kingdom. Employing a critical discourse analysis, we identified the dominant discourses and subject positions shaping the formation of drivers' health and lifestyle choices. This analysis was systematically combined with an exploration of the gendered ways in which an almost exclusively male workforce talked about health. Findings revealed that drivers were constituted within a neoliberal economic discourse, which is reflective of the broader social structure, and which partly restricted drivers' opportunities for healthy living. Concurrently, drivers adopted the subject position of 'average man' as a way of defending their personal and masculine status in regards to health and to justify jettisoning approaches to healthy living that were deemed too extreme or irrational in the face of the constraints of their working lives. Suggestions for driver health promotion include refocusing on the social and cultural - rather than individual - underpinnings of driver health issues and a move away from moralistic approaches to health promotion.

Associations of Sedentary Time with Fat Distribution in a High-Risk Population

PURPOSE

The effect of sedentary behavior on regional fat deposition, independent of physical activity, remains equivocal. We examined the cross-sectional associations between objectively measured sedentary time and markers of regional fat distribution (heart, liver, visceral, subcutaneous, and total body fat) in a population at a high risk of type 2 diabetes mellitus (T2DM).

METHODS

Participants were recruited from primary care to two diabetes prevention programs. Sedentary time (<25 counts per 15 s) was measured using ActiGraph GT3X accelerometers. Heart, liver, visceral, subcutaneous, and total body fat were quantified using magnetic resonance images. Fat volumes were calculated by multiplying the cross-sectional areas of the fat-containing pixels by the slice thickness. The liver fat percentage was measured using a representative region of interest created in the right lobe of the liver, avoiding the main portal veins. Linear regression models examined the association of sedentary time with markers of regional fat deposition.

RESULTS

Sixty-six participants (age, 47.9 ± 16.2 yr; male, 50.0%) were included. After adjustment for several covariates, including glycemia, whole-body fat, and moderate-to-vigorous physical activity, each 30 min of sedentary time was associated with 15.7 cm higher heart fat (P = 0.008), 1.2% higher liver fat (P = 0.026), and 183.7 cm higher visceral fat (P = 0.039).

CONCLUSIONS

This study provides new evidence suggesting that objectively measured sedentary behavior may have an independent association with heart, liver, and visceral fat in individuals at a high risk of T2DM.

A Randomised Controlled Trial to Reduce Sedentary Time in Young Adults at Risk of Type 2 Diabetes Mellitus: Project STAND (Sedentary Time ANd Diabetes)

AIMS

Type 2 diabetes mellitus (T2DM), a serious and prevalent chronic disease, is traditionally associated with older age. However, due to the rising rates of obesity and sedentary lifestyles, it is increasingly being diagnosed in the younger population. Sedentary (sitting) behaviour has been shown to be associated with greater risk of cardio-metabolic health outcomes, including T2DM. Little is known about effective interventions to reduce sedentary behaviour in younger adults at risk of T2DM. We aimed to investigate, through a randomised controlled trial (RCT) design, whether a group-based structured education workshop focused on sitting reduction, with self-monitoring, reduced sitting time.

METHODS

Adults aged 18-40 years who were either overweight (with an additional risk factor for T2DM) or obese were recruited for the Sedentary Time ANd Diabetes (STAND) RCT. The intervention programme comprised of a 3-hour group-based structured education workshop, use of a self-monitoring tool, and follow-up motivational phone call. Data were collected at three time points: baseline, 3 and 12 months after baseline. The primary outcome measure was accelerometer-assessed sedentary behaviour after 12 months. Secondary outcomes included other objective (activPAL) and self-reported measures of sedentary behaviour and physical activity, and biochemical, anthropometric, and psycho-social variables.

RESULTS

187 individuals (69% female; mean age 33 years; mean BMI 35 kg/m2) were randomised to intervention and control groups. 12 month data, when analysed using intention-to-treat analysis (ITT) and per-protocol analyses, showed no significant difference in the primary outcome variable, nor in the majority of the secondary outcome measures.

CONCLUSIONS

A structured education intervention designed to reduce sitting in young adults at risk of T2DM was not successful in changing behaviour at 12 months. Lack of change may be due to the brief nature of such an intervention and lack of focus on environmental change. Moreover, some participants reported a focus on physical activity rather than reductions in sitting per se. The habitual nature of sedentary behaviour means that behaviour change is challenging.

TRIAL REGISTRATION

Controlled-Trials.com ISRCTN08434554.

Acute molecular responses to concurrent resistance and high-intensity interval exercise in untrained skeletal muscle

Concurrent training involving resistance and endurance exercise may augment the benefits of single-mode training for the purpose of improving health. However, muscle adaptations, associated with resistance exercise, may be blunted by a subsequent bout of endurance exercise, via molecular interference. High-intensity interval training (HIIT), generating similar adaptations to endurance exercise, may offer an alternative exercise mode to traditional endurance exercise. This study examined the influence of an acute HIIT session on the molecular responses following resistance exercise in untrained skeletal muscle. Ten male participants performed resistance exercise (4 × 8 leg extensions, 70% 1RM, (RE)) or RE followed by HIIT (10 × 1 min at 90% HRmax, (RE+HIIT)). Muscle biopsies were collected from the vastus lateralis before, 2 and 6 h post-RE to determine intramuscular protein phosphorylation and mRNA responses. Phosphorylation of Akt (Ser(473)) decreased at 6 h in both trials (P < 0.05). Phosphorylation of mTOR (Ser(2448)) was higher in RE+HIIT (P < 0.05). All PGC-1α mRNA variants increased at 2 h in RE+HIIT with PGC-1α and PGC-1α-ex1b remaining elevated at 6 h, whereas RE-induced increases at 2 and 6 h for PGC-1α-ex1b only (P < 0.05). Myostatin expression decreased at 2 and 6 h in both trials (P < 0.05). MuRF-1 was elevated in RE+HIIT versus RE at 2 and 6 h (P < 0.05). Atrogin-1 was lower at 2 h, with FOXO3A downregulated at 6 h (P < 0.05). These data do not support the existence of an acute interference effect on protein signaling and mRNA expression, and suggest that HIIT may be an alternative to endurance exercise when performed after resistance exercise in the same training session to optimize adaptations.

Highly manufacturable graphene oxide biosensor for sensitive Interleukin-6 detection

Reduced graphene oxide can be used as a sensitive label-free sensor transducer for detection of Interleukin-6 proteins, by overcoming the variable coverage and high electrical resistance, via ethanol Chemical Vapour Deposition (CVD).

Interleukin-6 in combination with the interleukin-6 receptor stimulates glucose uptake in resting human skeletal muscle independently of insulin action

AIM

To examine if the physiological concentrations of both interleukin-6 (IL-6), in combination with IL-6 receptor (IL-6R), are able to stimulate glucose uptake in human skeletal muscle and to identify the associated signalling pathways.

METHODS

Skeletal muscle tissue (~60 mg) obtained from healthy female volunteers via muscle biopsy was subjected to incubation in the absence or presence of insulin (60 µU/ml), recombinant human IL-6 (rhIL-6) (4 ng/ml) or a combination of rhIL-6 (4 ng/ml) and rhIL-6R (100 ng/ml) for 30 min, with glucose transport measured for each incubation. Western blot analysis was conducted on key signalling proteins, protein kinase B (PKB/Akt), adenosine monophosphate kinase (AMPK) and mammalian target of rapamycin (mTOR) to gain an early insight into any differing transport mechanisms.

RESULTS

Human skeletal muscle exhibited increased glucose uptake with insulin (1.85-fold; p < 0.05) and stimulated phosphorylation of PKB/Akt and AMPK (0.98 ± 0.23 and 1.49 ± 0.13, respectively, phosphorylated: total; p < 0.05). IL-6/IL-6R increased phosphorylation of mTOR (fourfold, p < 0.05) compared to insulin, IL-6 alone and basal control. IL-6 did not stimulate glucose uptake but combined with IL-6R, induced 1.5-fold increase in glucose uptake (p < 0.05) and phosphorylation of AMPK (0.95 ± 0.19; phosphorylated: total, p < 0.05).

CONCLUSIONS

IL-6 in combination with IL-6R and not IL-6 alone increased glucose uptake in human skeletal muscle. IL-6/IL-6R-mediated glucose uptake occurred independently of PKB/Akt phosphorylation, showing that IL-6/IL-6R-induced glucose uptake is dependent on a divergent pathway.

Tapering strategies in elite British endurance runners

The aim of the study was to explore pre-competition training practices of elite endurance runners. Training details from elite British middle distance (MD; 800 m and 1500 m), long distance (LD; 3000 m steeplechase to 10,000 m) and marathon (MAR) runners were collected by survey for 7 days in a regular training (RT) phase and throughout a pre-competition taper. Taper duration was [median (interquartile range)] 6 (3) days in MD, 6 (1) days in LD and 14 (8) days in MAR runners. Continuous running volume was reduced to 70 (16)%, 71 (24)% and 53 (12)% of regular levels in MD, LD and MAR runners, respectively (P < 0.05). Interval running volume was reduced compared to regular training (MD; 53 (45)%, LD; 67 (23)%, MAR; 64 (34)%, P < 0.05). During tapering, the peak interval training intensity was above race speed in LD and MAR runners (112 (27)% and 114 (3)%, respectively, P < 0.05), but not different in MD (100 (2)%). Higher weekly continuous running volume and frequency in RT were associated with greater corresponding reductions during the taper (R = -0.70 and R = -0.63, respectively, both P < 0.05). Running intensity during RT was positively associated with taper running intensity (continuous intensity; R = 0.97 and interval intensity; R = 0.81, both P < 0.05). Algorithms were generated to predict and potentially prescribe taper content based on the RT of elite runners. In conclusion, training undertaken prior to the taper in elite endurance runners is predictive of the tapering strategy implemented before competition.

Dynamic changes in dna methylation status in peripheral blood Mononuclear cells following an acute bout of exercise: Potential impact of exercise-induced elevations in interleukin-6 concentration

The aim of the present study was to examine the relationship between interleukin (IL)-6 concentrations and DNA methylation in the peripheral blood mononuclear cells (PBMCs) of trained runners after a bout of prolonged, strenuous exercise. Eight healthy trained males completed a treadmill run at 60% vVO(2max) for 120 min followed by a 5-km time trial in a fasted condition. Whole blood samples were taken prior to, immediately before and 24 h following exercise. From these samples, PBMCs were isolated for analysis and plasma IL-6 concentrations were measured. The methylation status of DNA extracted from PBMCs was analysed using the Illumina 27k methylation beadchip platform. Global DNA methylation status was unaltered immediately and up to 24 hours following a bout of prolonged exercise in comparison to pre-exercise. Despite no change in global DNA methylation, plasma IL-6 concentrations were significantly related to the DNA methylation status of 11 genes. Our study demonstrates that the methylome is stable, while discovering a novel link between exercise-induced increases in circulating IL-6 and the DNA methylation status of 11 individual genes. Based on our preliminary findings, the mechanisms by which changes in plasma IL-6 concentrations and DNA methylation in response to exercise interact require further study.

Type 2 diabetes mellitus and obesity in young adults: the extreme phenotype with early cardiovascular dysfunction

AIM

A pilot study to phenotype young adults (< 40 years) with Type 2 diabetes mellitus.

METHODS

Twenty people with Type 2 diabetes (aged 18-40 years), 10 lean and 10 obese control subjects underwent detailed assessment, including tagged cardiac magnetic resonance imaging, inflammatory proteins, lipids, vitamin D and maximal oxygen uptake. Outcomes were compared between the group with Type 2 diabetes and the control group.

RESULTS

Mean (standard deviation) age, Type 2 diabetes duration and BMI in the group with Type 2 diabetes were 31.8 (6.6) years, 4.7 (4.0) years and 33.9 (5.8) kg/m(2) respectively. Compared with lean control subjects, those with Type 2 diabetes had more deleterious profiles of hyperlipidaemia, vitamin D deficiency, inflammation and maximal oxygen uptake relative to body mass. However, there was no difference between the group with Type 2 diabetes and the obese control group. The group with Type 2 diabetes had a higher left ventricular mass and a trend towards concentric remodelling compared with the lean control group (P = 0.002, P = 0.052) but not the obese control group (P > 0.05). Peak early diastolic strain rate was reduced in the group with Type 2 diabetes [1.51 (0.24)/s] compared with the lean control [1.97 (0.34)/s, P = 0.001] and obese control [1.78 (0.39)/s, P = 0.042] group.

CONCLUSIONS

Young adults with Type 2 diabetes and those with obesity have similar adverse cardiovascular risk profiles, higher left ventricular mass and a trend towards left ventricular concentric remodelling. In addition, those with Type 2 diabetes demonstrate diastolic dysfunction, a known risk marker for future heart failure and mortality.

The detection and measurement of interleukin-6 in venous and capillary blood samples, and in sweat collected at rest and during exercise

PURPOSE

This study aimed to quantify the relationship between venous and capillary blood sampling methods for the measurement of plasma interleukin-6 (IL-6). A parallel study was conducted to determine the possibility of measuring IL-6 in sweat using an enzyme-linked immunosorbent assay (ELISA) and investigate the relationship between plasma- and sweat-derived measures of IL-6.

METHODS

Twelve male participants were recruited for the measurement of IL-6 at rest and during exercise (study 1). An additional group of five female participants was recruited for the measurement of IL-6 in venous blood versus sweat at rest and following exercise (study 2). In study 1, venous and capillary blood samples were collected at rest and in response to exercise. In study 2, venous and sweat samples were collected following exercise.

RESULTS

Mean plasma IL-6 concentration was not different between venous and capillary blood sampling methods either at rest (4.27 ± 5.40 vs. 4.14 ± 4.45 pg ml(-1)), during (5.40 ± 5.17 vs. 5.58 ± 6.34 pg ml(-1)), or in response to exercise (6.95 ± 6.37 vs. 6.99 ± 6.74 pg ml(-1)). There was no IL-6 detectable in sweat either at rest or following exercise.

CONCLUSION

There are no differences in the measurement of plasma IL-6 using either venous or capillary blood sampling methods. Capillary measurement represents a minimally invasive way of measuring IL-6 and detecting changes in IL-6, which are linked to fatigue and overtraining.

The impact of high-intensity intermittent exercise on resting metabolic rate in healthy males

INTRODUCTION

High-intensity intermittent exercise training (HIT) may favourably alter body composition despite low training volumes and predicted energy expenditure (EE).

PURPOSE

To characterise the acute impact of two common HIT protocols on EE and post-exercise oxygen consumption (11 h EPOC).

METHODS

Oxygen consumption (l min(-1)), respiratory exchange ratio (RER) and EE were measured in nine healthy, lean males over 12 h under three conditions: control (CON), HIT1 (10 × 1 min high-intensity cycling bouts followed by 1 min rest) and HIT2 (10 × 4 min high-intensity cycling bouts followed by 2 min rest).

RESULTS

Total exercise period EE during HIT1 (1,151 ± 205 kJ) (mean ± SD) was significantly lower than HIT2 (2,788 ± 322 kJ; p < 0.001). EE within the 60 min after exercise was significantly albeit marginally higher after HIT1 (388 ± 44 kJ; p = 0.02) and HIT2 (389 ± 39 kJ; p = 0.01) compared with CON (329 ± 39 kJ), with no difference between exercise conditions (p = 0.778). RER during this period was significantly lower in HIT1 (0.78 ± 0.06; p = 0.011) and HIT2 (0.76 ± 0.04; p = 0.004) compared with CON (0.87 ± 0.06). During the 'slow phase' of EPOC (1.25-9.75 h), there were no significant differences in EE (p = 0.07) or RER (p = 0.173) between trials.

CONCLUSIONS

Single HIT sessions notably increases EE during exertion; however, the influence on metabolic rate post-exercise is transient and relatively minor.

The effect of physical activity on mediators of inflammation

Being physically active and undertaking exercise on a regular basis are critical lifestyle behaviours which protect against the development of numerous chronic metabolic conditions. One of the key mechanisms by which physical activity exerts favourable health effects appears to be due to its capacity to reduce chronic low-grade inflammation. Single bouts of exercise have a potent anti-inflammatory influence with recent advances describing important effects of acute exercise on inflammatory mediators produced within skeletal muscle (myokines), adipose tissue (adipokines) and leucocytes. The accumulated effects of physical activity or exercise training on systemic inflammation have been studied widely within epidemiological research; however, information from intervention trials is still emerging. Current data suggest that the most marked improvements in the inflammatory profile are conferred with exercise performed at higher intensities, with combined aerobic and resistance exercise training potentially providing the greatest benefit. The purpose of this review is to describe recent advances in our understanding surrounding the acute and chronic effects of physical activity on key mediators of inflammation. Within this, particular attention is given to the interleukin-6 system owing to its apparent centrality in mediating the anti-inflammatory effects of exercise.

Prevalence of diabetes and impaired glucose metabolism in younger 'at risk' UK adults: insights from the STAND programme of research

AIMS

Rising rates of obesity have led to an increasing prevalence of Type 2 diabetes mellitus in young people. Uncertainty exists over the utility of screening younger adults for Type 2 diabetes, as existing data sets have focused on mature (> 40 years) cohorts. The aim of this study was to determine the prevalence of impaired glucose metabolism in higher risk younger adults.

METHODS

Overweight (with an additional risk factor) or obese adults (18-40 years) were recruited for the Sedentary Time And Diabetes (STAND) randomized controlled trial. Measures included an oral glucose tolerance test, HbA1c , biochemical and anthropometric data.

RESULTS

One hundred and ninety-three individuals (68% female; median age 33.8 years; median BMI 33.9 kg/m²) were recruited. Forty-three per cent had a first-degree family history of Type 2 diabetes. Previously undiagnosed Type 2 diabetes was present in 4.7% (n = 9). Of participants, 18.1% (n = 35) had impaired glucose metabolism: 4.7% (n = 9) HbA1c ≥ 48 mmol/mol (6.5%); 9.3% (n = 18) HbA1c 42-46 mmol/mol (6.0-6.4%); 3.1% (n = 6) Type 2 diabetes on oral glucose tolerance test; 6.2% (n = 12) isolated impaired glucose tolerance; 2.1% (n = 4) isolated impaired fasting glucose; 1% (n = 2) both impaired fasting glucose and impaired glucose tolerance. Of participants, 58.5% (n = 113) had dyslipidaemia, 28.0% (n = 54) had hypertension, 31.1% (n = 60) were vitamin D deficient and 7.3% (n = 14) had abnormal liver function.

CONCLUSIONS

This study identified a high prevalence of Type 2 diabetes and impaired glucose regulation in overweight and obese younger adults. These findings require confirmation in a larger, representative, population.