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Bellini A, Scotto di Palumbo A, Nicolò A, Bazzucchi I, Sacchetti M. Exercise Prescription for Postprandial Glycemic Management. Nutrients 2024; 16:1170. [PMID: 38674861 PMCID: PMC11053955 DOI: 10.3390/nu16081170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/22/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
The detrimental impacts of postprandial hyperglycemia on health are a critical concern, and exercise is recognized a pivotal tool in enhancing glycemic control after a meal. However, current exercise recommendations for managing postprandial glucose levels remain fairly broad and require deeper clarification. This review examines the existing literature aiming to offer a comprehensive guide for exercise prescription to optimize postprandial glycemic management. Specifically, it considers various exercise parameters (i.e., exercise timing, type, intensity, volume, pattern) for crafting exercise prescriptions. Findings predominantly indicate that moderate-intensity exercise initiated shortly after meals may substantially improve glucose response to a meal in healthy individuals and those with type 2 diabetes. Moreover, incorporating short activity breaks throughout the exercise session may provide additional benefits for reducing glucose response.
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Affiliation(s)
| | | | | | - Ilenia Bazzucchi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy; (A.B.); (A.S.d.P.); (A.N.); (M.S.)
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Adams NT, Paterson C, Poles J, Higgins S, Stoner L. The Effect of Sitting Duration on Peripheral Blood Pressure Responses to Prolonged Sitting, With and Without Interruption: A Systematic Review and Meta-Analysis. Sports Med 2024; 54:169-183. [PMID: 37682412 PMCID: PMC10872309 DOI: 10.1007/s40279-023-01915-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND A previous meta-analysis reported that: (i) an acute bout of prolonged uninterrupted sitting induces a significant increase in peripheral blood pressure (BP) and (ii) the increase in BP can be offset by interrupting the sitting bout with light aerobic activities such as walking. However, the temporal association between prolonged uninterrupted sitting and BP was not determined. A better understanding of temporality, for example, how long it takes BP to increase, will assist in prescribing sitting interruption strategies. OBJECTIVES We aimed to determine: (1) the temporal association between the duration of uninterrupted sitting and BP and (2) whether regular sitting interruptions moderate the association between uninterrupted sitting and BP. DATA SOURCES Electronic databases (PubMed, Web of Science, SPORTDiscus) were searched from inception to July 2022. Reference lists of eligible studies and relevant reviews were also screened. STUDY SELECTION Inclusion criteria for objective (1) were: (i) participants aged ≥ 18 years; (ii) a prolonged sitting bout ≥ 1 h; and (iii) peripheral BP measurements (systolic BP, diastolic BP, and/or mean arterial pressure) at more than two timepoints during the sitting bout. Additional criteria for objective (2) were: (i) the sitting interruption strategy was implemented during the sitting bout (i.e., not prior to engaging in sitting) and (ii) the study included a control (uninterrupted sitting) condition or group. APPRAISAL AND SYNTHESIS METHODS There were 1555 articles identified, of which 33 met inclusion criteria for objective (1). Of those articles, 20 met inclusion criteria for objective (2). To investigate the effect of sitting duration on the BP response, unstandardized b coefficients (mmHg/h) and 95% confidence intervals (CIs) were calculated using a three-level mixed-effect meta-regression. RESULTS Increased sitting duration was positively associated with systolic BP (b = 0.42 mmHg/h, 95% CI 0.18-0.60), diastolic BP (b = 0.24 mmHg/h, 95% CI 0.06-0.42), and mean arterial pressure (b = 0.66 mmHg/h, 95% CI 0.36-0.90). In trials where sitting was interrupted, there was a significant decrease in systolic BP (b = - 0.24 mmHg/h, 95% CI - 0.42 to - 0.06) and diastolic BP (b = - 0.24 mmHg/h, 95% CI - 0.42 to - 0.12), and a non-significant change in mean arterial pressure (p = 0.69). CONCLUSIONS Increased uninterrupted sitting duration results in greater increases in BP; however, regularly interrupting sitting may offset negative effects.
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Affiliation(s)
- Nathan T Adams
- School of Health and Exercise Science, University of British Columbia, 1238 Discovery Ave, Kelowna, BC, V1V 1V9, Canada.
| | - Craig Paterson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jillian Poles
- Vilcek Institute of Graduate Biomedical Sciences, New York University, New York, NY, USA
| | - Simon Higgins
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Jarvis PRE, Cardin JL, Nisevich-Bede PM, McCarter JP. Continuous glucose monitoring in a healthy population: understanding the post-prandial glycemic response in individuals without diabetes mellitus. Metabolism 2023:155640. [PMID: 37356796 DOI: 10.1016/j.metabol.2023.155640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 06/27/2023]
Abstract
Continuous glucose monitoring has become a common adjunct in the management of Diabetes Mellitus. However, there has been a recent trend among individuals without diabetes using these devices as a means of monitoring their health. The increased visibility of glucose data has allowed users to study the effect lifestyle has upon post-prandial glucose levels. Although post-prandial hyperglycemia is well understood in the setting of diabetes, its impact in individuals without diabetes is less well defined. This article reviews the factors which contribute to post-prandial hyperglycemia in individuals without diabetes and how the data obtained from continuous glucose monitoring can be used to improve an individual's metabolic health.
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Affiliation(s)
| | | | | | - James P McCarter
- Medical and Clinical Affairs, Abbott Laboratories, Alameda, CA, USA; Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA.
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Bellini A, Nicolò A, Rocchi JE, Bazzucchi I, Sacchetti M. Walking Attenuates Postprandial Glycemic Response: What Else Can We Do without Leaving Home or the Office? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:253. [PMID: 36612575 PMCID: PMC9819328 DOI: 10.3390/ijerph20010253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/11/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
We evaluated the effects of different exercise types suitable for a home/work setting on the postprandial glucose response. Twenty-three healthy, active, young individuals performed one of two studies (12 in Study 1 and 11 in Study 2), with four randomized protocols each. After a meal high in carbohydrate content (1 g of carbohydrate per kg of body weight), in Study 1, participants performed 30 min of either walking (WALK), bench stepping exercise (STEP) or isometric wall squat (SQUAT); in Study 2, participants performed 30 min of either walking (WALK), neuromuscular electrical stimulation alone (P_NMES) or superimposed on voluntary muscle contraction (VC_NMES). In both studies, participants performed a prolonged sitting condition (CON) that was compared to the exercise sessions. In Study 1, WALK and STEP significantly reduced the glucose peak compared to CON (p < 0.011). In Study 2, the peak was significantly reduced in WALK compared to CON, P_NMES and VC_NMES (p < 0.011) and in VC_NMES compared to CON and P_NMES (p < 0.011). A significant reduction of 3 h glucose iAUC was found for WALK and VC_NMES compared to CON and P_NMES (p < 0.033). In conclusion, WALK is the most effective strategy for improving the postprandial glycemic response. However, STEP and VC_NMES can also be used for reducing postprandial glycemia.
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Debik J, Isaksen SH, Strømmen M, Spraul M, Schäfer H, Bathen TF, Giskeødegård GF. Effect of Delayed Centrifugation on the Levels of NMR-Measured Lipoproteins and Metabolites in Plasma and Serum Samples. Anal Chem 2022; 94:17003-17010. [PMID: 36454175 DOI: 10.1021/acs.analchem.2c02167] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Metabolic profiling is widely used for large-scale association studies, based on biobank material. The main obstacle to the translation of metabolomic findings into clinical application is the lack of standardization, making validation in independent cohorts challenging. One reason for this is sensitivity of metabolites to preanalytical conditions. We present a systematic investigation of the effect of delayed centrifugation on the levels of NMR-measured metabolites and lipoproteins in serum and plasma samples. Blood was collected from 20 anonymous donors, of which 10 were recruited from an obesity clinic. Samples were stored at room temperature until centrifugation after 30 min, 1, 2, 4, or 8 h, which is within a realistic time scenario in clinical practice. The effect of delaying centrifugation on plasma and serum metabolic concentrations, and on concentrations of lipoprotein subfractions, was investigated. Our results show that lipoproteins are only minimally affected by a delay in centrifugation while metabolite levels are more sensitive to a delay. Metabolites significantly increased or decreased in concentration depending on delay duration. Further, we describe differences in the stability of serum and plasma, showing that plasma is more stable for metabolites, while lipoprotein subfractions are equally stable for both types of matrices.
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Affiliation(s)
- Julia Debik
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim 7491, Norway.,K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim 7491, Norway
| | - Sylvia Hetlelid Isaksen
- Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim 7491, Norway
| | - Magnus Strømmen
- Centre for Obesity Research, Clinic of Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim 7030, Norway.,The Clinical Research Ward, Department for Research and Development, St. Olavs Hospital, Trondheim University Hospital, Trondheim 7030, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim 7491, Norway
| | - Manfred Spraul
- Bruker BioSpin AIC Division, Ettlingen, Rheinstetten 76287, Germany
| | - Hartmut Schäfer
- Bruker BioSpin AIC Division, Ettlingen, Rheinstetten 76287, Germany
| | - Tone F Bathen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim 7491, Norway.,Department of Radiology and Nuclear Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim 7030, Norway
| | - Guro F Giskeødegård
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim 7491, Norway.,Clinic of Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim 7030, Norway
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Abstract
BACKGROUND Increased physical activity has been recommended as an important lifestyle modification for the prevention and control of hypertension. Walking is a low-cost form of physical activity and one which most people can do. Studies testing the effect of walking on blood pressure have revealed inconsistent findings. OBJECTIVES To determine the effect of walking as a physical activity intervention on blood pressure and heart rate. SEARCH METHODS We searched the following databases up to March 2020: the Cochrane Hypertension Specialised Register, CENTRAL (2020, Issue 2), Ovid MEDLINE, Ovid Embase, CINAHL, PsycINFO, SPORTDiscus, PEDro, the WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov. We also searched the following Chinese databases up to May 2020: Index to Taiwan Periodical Literature System; National Digital Library of Theses and Dissertation in Taiwan; China National Knowledge Infrastructure (CNKI) Journals, Theses & Dissertations; and Wanfang Medical Online. We contacted authors of relevant papers regarding further published and unpublished work. The searches had no language restrictions. SELECTION CRITERIA Randomised controlled trials of participants, aged 16 years and over, which evaluated the effects of a walking intervention compared to non-intervention control on blood pressure and heart rate were included. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Where data were not available in the published reports, we contacted authors. Pooled results for blood pressure and heart rate were presented as mean differences (MDs) between groups with 95% confidence intervals (CIs). We undertook subgroup analyses for age and sex. We undertook sensitivity analyses to assess the effect of sample size on our findings. MAIN RESULTS A total of 73 trials met our inclusion criteria. These 73 trials included 5763 participants and were undertaken in 22 countries. Participants were aged from 16 to 84 years and there were approximately 1.5 times as many females as males. The characteristics of walking interventions in the included studies were as follows: the majority of walking interventions was at home/community (n = 50) but supervised (n = 36 out of 47 reported the information of supervision); the average intervention length was 15 weeks, average walking time per week was 153 minutes and the majority of walking intensity was moderate. Many studies were at risk of selection bias and performance bias. Primary outcome We found moderate-certainty evidence suggesting that walking reduces systolic blood pressure (SBP) (MD -4.11 mmHg, 95% CI -5.22 to -3.01; 73 studies, n = 5060). We found moderate-certainty evidence suggesting that walking reduces SBP in participants aged 40 years and under (MD -4.41 mmHg, 95% CI -6.17 to -2.65; 14 studies, n = 491), and low-certainty evidence that walking reduces SBP in participants aged 41 to 60 years (MD -3.79 mmHg, 95% CI -5.64 to -1.94, P < 0.001; 35 studies, n = 1959), and those aged 60 years of over (MD -4.30 mmHg, 95% CI -6.17 to -2.44, 24 studies, n = 2610). We also found low certainty-evidence suggesting that walking reduces SBP in both females (MD -5.65 mmHg, 95% CI -7.89 to -3.41; 22 studies, n = 1149) and males (MD -4.64 mmHg, 95% CI -8.69 to -0.59; 6 studies, n = 203). Secondary outcomes We found low-certainty evidence suggesting that walking reduces diastolic blood pressure (DBP) (MD -1.79 mmHg, 95% CI -2.51 to -1.07; 69 studies, n = 4711) and heart rate (MD -2.76 beats per minute (bpm), 95% CI -4.57 to -0.95; 26 studies, n = 1747). We found moderate-certainty evidence suggesting that walking reduces DBP for participants aged 40 years and under (MD -3.01 mmHg, 95% CI -4.44 to -1.58; 14 studies, n = 491) and low-certainty evidence suggesting that walking reduces DBP for participants aged 41 to 60 years (MD -1.74 mmHg, 95% CI -2.95 to -0.52; 32 studies, n = 1730) and those aged 60 years and over (MD -1.33 mmHg, 95% CI -2.40 to -0.26; 23 studies, n = 2490). We found moderate-certainty evidence that suggests walking reduces DBP for males (MD -2.54 mmHg, 95% CI -4.84 to -0.24; 6 studies, n = 203) and low-certainty evidence that walking reduces DBP for females (MD -2.69 mmHg, 95% CI -4.16 to -1.23; 20 studies, n = 1000). Only 21 included studies reported adverse events. Of these 21 studies, 16 reported no adverse events, the remaining five studies reported eight adverse events, with knee injury being reported five times. AUTHORS' CONCLUSIONS Moderate-certainty evidence suggests that walking probably reduces SBP. Moderate- or low-certainty evidence suggests that walking may reduce SBP for all ages and both sexes. Low-certainty evidence suggests that walking may reduce DBP and heart rate. Moderate- and low-certainty evidence suggests walking may reduce DBP and heart rate for all ages and both sexes.
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Affiliation(s)
- Ling-Ling Lee
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien City, Hualien County, Taiwan
| | | | | | | | - Michael C Watson
- School of Health Sciences, The University of Nottingham, Nottingham, UK
| | - Hui-Hsin Lin
- Medical Affairs Division, Hualien Armed Forces General Hospital, Hualien, Taiwan
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BELLINI ALESSIO, NICOLÒ ANDREA, BAZZUCCHI ILENIA, SACCHETTI MASSIMO. Effects of Different Exercise Strategies to Improve Postprandial Glycemia in Healthy Individuals. Med Sci Sports Exerc 2021; 53:1334-1344. [PMID: 33481486 DOI: 10.1249/mss.0000000000002607] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE We systematically investigated the effects of different exercise strategies on postprandial glycemia. METHODS Six randomized repeated-measures crossover studies were performed. Study 1 compared the effects of 60 min of brisk walking started at 30, 60, or 90 min after breakfast on postbreakfast and postlunch glycemic responses. Study 2 investigated the effects of 30 min of different exercise types (aerobic vs resistance vs combined). Study 3 compared the effects of 30 min of different aerobic exercise types (walking vs cycling vs elliptical). Study 4 evaluated the effects of 30 min of brisk walking performed 45 min before or 15 and 30 min after breakfast. Study 5 compared 30 with 45 min of postprandial brisk walking. Study 6 compared the effects of a total of 30 min brisk walking exercise fragmented in bouts of 15, 5, or 2.5 min performed every 15 min. RESULTS Postprandial but not preprandial exercise improved glycemic response (studies 1 and 4). The glycemic peak was attenuated only when exercise started 15 min after the meal (study 4). A similar reduction of the postprandial glycemic response was observed with different exercise types (studies 2 and 3). Thirty and 45 min of brisk walking provided a similar reduction of the postprandial glucose response (study 5). When performing activity breaks, 10 and 20 min of cumulative exercise were sufficient to attenuate postprandial glycemia in the first hour postmeal (study 6). CONCLUSION Our findings provide insight into how to choose timing, type, duration, and modality for postprandial exercise prescription in healthy individuals.
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Simper TN, Morris C, Lynn A, O'Hagan C, Kilner K. Responses to oral glucose challenge differ by physical activity volume and intensity: A pilot study. JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:645-650. [PMID: 33308815 PMCID: PMC7749213 DOI: 10.1016/j.jshs.2017.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 09/12/2016] [Accepted: 03/03/2017] [Indexed: 06/12/2023]
Abstract
BACKGROUND One-hour postprandial hyperglycemia is associated with increased risk of type 2 diabetes and cardiovascular disease. Physical activity (PA) has short-term beneficial effects on post-meal glucose response. This study compared the oral glucose tolerance test results of 3 groups of people with habitually different levels of PA. METHODS Thirty-one adults without diabetes (age 25.9 ± 6.6 years; body mass index 23.8 ± 3.8 kg/m2; mean ± SD) were recruited and divided into 3 groups based on self-reported PA volume and intensity: low activity < 30 min/day of moderate-intensity activity (n = 11), moderately active ≥ 30 min/day of moderate-intensity PA (n = 10), and very active ≥ 60 min/day of PA at high intensity (n = 10). Participants completed an oral glucose tolerance test (50 g glucose) with capillary blood samples obtained at baseline, 15 min, 30 min, 45 min, 60 min, 90 min, and 120 min post-ingestion. RESULTS There were no significant differences between groups for age or body fat percentage or glycated hemoglobin (p > 0.05). The groups were significantly different in terms of baseline glucose level (p = 0.003) and, marginally, for gender (p = 0.053) and BMI (p = 0.050). There was a statistically significant effect of PA on the 1-h postprandial glucose results (p = 0.029), with differences between very active and low activity groups (p = 0.008) but not between the moderately active and low activity groups (p = 0.360), even when baseline glucose level and gender differences were accounted for. For incremental area under the curve there was no significant effect of activity group once gender and body fat percentage had been accounted for (p = 0.401). Those in the low activity group took 15 min longer to reach peak glucose level than those in the very active group (p = 0.012). CONCLUSION The results suggest that high levels of PA have a beneficial effect on postprandial blood glucose profiles when compared to low and moderate levels of activity.
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Affiliation(s)
- Trevor N Simper
- Food Group Sheffield Business School, Sheffield Hallam University, Sheffield S1 1WB, UK.
| | - Cecile Morris
- Food Group Sheffield Business School, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Anthony Lynn
- Food Group Sheffield Business School, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Ciara O'Hagan
- Academy of Sport and Physical Activity, Sheffield Hallam University, Sheffield S10 2BP, UK
| | - Karen Kilner
- Department for Health and Social Care Research, Sheffield Hallam University, Sheffield S10 2BP, UK
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Füzéki E, Groneberg DA, Banzer W. Physical activity during COVID-19 induced lockdown: recommendations. J Occup Med Toxicol 2020; 15:25. [PMID: 32817753 PMCID: PMC7422663 DOI: 10.1186/s12995-020-00278-9] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/04/2020] [Indexed: 02/04/2023] Open
Abstract
Measures aiming at containing the Coronavirus disease 2019 (COVID-19) include isolation, social distancing, and quarantine. Quarantine and other lockdown instruments show promise in reducing the number of COVID-19 infections and deaths. It is reasonable to assume that lockdown leads to reduced levels of physical activity in the general population. Potential detrimental health effects of lockdown, such as psychological distress and physical inactivity induced maladaptations must be addressed. The current review summarizes harmful effects of limited physical activity on mental and physical health due to social distancing and quarantine and highlights the effects of simple physical activity regimes counteracting these detrimental effects, with a special emphasis on acute effects.
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Affiliation(s)
- Eszter Füzéki
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, Haus 9B, 60590 Frankfurt am Main, Germany
| | - David A Groneberg
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, Haus 9B, 60590 Frankfurt am Main, Germany
| | - Winfried Banzer
- Division of Preventive and Sports Medicine, Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, Haus 9B, 60590 Frankfurt am Main, Germany
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Davis DW, Navalta JW, McGinnis GR, Serafica R, Izuora K, Basu A. Effects of Acute Dietary Polyphenols and Post-Meal Physical Activity on Postprandial Metabolism in Adults with Features of the Metabolic Syndrome. Nutrients 2020; 12:E1120. [PMID: 32316418 PMCID: PMC7230938 DOI: 10.3390/nu12041120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/07/2020] [Accepted: 04/15/2020] [Indexed: 01/10/2023] Open
Abstract
Approximately 22% of U.S. adults and 25% of adults globally have metabolic syndrome (MetS). Key features, such as dysglycemia and dyslipidemia, predict type 2 diabetes, cardiovascular disease, premature disability, and death. Acute supplementation of dietary polyphenols and post-meal physical activity hold promise in improving postprandial dysmetabolism. To our knowledge, no published review has described the effects of either intervention on postprandial glucose, insulin, lipids, and markers of oxidative damage and inflammation in adults with features of MetS. Thus, we conducted this review of controlled clinical trials that provided dietary polyphenols from oils, fruits, teas, and legumes during a dietary challenge, or implemented walking, cycling, and stair climbing and descending after a dietary challenge. Clinical trials were identified using ClinicalTrials.gov, PubMed, and Google Scholar and were published between 2000 and 2019. Dietary polyphenols from extra virgin olive oil, grapes, blackcurrants, strawberries, black tea, and black beans improved postprandial glucose, insulin, and markers of oxidative damage and inflammation, but results were not consistent among clinical trials. Freeze-dried strawberry powder distinctly improved postprandial insulin and markers of oxidative damage and inflammation. Post-meal physical activity attenuated postprandial glucose, but effects on postprandial lipids and markers of oxidative damage and inflammation were inconclusive. Consuming dietary polyphenols with a meal and completing physical activity after a meal may mitigate postprandial dysmetabolism in adults with features of MetS.
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Affiliation(s)
- Dustin W Davis
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (D.W.D.); (J.W.N.); (G.R.M.)
| | - James W Navalta
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (D.W.D.); (J.W.N.); (G.R.M.)
| | - Graham R McGinnis
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (D.W.D.); (J.W.N.); (G.R.M.)
| | - Reimund Serafica
- School of Nursing, University of Nevada, Las Vegas, NV 89154, USA;
| | - Kenneth Izuora
- Department of Internal Medicine, School of Medicine, University of Nevada, Las Vegas, NV 89154, USA;
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (D.W.D.); (J.W.N.); (G.R.M.)
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Suntornlohanakul O, Areevut C, Saetung S, Ingsathit A, Rattarasarn C. Glycemic effect of post-meal walking compared to one prandial insulin injection in type 2 diabetic patients treated with basal insulin: A randomized controlled cross-over study. PLoS One 2020; 15:e0230554. [PMID: 32236116 PMCID: PMC7112182 DOI: 10.1371/journal.pone.0230554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 02/25/2020] [Indexed: 11/21/2022] Open
Abstract
Studies demonstrate that post-meal walking decreases postprandial hyperglycemia in type 2 diabetic patients but it has never been tested with the active treatment comparator. The objective of this study was to determine the effect of post-meal walking on glycemic control compared with one prandial insulin in type 2 diabetic patients who failed basal insulin. A randomized controlled cross-over study of post-meal walking or one prandial insulin was done in type 2 diabetic patients who were being treated with basal insulin between May 2017 and March 2018. In post-meal walking group, patients walked after meal for 15–20 minutes one meal a day every day for 6 weeks. In prandial insulin (basal plus) group, one prandial insulin was injected before breakfast or main meal with rapid-acting insulin. The primary outcome was a difference in HbA1c reduction in post-meal walking compared with basal plus groups. Fourteen patients completed the study. By intention-to-treat analysis, HbA1c was reduced by -0.05(range:-1.08 to 0.74) and -0.19(range:-0.8 to 0.56) % in post-meal walking and basal plus groups respectively. By per-protocol analysis, post-meal walking and basal plus groups decreased HbA1c by 0.13(range:-0.74 to 1.08) and 0.2(range:-0.56 to 0.8) %, respectively. There was were no significant differences in HbA1c reduction from baseline in each group and between groups in both intention-to-treat and per-protocol analysis. Fructosamine levels were decreased by 17.5(-59 to 43) and 10(-15 to 40) μmol/L, respectively at 3 and 6 weeks in post-meal walking group whereas the respective changes in basal plus group were 12.5(-17 to 64) and 17.5(-28 to 38) μmol/L and there were no significant differences in fructosamine reduction from baseline in each group and between groups. In conclusion, although post-meal walking might be as effective as one prandial insulin to improve glycemic control in type 2 diabetic patients who failed basal insulin but the magnitude of reduction was small. A longer-term study with a larger sample size or with a different walking protocol is required.
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Affiliation(s)
- Onnicha Suntornlohanakul
- Division of Endocrinology and Metabolism, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chatvara Areevut
- Division of Endocrinology and Metabolism, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sunee Saetung
- Division of Endocrinology and Metabolism, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Atiporn Ingsathit
- Division of Nephrology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Department of Clinical Epidemiology and Biostatistics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chatchalit Rattarasarn
- Division of Endocrinology and Metabolism, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- * E-mail:
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12
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Moore JM, Bartholomae E, Ward K, Kressler J. Postprandial glucose response moderation by cardiorespiratory fitness following short exercise bouts. J Sports Med Phys Fitness 2020; 60:764-769. [PMID: 32162504 DOI: 10.23736/s0022-4707.20.10426-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Previous reports indicate that postprandial glucose (PPG) responses to exercise may depend on cardiorespiratory fitness (CRF), such that less fit individuals have greater reductions in PPG with exercise. Our aim was to investigate moderating effects of CRF on PPG response following exercise of progressively shorter durations and sedentary rest. METHODS Thirty-four participants (14 female) completed a 75-g oral glucose tolerance test (OGTT) at seated rest. On three subsequent visits, participants completed additional OGTT with either 1, 3, or 10 minutes of stair-climbing. Fingerstick blood glucose measurements were taken every 15 minutes for 1 hour. CRF was determined using a treadmill ramp test. RESULTS There was a main effect of condition F(3, 93)=13.07, P<0.001, ηp2=0.30. Stair-climbing reduced PPG iAUC compared to control by -3±27% (P=0.546), -11±29% (P=0.091), and -28±22% (P<0.000) for the 1, 3 and 10 min bouts, respectively. There was no trial by CRF interaction for glucose iAUC F(2.4, 73.8)=0.69, P=0.532, ηp2=0.02. Linear mixed model regression analysis revealed that CRF was not significantly associated with glucose iAUC, b=-14 (-45, 16), P=0.339. CONCLUSIONS Contrary to previous reports CRF did not moderate PPG responses for either sedentary or exercise conditions in healthy men and women. Short, single-bout stair stepping exercise at a self-selected pace is equally efficient for all fitness levels.
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Affiliation(s)
- Jeff M Moore
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA -
| | - Eric Bartholomae
- School of Life Sciences, Arizona State University, Tempe, AZ, USA
| | - Kathryn Ward
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - Jochen Kressler
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
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13
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Aqeel M, Forster A, Richards EA, Hennessy E, McGowan B, Bhadra A, Guo J, Gelfand S, Delp E, Eicher-Miller HA. The Effect of Timing of Exercise and Eating on Postprandial Response in Adults: A Systematic Review. Nutrients 2020; 12:nu12010221. [PMID: 31952250 PMCID: PMC7019516 DOI: 10.3390/nu12010221] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/04/2020] [Accepted: 01/10/2020] [Indexed: 01/30/2023] Open
Abstract
Type 2 diabetes is a major public health concern. Management of this condition has focused on behavior modification through diet and exercise interventions. A growing body of evidence has focused on temporality of dietary intake and exercise and potential effects on health. This review summarizes current literature that investigates the question "how does the timing of exercise relative to eating throughout the day effect postprandial response in adults?" Databases PubMed, Scopus, Cochrane Library, CINAHL, and SPORTDiscus were searched between March-May 2019. Experimental studies conducted in healthy adults (≥18 y) and those with type 2 diabetes were included. Full texts were examined by at least two independent reviewers. Twenty studies with a total of 352 participants met the inclusion criteria. The primary finding supports that exercise performed post-meal regardless of time of day had a beneficial impact on postprandial glycemia. There was insufficient evidence regarding whether timing of exercise performed pre- vs. post-meal or vice versa in a day is related to improved postprandial glycemic response due to inherent differences between studies. Future studies focusing on the investigation of timing and occurrence of meal intake and exercise throughout the day are needed to inform whether there is, and what is, an optimal time for these behaviors regarding long-term health outcomes.
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Affiliation(s)
- Marah Aqeel
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA;
| | - Anna Forster
- School of Nursing, Purdue University, West Lafayette, IN 47907, USA; (A.F.); (E.A.R.)
| | - Elizabeth A. Richards
- School of Nursing, Purdue University, West Lafayette, IN 47907, USA; (A.F.); (E.A.R.)
| | - Erin Hennessy
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02155, USA;
| | - Bethany McGowan
- Libraries and School of Information Studies, Purdue University, West Lafayette, IN 47907, USA;
| | - Anindya Bhadra
- Department of Statistics, Purdue University, West Lafayette, IN 47907, USA;
| | - Jiaqi Guo
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA; (J.G.); (S.G.); (E.D.)
| | - Saul Gelfand
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA; (J.G.); (S.G.); (E.D.)
| | - Edward Delp
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA; (J.G.); (S.G.); (E.D.)
| | - Heather A. Eicher-Miller
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA;
- Correspondence: ; Tel.: +1-765-494-6815; Fax: +1-765-494-0906
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14
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Büsing F, Hägele FA, Nas A, Hasler M, Müller MJ, Bosy-Westphal A. Impact of energy turnover on the regulation of glucose homeostasis in healthy subjects. Nutr Diabetes 2019; 9:22. [PMID: 31395858 PMCID: PMC6687696 DOI: 10.1038/s41387-019-0089-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/09/2019] [Accepted: 07/15/2019] [Indexed: 12/27/2022] Open
Abstract
Objective Sedentary lifestyle increases the risk of type 2 diabetes. The aim of this study was to investigate the impact of different levels of energy turnover (ET; low, medium, and high level of physical activity and the corresponding energy intake) on glucose metabolism at zero energy balance, caloric restriction, and overfeeding. Methods Sixteen healthy individuals (13 men, 3 women, 25.1 ± 3.9 years, BMI 24.0 ± 3.2 kg/m2) participated in a randomized crossover intervention under metabolic ward conditions. Subjects passed 3 × 3 intervention days. Three levels of physical activity (PAL: low 1.3, medium 1.6, and high 1.8 achieved by walking at 4 km/h for 0, 3 × 55, or 3 × 110 min) were compared under three levels of energy balance (zero energy balance (EB): 100% of energy requirement (Ereq); caloric restriction (CR): 75% Ereq, and overfeeding (OF): 125% Ereq). Continuous interstitial glucose monitoring, C-peptide excretion, and HOMA–IR, as well as postprandial glucose and insulin were measured. Results Daylong glycemia and insulin secretion did not increase with higher ET at all conditions of energy balance (EB, CR, and OF), despite a correspondingly higher CHO intake (Δ low vs. high ET: +86 to 135 g of CHO/d). At CR, daylong glycemia (p = 0.02) and insulin secretion (p = 0.04) were even reduced with high compared with low ET. HOMA–IR was impaired with OF and improved with CR, whereas ET had no effect on fasting insulin sensitivity. A higher ET led to lower postprandial glucose and insulin levels under conditions of CR and OF. Conclusion Low-intensity physical activity can significantly improve postprandial glycemic response of healthy individuals, independent of energy balance.
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Affiliation(s)
- Franziska Büsing
- Institute of Human Nutrition and Food Science, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Franziska Anna Hägele
- Institute of Human Nutrition and Food Science, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Alessa Nas
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Mario Hasler
- Applied Statistics, Faculty of Agricultural and Nutritional Sciences, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Manfred James Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts University of Kiel, Kiel, Germany.
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15
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Nakayama A, Aoi W, Takami M, Hirano N, Ogaya Y, Wada S, Higashi A. Effect of downhill walking on next-day muscle damage and glucose metabolism in healthy young subjects. J Physiol Sci 2019; 69:31-38. [PMID: 29679309 PMCID: PMC10717950 DOI: 10.1007/s12576-018-0614-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 04/12/2018] [Indexed: 12/11/2022]
Abstract
This study aimed to investigate the effect of downhill walking on muscle damage and glucose metabolism in healthy subjects. All ten healthy young men and women (age, 24.0 ± 1.4 years) performed rest, uphill walking, and downhill walking trials. In the exercise trials, uphill (+ 5%) or downhill (- 5%) treadmill walking was performed at 6 km/h for 30 min. On the next day, muscle soreness was significantly higher in the downhill trial than in the uphill trial (P < 0.01). Respiratory metabolic performance did not differ between trials. However, carbohydrate oxidation was negatively correlated with plasma creatine kinase (r = - 0.41) and muscle soreness (r = - 0.47). Fasting blood glucose was significantly lower in the uphill trial than in the rest trial (P < 0.01) but not in the downhill trial. These observations suggest that downhill but not uphill walking causes mild delayed-onset muscle damage, which did not cause marked impairment in glucose metabolism. However, higher muscle damage responders might exhibit lower glucose metabolism.
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Affiliation(s)
- Airi Nakayama
- Division of Applied Life Sciences, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, 1-5 Hangi-cho Shimogamo, Sakyo-ku, Kyoto, 606-8522, Japan
| | - Wataru Aoi
- Division of Applied Life Sciences, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, 1-5 Hangi-cho Shimogamo, Sakyo-ku, Kyoto, 606-8522, Japan.
| | - Maki Takami
- Division of Applied Life Sciences, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, 1-5 Hangi-cho Shimogamo, Sakyo-ku, Kyoto, 606-8522, Japan
| | - Nariyuki Hirano
- Division of Applied Life Sciences, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, 1-5 Hangi-cho Shimogamo, Sakyo-ku, Kyoto, 606-8522, Japan
| | - Yumi Ogaya
- Division of Applied Life Sciences, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, 1-5 Hangi-cho Shimogamo, Sakyo-ku, Kyoto, 606-8522, Japan
| | - Sayori Wada
- Division of Applied Life Sciences, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, 1-5 Hangi-cho Shimogamo, Sakyo-ku, Kyoto, 606-8522, Japan
| | - Akane Higashi
- Division of Applied Life Sciences, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, 1-5 Hangi-cho Shimogamo, Sakyo-ku, Kyoto, 606-8522, Japan
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16
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Reynolds AN, Venn BJ. The Timing of Activity after Eating Affects the Glycaemic Response of Healthy Adults: A Randomised Controlled Trial. Nutrients 2018; 10:nu10111743. [PMID: 30428521 PMCID: PMC6267507 DOI: 10.3390/nu10111743] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/02/2018] [Accepted: 11/12/2018] [Indexed: 11/16/2022] Open
Abstract
There is scant information on how a time lag between the cessation of eating and commencement of physical activity affects postprandial glycaemia. Starting at baseline (t = 0), participants ingested white bread containing 50 g of available carbohydrates within 10 min. Using two crossover conditions, we tested the effect over 2 h on postprandial glycaemia of participants undertaking light activity at 15 or 45 min following baseline and compared it with a sedentary control condition. The activity involved cycling on a stationary ergometer for 10 min at 40 revolutions per min with zero resistance. Seventy-eight healthy adults were randomized to the 15 or 45 min activity arm and then randomised to the order in which they undertook the active and sedentary conditions. Cycling 45 min after baseline changed the course of the blood glucose response (likelihood ratio chi square = 31.47, p < 0.01) and reduced mean blood glucose by 0.44 mmol/L (95% confidence interval 0.14 to 0.74) at 60 min when compared with the sedentary control. No differences in postprandial blood glucose response were observed when cycling started 15 min after baseline compared with the sedentary control. Undertaking activity after waiting for 30 min following eating might be optimal in modifying the glycaemic response.
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Affiliation(s)
- Andrew N Reynolds
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
- Edgar National Centre for Diabetes and Obesity Research, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Bernard J Venn
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
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17
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The Acute Metabolic and Vascular Impact of Interrupting Prolonged Sitting: A Systematic Review and Meta-Analysis. Sports Med 2018; 48:2347-2366. [DOI: 10.1007/s40279-018-0963-8] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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18
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Füzéki E, Banzer W. Physical Activity Recommendations for Health and Beyond in Currently Inactive Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15051042. [PMID: 29789470 PMCID: PMC5982081 DOI: 10.3390/ijerph15051042] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/21/2018] [Accepted: 05/21/2018] [Indexed: 12/14/2022]
Abstract
Widespread persistent inactivity makes continued efforts in physical activity promotion a persistent challenge. The precise content of physical activity recommendations is not broadly known, and there are concerns that the general messaging of the guidelines, including the recommendations to perform at least 150 min of at least moderate intensity physical activity per week might seem unattainable for and even actually discourage currently inactive people. Here we show that there are a myriad of ways of being physically active, and provide (in part) out-of-the-box examples of evidence based, pragmatic, easily accessible physical activity regimes below 150 min and/or with lower than moderate intensity that yield meaningful health benefits for currently inactive people.
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Affiliation(s)
- Eszter Füzéki
- Department of Sports Medicine, Goethe University Frankfurt, 60487 Frankfurt, Germany.
| | - Winfried Banzer
- Department of Sports Medicine, Goethe University Frankfurt, 60487 Frankfurt, Germany.
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Forberger S, Bammann K, Bauer J, Boll S, Bolte G, Brand T, Hein A, Koppelin F, Lippke S, Meyer J, Pischke CR, Voelcker-Rehage C, Zeeb H. How to Tackle Key Challenges in the Promotion of Physical Activity among Older Adults (65+): The AEQUIPA Network Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040379. [PMID: 28375177 PMCID: PMC5409580 DOI: 10.3390/ijerph14040379] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 03/17/2017] [Accepted: 03/27/2017] [Indexed: 12/21/2022]
Abstract
The paper introduces the theoretical framework and methods/instruments used by the Physical Activity and Health Equity: Primary Prevention for Healthy Ageing (AEQUIPA) prevention research network as an interdisciplinary approach to tackle key challenges in the promotion of physical activity among older people (65+). Drawing on the social-ecological model, the AEQUIPA network developed an interdisciplinary methodological design including quantitative/qualitative studies and systematic reviews, while combining expertise from diverse fields: public health, psychology, urban planning, sports sciences, health technology and geriatrics. AEQUIPA tackles key challenges when promoting physical activity (PA) in older adults: tailoring of interventions, fostering community readiness and participation, strengthening intersectoral collaboration, using new technological devices and evaluating intervention generated inequalities. AEQUIPA aims to strengthen the evidence base for age-specific preventive PA interventions and to yield new insights into the explanatory power of individual and contextual factors. Currently, the empirical work is still underway. First experiences indicate that thenetwork has achieved a strong regional linkage with communities, local stakeholders and individuals. However, involving inactive persons and individuals from minority groups remained challenging. A review of existing PA intervention studies among the elderly revealed the potential to assess equity effects. The results will add to the theoretical and methodological discussion on evidence-based age-specific PA interventions and will contribute to the discussion about European and national health targets.
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Affiliation(s)
- Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
| | - Karin Bammann
- Working Group Epidemiology of Demographic Change, Institute for Public Health und Nursing Research (IPP), Faculty for Human and Health Sciences, University of Bremen, 28359 Bremen, Germany.
| | - Jürgen Bauer
- Geriatrisches Zentrum, Universität Heidelberg, Agaplesion Bethanien-Krankenhaus, 69126 Heidelberg, Germany.
| | - Susanne Boll
- Media Informatics and Multimedia Systems, Department of Computing Science, Carl von Ossietzky University of Oldenburg, 26121 Oldenburg, Germany.
| | - Gabriele Bolte
- Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, 28359 Bremen, Germany.
- Research Focus Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
| | - Tilman Brand
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
| | - Andreas Hein
- Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, 26111 Oldenburg, Germany.
| | - Frauke Koppelin
- Section Technology and Health for Humans, Jade University of Applied Sciences Oldenburg, 26121 Oldenburg, Germany.
| | - Sonia Lippke
- Department of Psychology and Methods, Jacobs University Bremen, 28759 Bremen, Germany.
| | - Jochen Meyer
- OFFIS-Institute for Information Technology, 26121 Oldenburg, Germany.
| | - Claudia R Pischke
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
| | - Claudia Voelcker-Rehage
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09107 Chemnitz, Germany.
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
- Research Focus Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
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20
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Nygaard H, Grindaker E, Rønnestad BR, Holmboe-Ottesen G, Høstmark AT. Long-term effects of daily postprandial physical activity on blood glucose: a randomized controlled trial. Appl Physiol Nutr Metab 2017; 42:430-437. [PMID: 28177728 DOI: 10.1139/apnm-2016-0467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Previous studies have shown that a bout of moderate or light postprandial physical activity effectively blunts the postprandial increase in blood glucose. The objective of this study was to test whether regular light postprandial physical activity can improve glycemia in persons with hyperglycemia or with a high risk of hyperglycemia. We randomized 56 participants to an intervention or a control group. They were diagnosed as hyperglycemic, not using antidiabetics, or were categorized as high-risk individuals for type 2 diabetes. The intervention group was instructed to undertake a minimum 30 min of daily light physical activity, starting a maximum of 30 min after a meal in addition to their usual physical activity for 12 weeks. The control group maintained their usual lifestyle. Blood samples were taken pre- and post-test. Forty participants completed the study and are included in the results. The self-reported increase in daily physical activity from before to within the study period was higher in the intervention group compared with control (41 ± 25 vs. 2 ± 16 min, p < 0.001). Activity diaries and accelerometer recordings supported this observation. The activity in the intervention group started earlier after the last meal compared with control (30 ± 13 vs. 100 ± 57 min, p = 0.001). There were no within- or between-group differences in any glycemic variable from pre- to post-test. In conclusion, the present study does not seem to support the notion that regular light postprandial physical activity improves blood glucose in the long term in persons with hyperglycemia or with high risk of hyperglycemia.
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Affiliation(s)
- Håvard Nygaard
- a Department of Sport Science, Lillehammer University College, PB 952 2604 Lillehammer Norway
| | - Eirik Grindaker
- a Department of Sport Science, Lillehammer University College, PB 952 2604 Lillehammer Norway
| | - Bent Ronny Rønnestad
- a Department of Sport Science, Lillehammer University College, PB 952 2604 Lillehammer Norway
| | - Gerd Holmboe-Ottesen
- b Institute of Health and Society, Department of Community Medicine, University of Oslo, Norway
| | - Arne Torbjørn Høstmark
- b Institute of Health and Society, Department of Community Medicine, University of Oslo, Norway
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21
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Pahra D, Sharma N, Ghai S, Hajela A, Bhansali S, Bhansali A. Impact of post-meal and one-time daily exercise in patient with type 2 diabetes mellitus: a randomized crossover study. Diabetol Metab Syndr 2017; 9:64. [PMID: 28883892 PMCID: PMC5580296 DOI: 10.1186/s13098-017-0263-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 08/23/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND To evaluate the effectiveness of short-timed post-meal and one-time daily exercise on glycemic control in patients with T2DM. METHODS Sixty-four T2DM patients were randomised into crossover design. Group A (n = 32) underwent post-meal exercise (moderate-intensity brisk walking covering 1500-1600 steps for 15 min, starting 15 min after each meal) from d1 to d60 followed by one-time daily exercise (45 min pre-breakfast brisk walking at stretch covering 4500-4800 steps) from d61 to d120, while it was vice versa for the group B (n = 32). The five-point blood glucose profile was performed on d1, d30, d60, d90 and d120, and HbA1c on d1, d60 and d120. Fitness wrist band was used for step-counting to ensure the intensity of exercise and compliance to exercise protocol. RESULTS Group A patients showed a significant improvement in five point blood glucose profile and HbA1c after performing post-meal exercise (p < 0.001), which was mitigated after switchover to one-time daily exercise (p < 0.001). While, group B patients showed improvement in glucose profile and HbA1c (p < 0.001) after performing post-meal exercise, as compared to one-time daily exercise. Further, on pooled analysis (post-meal versus one-time daily exercise group) the beneficial effect of post-meal exercise on glucose profile and HbA1c was consistent as compared to one time daily exercise and the significance persisted on comparison between the two groups. No hypoglycemic events were noted between the groups during the study period. CONCLUSION Post-meal exercise is more effective than routine one-time daily exercise for glycemic control in T2DM patients.
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Affiliation(s)
- Daizy Pahra
- National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nitasha Sharma
- National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandhya Ghai
- National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Abhishek Hajela
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012 India
| | - Shobhit Bhansali
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012 India
| | - Anil Bhansali
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012 India
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22
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Dempsey PC, Owen N, Yates TE, Kingwell BA, Dunstan DW. Sitting Less and Moving More: Improved Glycaemic Control for Type 2 Diabetes Prevention and Management. Curr Diab Rep 2016; 16:114. [PMID: 27699700 DOI: 10.1007/s11892-016-0797-4] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Epidemiological evidence indicates that excessive time spent in sedentary behaviours (too much sitting) is associated with an increased risk of type 2 diabetes (T2D). Here, we highlight findings of experimental studies corroborating and extending the epidemiological evidence and showing the potential benefits for T2D of reducing and breaking up sitting time across the whole day. We also discuss future research opportunities and consider emerging implications for T2D prevention and management. This new evidence is stimulating an expansion of diabetes-related physical activity guidelines-suggesting that in addition to moderate-vigorous physical activity, reducing and regularly interrupting prolonged sitting time is likely to have important and varied benefits across the spectrum of diabetes risk.
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Affiliation(s)
- Paddy C Dempsey
- Physical Activity, Behavioural Epidemiology, and Metabolic & Vascular Physiology Laboratories, Baker IDI Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, VIC 3004, Australia.
- Central Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia.
| | - Neville Owen
- Physical Activity, Behavioural Epidemiology, and Metabolic & Vascular Physiology Laboratories, Baker IDI Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, VIC 3004, Australia
- Central Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
- Swinburne University of Technology, Melbourne, Australia
| | - Thomas E Yates
- Diabetes Research Centre, University of Leicester and NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester, UK
| | - Bronwyn A Kingwell
- Physical Activity, Behavioural Epidemiology, and Metabolic & Vascular Physiology Laboratories, Baker IDI Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, VIC 3004, Australia
- Central Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
| | - David W Dunstan
- Physical Activity, Behavioural Epidemiology, and Metabolic & Vascular Physiology Laboratories, Baker IDI Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, VIC 3004, Australia
- Central Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
- Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, Australia
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23
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Breaking up of prolonged sitting over three days sustains, but does not enhance, lowering of postprandial plasma glucose and insulin in overweight and obese adults. Clin Sci (Lond) 2015; 129:117-27. [PMID: 25731923 DOI: 10.1042/cs20140790] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
To compare the cumulative (3-day) effect of prolonged sitting on metabolic responses during a mixed meal tolerance test (MTT), with sitting that is regularly interrupted with brief bouts of light-intensity walking. Overweight/obese adults (n=19) were recruited for a randomized, 3-day, outpatient, cross-over trial involving: (1) 7-h days of uninterrupted sitting (SIT); and (2) 7-h days of sitting with light-intensity activity breaks [BREAKS; 2-min of treadmill walking (3.2 km/h) every 20 min (total: 17 breaks/day)]. On days 1 and 3, participants underwent a MTT (75 g of carbohydrate, 50 g of fat) and the incremental area under the curve (iAUC) was calculated from hourly blood samples. Generalized estimating equation (GEE) models were adjusted for gender, body mass index (BMI), energy intake, treatment order and pre-prandial values to determine effects of time, condition and time × condition. The glucose iAUC was 1.3 ± 0.5 and 1.5 ± 0.5 mmol·h·l(-1) (mean differences ± S.E.M.) higher in SIT compared with BREAKS on days 1 and 3 respectively (condition effect: P=0.001), with no effect of time (P=0.48) or time × condition (P=0.8). The insulin iAUC was also higher on both days in SIT (day 1: ∆151 ± 73, day 3: ∆91 ± 73 pmol·h·l(-1), P=0.01), with no effect of time (P=0.52) or time × condition (P=0.71). There was no between-treatment difference in triglycerides (triacylglycerols) iAUC. There were significant between-condition effects but no temporal change in metabolic responses to MTT, indicating that breaking up of sitting over 3 days sustains, but does not enhance, the lowering of postprandial glucose and insulin.
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van Dijk JW, Venema M, van Mechelen W, Stehouwer CDA, Hartgens F, van Loon LJC. Effect of moderate-intensity exercise versus activities of daily living on 24-hour blood glucose homeostasis in male patients with type 2 diabetes. Diabetes Care 2013; 36:3448-53. [PMID: 24041682 PMCID: PMC3816888 DOI: 10.2337/dc12-2620] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the impact of activities of daily living (ADL) versus moderate-intensity endurance-type exercise on 24-h glycemic control in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Twenty males with type 2 diabetes participated in a randomized crossover study consisting of three experimental periods of 3 days each. Subjects were studied under sedentary control conditions, and under conditions in which prolonged sedentary time was reduced either by three 15-min bouts of ADL (postmeal strolling, ∼3 METs) or by a single 45-min bout of moderate-intensity endurance-type exercise (∼6 METs). Blood glucose concentrations were assessed by continuous glucose monitoring, and plasma insulin concentrations were determined in frequently sampled venous blood samples. RESULTS Hyperglycemia (glucose >10 mmol/L) was experienced for 6 h 51 min ±1 h 4 min per day during the sedentary control condition and was significantly reduced by exercise (4 h 47 min ± 1 h 2 min; P < 0.001), but not by ADL (6 h 2 min ± 1 h 16 min; P = 0.67). The cumulative glucose incremental areas under the curve (AUCs) of breakfast, lunch, and dinner were, respectively, 35 ± 5% (P < 0.001) and 17 ± 6% (P < 0.05) lower during the exercise and ADL conditions compared with the sedentary condition. The insulin incremental AUCs were, respectively, 33 ± 4% (P < 0.001) and 17 ± 5% (P < 0.05) lower during the exercise and ADL conditions compared with the sedentary condition. CONCLUSIONS When matched for total duration, moderate-intensity endurance-type exercise represents a more effective strategy to improve daily blood glucose homeostasis than repeated bouts of ADL. Nevertheless, the introduction of repeated bouts of ADL during prolonged sedentary behavior forms a valuable strategy to improve postprandial glucose handling in patients with type 2 diabetes.
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Holmboe-Ottesen G, Wandel M. Changes in dietary habits after migration and consequences for health: a focus on South Asians in Europe. Food Nutr Res 2012; 56:18891. [PMID: 23139649 PMCID: PMC3492807 DOI: 10.3402/fnr.v56i0.18891] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 09/12/2012] [Accepted: 10/10/2012] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Immigrants from low-income countries comprise an increasing proportion of the population in Europe. Higher prevalence of obesity and nutrition related diseases, such as type 2 diabetes (T2D) and cardiovascular disease (CVD) is found in some immigrant groups, especially in South Asians. AIM To review dietary changes after migration and discuss the implication for health and prevention among immigrants from low-income countries to Europe, with a special focus on South Asians. METHOD Systematic searches in PubMed were performed to identify relevant high quality review articles and primary research papers. The searches were limited to major immigrant groups in Europe, including those from South Asia (India, Pakistan, Bangladesh, Sri Lanka). Articles in English from 1990 and onwards from Europe were included. For health implications, recent review articles and studies of particular relevance to dietary changes among South Asian migrants in Europe were chosen. RESULTS Most studies report on dietary changes and health consequences in South Asians. The picture of dietary change is complex, depending on a variety of factors related to country of origin, urban/rural residence, socio-economic and cultural factors and situation in host country. However, the main dietary trend after migration is a substantial increase in energy and fat intake, a reduction in carbohydrates and a switch from whole grains and pulses to more refined sources of carbohydrates, resulting in a low intake of fiber. The data also indicate an increase in intake of meat and dairy foods. Some groups have also reduced their vegetable intake. The findings suggest that these dietary changes may all have contributed to higher risk of obesity, T2D and CVD. IMPLICATIONS FOR PREVENTION: A first priority in prevention should be adoption of a low-energy density - high fiber diet, rich in whole grains and grain products, as well as fruits, vegetables and pulses. Furthermore, avoidance of energy dense and hyperprocessed foods is an important preventive measure.
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Affiliation(s)
- Gerd Holmboe-Ottesen
- Department of Community Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Margareta Wandel
- Department of Nutrition, Institute for Basic Medical Sciences, University of Oslo, Oslo, Norway
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