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Makino A, Yamaguchi K, Sumi D, Ichikawa M, Ohno M, Goto K. Comparison of energy expenditure and substrate oxidation between walking and running in men and women. Phys Act Nutr 2022; 26:8-13. [PMID: 35510440 PMCID: PMC9081357 DOI: 10.20463/pan.2022.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 03/22/2022] [Indexed: 11/22/2022] Open
Abstract
[Purpose] The present study compared energy metabolism between walking and running at equivalent speeds during two incremental exercise tests.[Methods] Thirty four university students (18 males, 16 females) were recruited. Each participant completed two trials, consisting of walking (Walk) and running (Run) trials on different days, with 2-3 days apart. Exercise on a treadmill was started from initial stage of 3 min (3.0 k/m in Walk trial, 5.0 km/h in Run trial), and the speed for walking and running was progressively every minute by 0.5 km/h. The changes in metabolic variables, heart rate (HR), and rating of perceived exertion (RPE) during exercise were compared between the trials.[Results] Energy expenditure (EE) increased with speed in each trial. However, the Walk trial had a significantly higher EE than the Run trial at speeds exceeding 92 ± 2 % of the maximal walking speed (MWS, p < 0.01). Similarly, carbohydrate (CHO) oxidation was significantly higher in the Walk trial than in the Run trial at above 92 ± 2 %MWS in males (p < 0.001) and above 93 ± 1 %MWS in females (p < 0.05).[Conclusion] These findings suggest that EE and CHO oxidation during walking increase non-linearly with speed, and walking at a fast speed causes greater metabolic responses than running at the equivalent speed in young participants.
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Moxley E, Bugaieski T. Exercise Intensities as Factors of Metabolic Outcomes in Type 2 Diabetes: A Systematic Review. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2019. [DOI: 10.1177/1084822318815446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Exercise is effective to prevent and treat type 2 diabetes, although currently underutilized. This review analyzes the metabolic response to exercise performance at various intensities in individuals with type 2 diabetes. These findings provide insight into the development of safe and efficacious exercise prescriptions and education. We conducted a systemic review of the literature to examine the association of various exercise protocols with metabolic outcomes in type 2 diabetes. Between 1984 and 2018, 29 studies were categorized per exercise mode and intensity levels according to the American College of Sports Medicine standards. The most consistent improvement was found in HbA1c following moderate- to high-intensity exercise—post-exercise fasting glucose improved to a lesser extent. Low-intensity exercise improved HOMA-IR (homeostasis model assessment for insulin resistance) levels. Glucose and HbA1c improved most following interval compared with continuous exercise, irrespective of intensity. A comparison of high-intensity exercise with moderate-intensity exercise demonstrated few differences in HbA1c, fasting glucose, fasting insulin, and HOMA-IR. Irrespective of exercise intensity, HbA1c improvements were observed, suggesting a delayed progression to diabetes-related complications. Initial low-intensity exercise, with increased quantities when feasible, will contribute to metabolic improvements. The variability in methodology and measurement contributed to inconsistent outcomes; additional research with larger samples sizes is warranted.
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Pan B, Ge L, Xun YQ, Chen YJ, Gao CY, Han X, Zuo LQ, Shan HQ, Yang KH, Ding GW, Tian JH. Exercise training modalities in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis. Int J Behav Nutr Phys Act 2018; 15:72. [PMID: 30045740 PMCID: PMC6060544 DOI: 10.1186/s12966-018-0703-3] [Citation(s) in RCA: 186] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 07/17/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Current international guidelines recommend aerobic, resistance, and combined exercises for the management of type 2 diabetes mellitus (T2DM). In our study, we conducted a network meta-analysis to assess the comparative impact of different exercise training modalities on glycemic control, cardiovascular risk factors, and weight loss in patients with T2DM. METHODS We searched five electronic databases to identify randomized controlled trials (RCTs) that compared the differences between different exercise training modalities for patients with T2DM. The risk of bias in the included RCTs was evaluated according to the Cochrane tool. Network meta-analysis was performed to calculate mean difference the ratio of the mean and absolute risk differences. Data were analyzed using R-3.4.0. RESULTS A total of 37 studies with 2208 patients with T2DM were included in our study. Both supervised aerobic and supervised resistance exercises showed a significant reduction in HbA1c compared to no exercise (0.30% lower, 0.30% lower, respectively), however, there was a less reduction when compared to combined exercise (0.17% higher, 0.23% higher). Supervised aerobic also presented more significant improvement than no exercise in fasting plasma glucose (9.38 mg/dl lower), total cholesterol (20.24 mg/dl lower), triacylglycerol (19.34 mg/dl lower), and low-density lipoprotein cholesterol (11.88 mg/dl lower). Supervised resistance showed more benefit than no exercise in improving systolic blood pressure (3.90 mmHg lower]) and total cholesterol (22.08 mg/dl lower]. In addition, supervised aerobic exercise was more powerful in improving HbA1c and weight loss than unsupervised aerobic (HbA1c: 0.60% lower; weight loss: 5.02 kg lower) and unsupervised resistance (HbA1c: 0.53% lower) exercises. CONCLUSION Compared with either supervised aerobic or supervised resistance exercise alone, combined exercise showed more pronounced improvement in HbA1c levels; however, there was a less marked improvement in some cardiovascular risk factors. In terms of weight loss, there were no significant differences among the combined, supervised aerobic, and supervised resistance exercises. TRIAL REGISTRATION Our study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO); registration number: CRD42017067518 .
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Affiliation(s)
- Bei Pan
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, 730000 China
| | - Long Ge
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, 730000 China
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000 China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No. 199, Dong gang West Road, Chengguan District, Lanzhou City, Gansu province China
| | - Yang-qin Xun
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, 730000 China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No. 199, Dong gang West Road, Chengguan District, Lanzhou City, Gansu province China
| | - Ya-jing Chen
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, 730000 China
| | - Cai-yun Gao
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, 730000 China
| | - Xue Han
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, 730000 China
| | - Li-qian Zuo
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, 730000 China
| | - Hou-qian Shan
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, 730000 China
| | - Ke-hu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No. 199, Dong gang West Road, Chengguan District, Lanzhou City, Gansu province China
| | - Guo-wu Ding
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, 730000 China
| | - Jin-hui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No. 199, Dong gang West Road, Chengguan District, Lanzhou City, Gansu province China
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Grace A, Chan E, Giallauria F, Graham PL, Smart NA. Clinical outcomes and glycaemic responses to different aerobic exercise training intensities in type II diabetes: a systematic review and meta-analysis. Cardiovasc Diabetol 2017; 16:37. [PMID: 28292300 PMCID: PMC5351065 DOI: 10.1186/s12933-017-0518-6] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/03/2017] [Indexed: 12/13/2022] Open
Abstract
Aims To establish if aerobic exercise training is associated with beneficial effects on clinical outcomes and glycaemic profile in people with type II diabetes. Methods A systematic search was conducted to identify studies through a search of MEDLINE (1985 to Sept 1, 2016, Cochrane Controlled Trials Registry (1966 to Sept 1, 2016), CINAHL, SPORTDiscus and Science Citation Index. The search strategy included a mix of MeSH and free text terms for related key concepts. Searches were limited to prospective randomized or controlled trials of aerobic exercise training in humans with type II diabetes, aged >18 years, lasting >2 weeks. Results Our analysis included 27 studies (38 intervention groups) totalling 1372 participants, 737 exercise and 635 from control groups. The studies contain data from 39,435 patient-hours of exercise training. Our analyses showed improvements with exercise in glycosylated haemoglobin (HbA1C%) MD: −0.71%, 95% CI −1.11, −0.31; p value = 0.0005. There were significant moderator effects; for every additional week of exercise HbA1C% reduces between 0.009 and 0.04%, p = 0.002. For those exercising at vigorous intensity peak oxygen consumption (peak VO2) increased a further 0.64 and 5.98 ml/kg/min compared to those doing low or moderate intensity activity. Homeostatic model assessment of insulin resistance (HOMA-IR) was also improved with exercise MD: −1.02, 95% CI −1.77, −0.28; p value = 0.007; as was fasting serum glucose MD: −12.53 mmol/l, 95% CI −18.94, −6.23; p value <0.0001; and serum MD: −10.39 IU, 95% CI −17.25, −3.53; p value = 0.003. Conclusions Our analysis support existing guidelines that for those who can tolerate it, exercise at higher intensity may offer superior fitness benefits and longer program duration will optimize reductions in HbA1C%. Electronic supplementary material The online version of this article (doi:10.1186/s12933-017-0518-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aimee Grace
- School of Science and Technology, University of New England, Armidale, NSW, 2351, Australia
| | - Erick Chan
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Francesco Giallauria
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Petra L Graham
- Department of Statistics, Macquarie University, North Ryde, Sydney, NSW, 2113, Australia
| | - Neil A Smart
- School of Science and Technology, University of New England, Armidale, NSW, 2351, Australia.
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Cardiorespiratory Exertion While Playing Video Game Exercises in Elderly Individuals With Type 2 Diabetes. Clin J Sport Med 2016; 26:326-31. [PMID: 26513387 DOI: 10.1097/jsm.0000000000000258] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the suitability of the Wii Fit Plus exergame as a tool to improve cardiorespiratory fitness in individuals with type 2 diabetes. DESIGN Experimental cross-sectional study. SETTING Controlled laboratory. PARTICIPANTS Twelve type 2 diabetic patients (10 male and 2 female; age, 60.2 ± 7.7 years; body mass index, 30.9 ± 6.2 kg/m). INTERVENTIONS At baseline, all participants underwent an all-out cardiopulmonary exercise test on a treadmill to assess peak and average oxygen consumption (V[Combining Dot Above]O2peak and V[Combining Dot Above]O2mean). Forty-eight to 72 hours after the cardiopulmonary exercise test, the same parameters were assessed during three 10-minute bouts of Wii Fit Plus exergaming and converted to percentage of treadmill V[Combining Dot Above]O2peak (%V[Combining Dot Above]O2peak). MAIN OUTCOME MEASURES V[Combining Dot Above]O2peak and V[Combining Dot Above]O2mean during Wii Fit Plus play relative to V[Combining Dot Above]O2peak achieved during the cardiopulmonary exercise test. RESULTS All Wii Fit Plus exercises generated a V[Combining Dot Above]O2peak of around 60% and V[Combining Dot Above]O2mean of around 40% of the V[Combining Dot Above]O2peak as established during the cardiopulmonary exercise test. Mean heart rate and resting energy expenditure (respiratory exchange ratio) lay in a range of moderate aerobic exercise. A moderate-to-strong correlation between treadmill V[Combining Dot Above]O2peak and both exergame V[Combining Dot Above]O2peak and exergame V[Combining Dot Above]O2mean was found. CONCLUSIONS Video gaming has the potential to offer training intensities that concur with established guidelines for type 2 diabetic patients. The training intensity is self-adjusting based on fitness level allowing for an effective workout for different users.
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Monteiro WD, Cunha FA, Ivo EX, Freire RA, Silva BS, Farinatti P. Physiological strain to prolonged exercise bouts at the walk-run transition speeds depends on locomotion mode in healthy untrained men. Scand J Med Sci Sports 2016; 27:762-769. [PMID: 27230405 DOI: 10.1111/sms.12693] [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] [Accepted: 03/30/2016] [Indexed: 01/10/2023]
Abstract
This study compared the physiological strain induced by prolonged walking and running performed at the walk-run transition speed (WRTS) in healthy untrained men. Twenty volunteers (age: 28 ± 5.01 years; height: 174.0 ± 0.3 cm; body mass: 74.5 ± 0.6 kg) underwent the following: (a) ramp-incremental maximal cardiopulmonary exercise test (CPET); (b) specific protocol to detect the WRTS; and (c) two 30-min walking and running bouts at WRTS (mean ± SD: 6.9 ± 0.06 km/h). Expired gases were collected during exercise bouts via the metabolic cart. A significant effect of locomotion mode (F = 4.8, P < 0.001) was observed with running resulting in higher cardiorespiratory responses than walking at the WRTS (oxygen uptake: mean difference = 0.26 L/min; pulmonary ventilation: mean difference = 5.53 L/min; carbon dioxide output: mean difference = 0.32 L/min; heart rate: mean difference = 13 beats/min; total energy expenditure: mean difference = 59 kcal). The rating of perceived exertion was similar across locomotion modes (mean difference = 0.3; P = 0.490). In conclusion, running promoted greater cardiorespiratory responses than walking at the WRTS in untrained healthy men. These data might have practical impact on aerobic training performed at intensities corresponding to WRTS.
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Affiliation(s)
- W D Monteiro
- Physical Activity Sciences Graduate Program, Salgado de Oliveira University, Niterói, Rio de Janeiro, Brazil.,Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | - F A Cunha
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, Brazil.,Rehabilitation Sciences Graduate Program, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil
| | - E X Ivo
- Physical Activity Sciences Graduate Program, Salgado de Oliveira University, Niterói, Rio de Janeiro, Brazil
| | - R A Freire
- Physical Activity Sciences Graduate Program, Salgado de Oliveira University, Niterói, Rio de Janeiro, Brazil.,Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | - B S Silva
- Physical Activity Sciences Graduate Program, Salgado de Oliveira University, Niterói, Rio de Janeiro, Brazil
| | - P Farinatti
- Physical Activity Sciences Graduate Program, Salgado de Oliveira University, Niterói, Rio de Janeiro, Brazil.,Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, Brazil
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Gordon BA, Bird SR, MacIsaac RJ, Benson AC. Does a single bout of resistance or aerobic exercise after insulin dose reduction modulate glycaemic control in type 2 diabetes? A randomised cross-over trial. J Sci Med Sport 2016; 19:795-9. [PMID: 26906164 DOI: 10.1016/j.jsams.2016.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 12/21/2015] [Accepted: 01/21/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Regular exercise is advocated for individuals with type 2 diabetes, without fully understanding the acute (0-72h post-exercise) glycaemic response. This study assessed post-exercise glycaemic profiles of non-exercising individuals with insulin treated type 2 diabetes, following resistance and aerobic exercise. DESIGN Randomised cross-over trial. METHODS Fourteen individuals with insulin treated type 2 diabetes (9 males, 5 females) aged 58.1±7.1 years (HbA1c: 8.0±0.6%) were allocated to single sessions of resistance (six whole-body exercises, three sets, 8-10 repetitions, 70% 1RM) and aerobic (30min cycling, 60% VO2peak) exercise, 7-days apart, with the day prior to the first exercise day of each intervention being the control condition. Immediately prior to exercise, insulin dosage was halved and breakfast consumed. Continuous glucose monitoring was undertaken to determine area under the curve and glucose excursions. RESULTS Blood glucose initially increased (0-2h) following both resistance and aerobic exercise (p<0.001), peaking at 12.3±3.4mmolL(-1) and 12.3±3.3mmolL(-1), respectively. Area under the glucose curve was not statistically different over any of the 24h periods (p=0.12), or different in response to resistance (222±41mmolL(-1)24h(-1)) or aerobic (211±40 mmolL(-1)24h(-1)) exercise (p=0.56). Incidence of hyperglycaemia did not differ between exercise modes (p=0.68). Hypoglycaemic events were identified in three and four participants following resistance and aerobic exercise respectively: these did not require treatment. CONCLUSIONS Glycaemic response is not different between exercise modes, although 50% insulin dose reduction prior to exercise impairs the expected improvement. A common clinical recommendation of 50% insulin dose reduction does not appear to cause adverse glycaemic events.
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Affiliation(s)
- Brett A Gordon
- Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Australia; Physiotherapy Department, Austin Hospital, Austin Health, Australia; Discipline of Exercise Sciences, School of Medical Sciences, RMIT University, Australia.
| | - Stephen R Bird
- Discipline of Exercise Sciences, School of Medical Sciences, RMIT University, Australia
| | - Richard J MacIsaac
- Endocrinology and Diabetes, St. Vincent's Hospital & University of Melbourne, Australia
| | - Amanda C Benson
- Discipline of Exercise Sciences, School of Medical Sciences, RMIT University, Australia
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Wens I, Dalgas U, Vandenabeele F, Grevendonk L, Verboven K, Hansen D, Eijnde BO. High Intensity Exercise in Multiple Sclerosis: Effects on Muscle Contractile Characteristics and Exercise Capacity, a Randomised Controlled Trial. PLoS One 2015; 10:e0133697. [PMID: 26418222 PMCID: PMC4587912 DOI: 10.1371/journal.pone.0133697] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 06/30/2015] [Indexed: 12/22/2022] Open
Abstract
Introduction Low-to-moderate intensity exercise improves muscle contractile properties and endurance capacity in multiple sclerosis (MS). The impact of high intensity exercise remains unknown. Methods Thirty-four MS patients were randomized into a sedentary control group (SED, n = 11) and 2 exercise groups that performed 12 weeks of a high intensity interval (HITR, n = 12) or high intensity continuous cardiovascular training (HCTR, n = 11), both in combination with resistance training. M.vastus lateralis fiber cross sectional area (CSA) and proportion, knee-flexor/extensor strength, body composition, maximal endurance capacity and self-reported physical activity levels were assessed before and after 12 weeks. Results Compared to SED, 12 weeks of high intensity exercise increased mean fiber CSA (HITR: +21±7%, HCTR: +23±5%). Furthermore, fiber type I CSA increased in HCTR (+29±6%), whereas type II (+23±7%) and IIa (+23±6%,) CSA increased in HITR. Muscle strength improved in HITR and HCTR (between +13±7% and +45±20%) and body fat percentage tended to decrease (HITR: -3.9±2.0% and HCTR: -2.5±1.2%). Furthermore, endurance capacity (Wmax +21±4%, time to exhaustion +24±5%, VO2max +17±5%) and lean tissue mass (+1.4±0.5%) only increased in HITR. Finally self-reported physical activity levels increased 73±19% and 86±27% in HCTR and HITR, respectively. Conclusion High intensity cardiovascular exercise combined with resistance training was safe, well tolerated and improved muscle contractile characteristics and endurance capacity in MS. Trial Registration ClinicalTrials.gov NCT01845896
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Affiliation(s)
- Inez Wens
- REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building A, Diepenbeek, Belgium
- * E-mail:
| | - Ulrik Dalgas
- Section of Sport Science, Dep. Public Health, Aarhus University, Dalgas Avenue 4, 8000, Aarhus, C, Denmark
| | - Frank Vandenabeele
- REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building A, Diepenbeek, Belgium
| | - Lotte Grevendonk
- REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building A, Diepenbeek, Belgium
| | - Kenneth Verboven
- REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building A, Diepenbeek, Belgium
| | - Dominique Hansen
- REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building A, Diepenbeek, Belgium
| | - Bert O. Eijnde
- REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Building A, Diepenbeek, Belgium
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Lin X, Zhang X, Guo J, Roberts CK, McKenzie S, Wu WC, Liu S, Song Y. Effects of Exercise Training on Cardiorespiratory Fitness and Biomarkers of Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc 2015; 4:JAHA.115.002014. [PMID: 26116691 PMCID: PMC4608087 DOI: 10.1161/jaha.115.002014] [Citation(s) in RCA: 416] [Impact Index Per Article: 46.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Guidelines recommend exercise for cardiovascular health, although evidence from trials linking exercise to cardiovascular health through intermediate biomarkers remains inconsistent. We performed a meta-analysis of randomized controlled trials to quantify the impact of exercise on cardiorespiratory fitness and a variety of conventional and novel cardiometabolic biomarkers in adults without cardiovascular disease. METHODS AND RESULTS Two researchers selected 160 randomized controlled trials (7487 participants) based on literature searches of Medline, Embase, and Cochrane Central (January 1965 to March 2014). Data were extracted using a standardized protocol. A random-effects meta-analysis and systematic review was conducted to evaluate the effects of exercise interventions on cardiorespiratory fitness and circulating biomarkers. Exercise significantly raised absolute and relative cardiorespiratory fitness. Lipid profiles were improved in exercise groups, with lower levels of triglycerides and higher levels of high-density lipoprotein cholesterol and apolipoprotein A1. Lower levels of fasting insulin, homeostatic model assessment-insulin resistance, and glycosylated hemoglobin A1c were found in exercise groups. Compared with controls, exercise groups had higher levels of interleukin-18 and lower levels of leptin, fibrinogen, and angiotensin II. In addition, we found that the exercise effects were modified by age, sex, and health status such that people aged <50 years, men, and people with type 2 diabetes, hypertension, dyslipidemia, or metabolic syndrome appeared to benefit more. CONCLUSIONS This meta-analysis showed that exercise significantly improved cardiorespiratory fitness and some cardiometabolic biomarkers. The effects of exercise were modified by age, sex, and health status. Findings from this study have significant implications for future design of targeted lifestyle interventions.
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Affiliation(s)
- Xiaochen Lin
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI (X.L., W.C.W., S.L.)
| | - Xi Zhang
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN (X.Z., Y.S.)
| | - Jianjun Guo
- Center for the Youth Sport Research and Development, China Institute of Sport Science, Beijing, China (J.G.)
| | - Christian K Roberts
- Geriatrics, Research, Education and Clinical Centers, VA Greater Los Angeles Healthcare System, Los Angeles, CA (C.K.R.)
| | - Steve McKenzie
- Department of Kinesiology, Center for Physical Activity in Wellness and Prevention, Indiana University-Purdue University at Indianapolis, IN (S.M.K.)
| | - Wen-Chih Wu
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI (X.L., W.C.W., S.L.) Division of Cardiology and Veterans Affairs Medical Center, Department of Medicine, Alpert Medical School, Brown University, Providence, RI (W.C.W., S.L.)
| | - Simin Liu
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI (X.L., W.C.W., S.L.) Division of Cardiology and Veterans Affairs Medical Center, Department of Medicine, Alpert Medical School, Brown University, Providence, RI (W.C.W., S.L.) Division of Endocrinology, Department of Medicine, Rhode Island Hospital, Providence, RI (S.L.)
| | - Yiqing Song
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN (X.Z., Y.S.)
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Keytsman C, Dendale P, Hansen D. Chronotropic Incompetence During Exercise in Type 2 Diabetes: Aetiology, Assessment Methodology, Prognostic Impact and Therapy. Sports Med 2015; 45:985-95. [DOI: 10.1007/s40279-015-0328-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Karoline de Morais P, Sales MM, Alves de Almeida J, Motta-Santos D, Victor de Sousa C, Simões HG. Effects of aerobic exercise intensity on 24-h ambulatory blood pressure in individuals with type 2 diabetes and prehypertension. J Phys Ther Sci 2015; 27:51-6. [PMID: 25642036 PMCID: PMC4305596 DOI: 10.1589/jpts.27.51] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 07/04/2014] [Indexed: 01/24/2023] Open
Abstract
[Purpose] To verify the effects of different intensities of aerobic exercise on 24-hour
ambulatory blood pressure (BP) responses in individuals with type 2 diabetes mellitus
(T2D) and prehypertension. [Subjects and Methods] Ten individuals with T2D and
prehypertension (55.8 ± 7.7 years old; blood glucose 133.0 ± 36.7 mg·dL−1 and
awake BP 130.6 ± 1.6/ 80.5 ± 1.8 mmHg) completed three randomly assigned experiments:
non-exercise control (CON) and exercise at moderate (MOD) and maximal (MAX) intensities.
Heart rate (HR), BP, blood lactate concentrations ([Lac]), oxygen uptake (VO2),
and rate of perceived exertion (RPE) were measured at rest, during the experimental
sessions, and during the 60 min recovery period. After this period, ambulatory blood
pressure was monitored for 24 h. [Results] The results indicate that [Lac] (MAX: 6.7±2.0
vs. MOD: 3.8±1.2 mM), RPE (MAX: 19±1.3 vs. MOD: 11±2.3) and VO2peak (MAX:
20.2±4.1 vs. MOD: 14.0±3.0 mL·kg−1·min−1) were highest following the
MAX session. Compared with CON, only MAX elicited post-exercise BP reduction that lasted
for 8 h after exercise and during sleep. [Conclusion] A single session of aerobic exercise
resulted in 24 h BP reductions in individuals with T2D, especially while sleeping, and
this reduction seems to be dependent on the intensity of the exercise performed.
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Affiliation(s)
- Pâmella Karoline de Morais
- Universidade Católica de Brasília: EPTC, QS07, LT1 s/n. Bloco G Sala 15, CEP 72030-170 Águas Claras, Taguatinga/DF, Brazil
| | - Marcelo Magalhães Sales
- Universidade Católica de Brasília: EPTC, QS07, LT1 s/n. Bloco G Sala 15, CEP 72030-170 Águas Claras, Taguatinga/DF, Brazil
| | | | | | - Caio Victor de Sousa
- Universidade Católica de Brasília: EPTC, QS07, LT1 s/n. Bloco G Sala 15, CEP 72030-170 Águas Claras, Taguatinga/DF, Brazil
| | - Herbert Gustavo Simões
- Universidade Católica de Brasília: EPTC, QS07, LT1 s/n. Bloco G Sala 15, CEP 72030-170 Águas Claras, Taguatinga/DF, Brazil
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Emerenziani GP, Gallotta MC, Meucci M, Di Luigi L, Migliaccio S, Donini LM, Strollo F, Guidetti L. Effects of Aerobic Exercise Based upon Heart Rate at Aerobic Threshold in Obese Elderly Subjects with Type 2 Diabetes. Int J Endocrinol 2015; 2015:695297. [PMID: 26089890 PMCID: PMC4452101 DOI: 10.1155/2015/695297] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 09/16/2014] [Accepted: 09/17/2014] [Indexed: 11/18/2022] Open
Abstract
In obese diabetic subjects, a correct life style, including diet and physical activity, is part of a correct intervention protocol. Thus, the aim of this study was to evaluate the effects of aerobic training intervention, based on heart rate at aerobic gas exchange threshold (AerTge), on clinical and physiological parameters in obese elderly subjects with type 2 diabetes (OT2DM). Thirty OT2DM subjects were randomly assigned to an intervention (IG) or control group (CG). The IG performed a supervised aerobic exercise training based on heart rate at AerTge whereas CG maintained their usual lifestyle. Anthropometric measures, blood analysis, peak oxygen consumption ([Formula: see text]), metabolic equivalent (METpeak), work rate (WRpeak), and WRAerTge were assessed at baseline and after intervention. After training, patients enrolled in the IG had significantly higher (P < 0.001) [Formula: see text], METpeak, WRpeak, and WRAerTge and significantly lower (P < 0.005) weight, BMI, %FM, and waist circumference than before intervention. Both IG and CG subjects had lower glycated haemoglobin levels after intervention period. No significant differences were found for all the other parameters between pre- and posttraining and between groups. Aerobic exercise prescription based upon HR at AerTge could be a valuable physical intervention tool to improve the fitness level and metabolic equilibrium in OT2DM patients.
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Affiliation(s)
- Gian Pietro Emerenziani
- Exercise and Sport Sciences Unit, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy
| | - Maria Chiara Gallotta
- Exercise and Sport Sciences Unit, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy
| | - Marco Meucci
- Department of Health and Exercise Sciences, Appalachian State University, Boone, USA
| | - Luigi Di Luigi
- Endocrinology Unit, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, , Italy
Endocrinology Unit, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy
| | - Silvia Migliaccio
- Endocrinology Unit, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, , Italy
Endocrinology Unit, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy
| | - Lorenzo Maria Donini
- Medical Physiopathology, Food Science and Endocrinology Section, Department of Experimental Medicine, Food Science and Human Nutrition Research Unit, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Felice Strollo
- Diabetes Care Unit, St. Spirito Hospital, Lungo Tevere in Saxia 1, 00193 Rome, Italy
| | - Laura Guidetti
- Exercise and Sport Sciences Unit, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy
- *Laura Guidetti:
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Karstoft K, Winding K, Knudsen SH, Nielsen JS, Thomsen C, Pedersen BK, Solomon TPJ. The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients: a randomized, controlled trial. Diabetes Care 2013; 36:228-36. [PMID: 23002086 PMCID: PMC3554285 DOI: 10.2337/dc12-0658] [Citation(s) in RCA: 220] [Impact Index Per Article: 20.0] [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 evaluate the feasibility of free-living walking training in type 2 diabetic patients and to investigate the effects of interval-walking training versus continuous-walking training upon physical fitness, body composition, and glycemic control. RESEARCH DESIGN AND METHODS Subjects with type 2 diabetes were randomized to a control (n = 8), continuous-walking (n = 12), or interval-walking group (n = 12). Training groups were prescribed five sessions per week (60 min/session) and were controlled with an accelerometer and a heart-rate monitor. Continuous walkers performed all training at moderate intensity, whereas interval walkers alternated 3-min repetitions at low and high intensity. Before and after the 4-month intervention, the following variables were measured: VO(2)max, body composition, and glycemic control (fasting glucose, HbA(1c), oral glucose tolerance test, and continuous glucose monitoring [CGM]). RESULTS Training adherence was high (89 ± 4%), and training energy expenditure and mean intensity were comparable. VO(2)max increased 16.1 ± 3.7% in the interval-walking group (P < 0.05), whereas no changes were observed in the continuous-walking or control group. Body mass and adiposity (fat mass and visceral fat) decreased in the interval-walking group only (P < 0.05). Glycemic control (elevated mean CGM glucose levels and increased fasting insulin) worsened in the control group (P < 0.05), whereas mean (P = 0.05) and maximum (P < 0.05) CGM glucose levels decreased in the interval-walking group. The continuous walkers showed no changes in glycemic control. CONCLUSIONS Free-living walking training is feasible in type 2 diabetic patients. Continuous walking offsets the deterioration in glycemia seen in the control group, and interval walking is superior to energy expenditure-matched continuous walking for improving physical fitness, body composition, and glycemic control.
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Affiliation(s)
- Kristian Karstoft
- Centre of Inflammation and Metabolism, Department of Infectious Diseases and CMRC, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Kelly P, Murphy M, Oja P, Murtagh EM, Foster C. Estimates of the number of people in England who attain or exceed vigorous intensity exercise by walking at 3 mph. J Sports Sci 2011; 29:1629-34. [DOI: 10.1080/02640414.2011.609897] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Belli T, Ribeiro LFP, Ackermann MA, Baldissera V, Gobatto CA, Galdino da Silva R. Effects of 12-week overground walking training at ventilatory threshold velocity in type 2 diabetic women. Diabetes Res Clin Pract 2011; 93:337-43. [PMID: 21636159 DOI: 10.1016/j.diabres.2011.05.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Revised: 03/20/2011] [Accepted: 05/05/2011] [Indexed: 10/18/2022]
Abstract
This study analyzed the effects of overground walking training at ventilatory threshold (VT) velocity on glycaemic control, body composition, physical fitness and lipid profile in DM2 women. Nineteen sedentary patients were randomly assigned to a control group (CG; n=10, 55.9±2.2 years) or a trained group (TG; n=9, 53.4±2.3 years). Both groups were subjected to anthropometric measures, a 12-h fasting blood sampling and a graded treadmill exercise test at baseline and after a 12-week period, during which TG followed a training program involving overground walking at VT velocity for 20-60min/session three times/week. Significant group×time interactions (P<0.05) in glycated hemoglobin (HbA1c), body mass, body mass index (BMI), peak oxygen uptake (VO(2peak)) and exercise duration were observed as effects of training exercise, whereas intervention did not induced significant changes (P>0.05) in fasting blood glucose, submaximal fitness parameters and lipid profile. Our results suggest that overground walking training at VT velocity improves long term glycaemic control, body composition and exercise capacity, attesting for the relevance of this parameter as an effective strategy for the exercise intensity prescription in DM2 population.
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Affiliation(s)
- Taisa Belli
- Laboratory of Sports Applied Physiology, FCA, UNICAMP, Limeira, SP, Brazil.
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Abstract
PURPOSE OF REVIEW Health professionals are presented with the challenge of prescribing physical activity that is likely to be sustained by the sedentary majority. Walking is eminently suited to physical activity prescription for inactive individuals as it is accessible to men and women of all ages and social groups and poses little risk of injury. This paper reviews recent evidence of the health benefits of walking and promotion of walking behavior. RECENT FINDINGS Large observational studies consistently show associations between walking and cardiovascular disease endpoints over long periods of follow-up. Intervention studies further support the health benefits of walking, showing improvements in clinical biomarkers and measures after shorter periods of follow-up. Walking appears to have cardiovascular disease-related health benefits in younger, middle-aged, and older men and women, in both healthy and patient populations. Pedometer-based, mobile phone-based, and computer-based programs are effective in increasing walking levels. Neighborhood and workplace amenities and programs may be important supports for walking behaviors. SUMMARY Walking has the potential to play a key role in the primary and secondary prevention of cardiovascular disease. Clinicians can prescribe walking to assist patients meet physical activity recommendations and help identify supports available to the patient.
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Influence of physical exercise on neuroimmunological functioning and health: aging and stress. Neurotox Res 2010; 20:69-83. [PMID: 20953749 DOI: 10.1007/s12640-010-9224-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Revised: 09/16/2010] [Accepted: 09/21/2010] [Indexed: 12/20/2022]
Abstract
Chronic and acute stress, with associated pathophysiology, are implicated in a variety of disease states, with neuroimmunological dysregulation and inflammation as major hazards to health and functional sufficiency. Psychosocial stress and negative affect are linked to elevations in several inflammatory biomarkers. Immunosenescence, the deterioration of immune competence observed in the aged aspect of the life span, linked to a dramatic rise in morbidity and susceptibility to diseases with fatal outcomes, alters neuroimmunological function and is particularly marked in the neurodegenerative disorders, e.g., Parkinson's disease and diabetes. Physical exercise diminishes inflammation and elevates agents and factors involved in immunomodulatory function. Both the alleviatory effects of life-long physical activity upon multiple cancer forms and the palliative effects of physical activity for individuals afflicted by cancer offer advantages in health intervention. Chronic conditions of stress and affective dysregulation are associated with neuroimmunological insufficiency and inflammation, contributing to health risk and mortality. Physical exercise regimes have induced manifest anti-inflammatory benefits, mediated possibly by brain-derived neurotrophic factor. The epidemic proportions of metabolic disorders, obesity, and diabetes demand attention; several variants of exercise regimes have been found repeatedly to induce both prevention and improvement under both laboratory and clinical conditions. Physical exercise offers a unique non-pharmacologic intervention incorporating multiple activity regimes, e.g., endurance versus resistance exercise that may be adapted to conform to the particular demands of diagnosis, intervention and prognosis inherent to the staging of autoimmune disorders and related conditions.
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