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Moore JM, Salmons H, Vinoskey C, Hooshmand S, Kressler J. One minute of stair climbing and descending reduces postprandial insulin and glucose with 3-min improving insulin resistance following a mixed meal in young adults: A Randomized Controlled Crossover Trial. J Exerc Sci Fit 2024; 22:266-270. [PMID: 38572086 PMCID: PMC10987319 DOI: 10.1016/j.jesf.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/20/2024] [Accepted: 03/16/2024] [Indexed: 04/05/2024] Open
Abstract
Background Glycemic markers, including postprandial glucose, insulin, and insulin resistance, are strong predictors of morbidity and mortality in individuals with and without diabetes. Stair-climbing and -descending (SCD) at a comfortable pace for 3 minutes after a sugary beverage (300 kilocalories; 100% carbohydrate) lowers insulin, with insulin sensitivity improving in 10 minutes. If similar benefits are seen following consumption of a mixed meal is unknown. We hypothesize SCD will improve these markers in a dose-response manner following a mixed meal. Methods In a randomized, controlled, crossover trial, young adults (N = 31) performed SCD for 0 (seated control), 1, 3, and 10 minutes after a mixed meal (650 kilocalories; 53% carbohydrates, 33% fat, and 14% protein). Differences in glucose, insulin, and insulin sensitivity (ISI) from baseline to 30 min were analyzed using a mixed-effects ANOVA. Results A significant fixed-effect was found for change in glucose [F(2.551,67.17) = 4.724,p = 0.007)], insulin [F(2.692,74.49) = 11.28,p < 0.001)], and ISI [F(2.127,56.00) = 5.848,p = 0.004)]. Compared to the seated control (0 minutes), changes in glucose were lower after 1 minute (-14.0 (-7.2)mg/dL,p < 0.001), 3 minutes (-18.4 (-7.0)mg/dL,p = 0.0007), and 10 minutes (-10.0 (-8.1)mg/dL,p = 0.039); changes in insulin were lower after 1 minute (-1.8 (-0.9)μIU/mL,p = 0.0011), 3 minutes (-2.8 (-0.9)μIU/mL,p < 0.001), and 10 minutes (-1.1 (-0.9)μIU/mL,p = 0.033); and changes in ISI were significantly higher after 3 minutes (2.4 (1.5),p < 0.001) and 10 minutes (1.3 (1.6),p = 0.014) but not 1 minute (1.2 (1.5),p = 0.059). Conclusion Postprandial glucose and insulin improved with 1 minute, and insulin resistance improved with 3 minutes, of SCD at a self-selected, comfortable pace, after consumption of a mixed meal in apparently healthy young adults. Protocol Trial registration: ClinicalTrials.gov Identifier: NCT04232475.
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Affiliation(s)
- Jeff M. Moore
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
| | - Hannah Salmons
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Cameron Vinoskey
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Shirin Hooshmand
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Jochen Kressler
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
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2
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Christie HE, Winter M, Meyer BJ, Francois ME. Diagnosis to Delivery: A Randomized Clinical Trial of Postmeal Walking in Women with Gestational Diabetes. Med Sci Sports Exerc 2024; 56:860-867. [PMID: 38233988 DOI: 10.1249/mss.0000000000003382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE The aim of this study was to determine whether advice to perform postmeal walking could be an effective and feasible alternate to standard care continuous walking for the management of gestational diabetes (GDM). METHODS Forty women with GDM were randomized between 28 and 30 wk of gestation into either standard care (CTL; 30-min continuous walking, most days per week) or standard care with advice to PMW (daily 10-min walks after three main meals) for ~7 wk. The primary outcome for this randomized controlled trial was postprandial glucose assessed by continuous glucose monitors. Continuous glucose monitor and ActivPAL inclinometers (physical activity parameters) were each worn for 7 d at ~28 and ~35 wk gestation. Delivery outcomes were also collected. A linear mixed model compared the changes across time between groups. RESULTS Twenty-six women (PMW: n = 12, CTL: n = 14; age 34 ± 5 y) completed the trial. Mean 3 h postprandial glucose at dinner was higher in the PMW versus CTL group at baseline and across the intervention (main effect group, P = 0.04). Twenty-four hours, nocturnal, and fasting glucose were similar between groups. The PMW group spent ~57 min·d -1 more time sedentary and ~11 min·d -1 less time stepping versus CTL (main effect group: P = 0.02 and 0.05). Adherence to the prescribed 30 min·d -1 of physical activity was high, regardless of whether accumulated as 3 × 10-min or one single bout of walking. CONCLUSIONS Distributing activity as 10-min bouts after main meals did not improve postprandial glucose outcomes compared with standard-care control. More research on the optimal duration and intensity of postmeal walks to improve postprandial responses are needed. Strategies that mitigate sedentary time and increase the minutes of physical activity accumulated across the day in pregnancy are also warranted.
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Affiliation(s)
| | - Meagan Winter
- Illawarra Shoalhaven Local Health District Diabetes Service, Wollongong, New South Wales, AUSTRALIA
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3
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Ratajczak M, Krzywicka M, Szulińska M, Musiałowska D, Kusy K, Karolkiewicz J. Effects of 12-Week Combined Strength and Endurance Circuit Training Program on Insulin Sensitivity and Retinol-Binding Protein 4 in Women with Insulin-Resistance and Overweight or Mild Obesity: A Randomized Controlled Trial. Diabetes Metab Syndr Obes 2024; 17:93-106. [PMID: 38204866 PMCID: PMC10778163 DOI: 10.2147/dmso.s432954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Background Circuit training is an exercise mode, that may include both endurance and resistance components. There are premises that a combination of these two modalities brings additional benefits, particularly in improving insulin sensitivity. The retinol-binding protein 4 (RBP4) may inhibit signaling from insulin metabolic pathways in skeletal muscles, thus developing insulin resistance. This study aimed to evaluate whether moderate intensity circuit training combining strength and endurance exercise induces changes in tissue insulin sensitivity, carbohydrate and lipid metabolism, and serum RBP4 levels in insulin-resistant women. Methods In this clinical controlled trial women diagnosed with insulin-resistance were randomly divided into two groups. The training group (T) performed circuit training combining strength (50%-80%1RM) and endurance (50%-75%HRR) exercise on five weight and two cardio machines, for 33 minutes, three times per week, for 3 months. Women from the control non-training group (NT) did not change their previous physical activity. At the beginning of the study and after the intervention period, a one-repetition maximum, body mass, and composition, resting heart rate (HR), blood pressure, glucose, insulin, blood lipids, thyroid-stimulating hormone (TSH), insulin-like growth factor-1 (IGF-1), RBP4, and insulin resistance (HOMA-IR) were measured. The results of 27 patients were analyzed using a two-way repeated measures ANOVA. Results Significant differences in the pattern of change over time between the groups for resting HR (p < 0.010) and total lean mass (p < 0.039) were found. No differences in HOMA-IR, and RBP4 were observed post-study compared to pre-study in the T group. A significant correlation between RBP4 and TSH concentration was found. Conclusion Twelve-week circuit training combining strength and endurance exercise has minor effects on HOMA-IR, glucose and lipid metabolism, IGF-1, TSH, and RBP4. Although moderate-intensity circuit training is considered safe, its effectiveness in patients with overweight and mild obesity may be insufficient to reduce insulin resistance. Trial Registration ClinicalTrials.gov: NCT04528693, registered August 23, 2020.
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Affiliation(s)
- Marzena Ratajczak
- Department of Medical Biology, Poznan University of Physical Education, Poznan, 61-871, Poland
| | - Monika Krzywicka
- Department of Cardiological and Rheumatological Rehabilitation, Poznan University of Physical Education, Poznan, 61-871, Poland
| | - Monika Szulińska
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, Poznan, 61-701, Poland
| | - Dominika Musiałowska
- Insulin Resistance Foundation – Healthy Diet and Healthy Life, Poznan, 61-379, Poland
| | - Krzysztof Kusy
- Department of Athletics Strength and Conditioning, Poznan University of Physical Education, Poznan, 61-871, Poland
| | - Joanna Karolkiewicz
- Department of Food and Nutrition, Poznan University of Physical Education, Poznan, 61-871, Poland
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4
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Rogers EM, Banks NF, Jenkins NDM. Acute effects of daily step count on postprandial metabolism and resting fat oxidation: a randomized controlled trial. J Appl Physiol (1985) 2023; 135:812-822. [PMID: 37560764 DOI: 10.1152/japplphysiol.00052.2023] [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: 01/27/2023] [Revised: 07/20/2023] [Accepted: 08/05/2023] [Indexed: 08/11/2023] Open
Abstract
To examine the effects of daily step count on same-day fat oxidation and postprandial metabolic responses to an evening high-fat mixed meal (HFMM). Ten healthy participants (5 females, 30 ± 7 yr) completed four different daily step counts-2,000 (2 K), 5,000 (5 K), 10,000 (10 K), and 15,000 (15 K) steps-on separate days in randomized order. On experimental days, participants ate the same meals and walked all steps on an indoor track at a pace of 100 steps/min in three roughly equal bouts throughout the day. After the final walking bout, participants' resting energy expenditure (REE), respiratory exchange ratio (RER), and fat oxidation rate (FATOX) were measured. Blood samples were obtained before (BL) and 30-, 60-, 90-, 120-, and 240-min following consumption of an HFMM (960 kcal; 48% fat) to measure triglycerides (i.e., postprandial lipemia; PPL), nonesterified fatty acids (NEFAs), insulin, and glucose. Two-way ANOVAs indicated condition effects where PPL was significantly higher after 2 K versus 10 K (+23 ± 8 mg/dL, P = 0.027), and NEFAs were significantly higher after 15 K versus 2 K (+86 ± 23 µmol/L; P = 0.006). No differences were found for insulin, glucose, or REE among conditions (all P > 0.124). Similarly, RER (P = 0.054; ηp2 = 0.24) and FATOX (P = 0.071; ηp2 = 0.23) were not significantly different among conditions. In young adults, 10 K steps elicited the greatest decrease in PPL, an established cardiovascular disease risk factor. NEFA levels were highest after the 15 K condition, likely due to alterations in adipose tissue lipolysis or lipoprotein lipase activity with increased activity.NEW & NOTEWORTHY This randomized controlled trial demonstrated that walking 10,000, compared with 2,000, steps/day significantly reduced postprandial lipemia (PPL), an independent predictor of cardiovascular disease (CVD) following same-day evening meal consumption. These experimental data support walking 10,000 steps/day to lower CVD risk.
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Affiliation(s)
- Emily M Rogers
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, The University of Iowa, Iowa City, Iowa, United States
| | - Nile F Banks
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, The University of Iowa, Iowa City, Iowa, United States
| | - Nathaniel D M Jenkins
- Integrative Laboratory of Applied Physiology and Lifestyle Medicine, The University of Iowa, Iowa City, Iowa, United States
- Abboud Cardiovascular Research Center, The University of Iowa, Iowa City, Iowa, United States
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The role of exercise and hypoxia on glucose transport and regulation. Eur J Appl Physiol 2023; 123:1147-1165. [PMID: 36690907 DOI: 10.1007/s00421-023-05135-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 01/06/2023] [Indexed: 01/25/2023]
Abstract
Muscle glucose transport activity increases with an acute bout of exercise, a process that is accomplished by the translocation of glucose transporters to the plasma membrane. This process remains intact in the skeletal muscle of individuals with insulin resistance and type 2 diabetes mellitus (T2DM). Exercise training is, therefore, an important cornerstone in the management of individuals with T2DM. However, the acute systemic glucose responses to carbohydrate ingestion are often augmented during the early recovery period from exercise, despite increased glucose uptake into skeletal muscle. Accordingly, the first aim of this review is to summarize the knowledge associated with insulin action and glucose uptake in skeletal muscle and apply these to explain the disparate responses between systemic and localized glucose responses post-exercise. Herein, the importance of muscle glycogen depletion and the key glucoregulatory hormones will be discussed. Glucose uptake can also be stimulated independently by hypoxia; therefore, hypoxic training presents as an emerging method for enhancing the effects of exercise on glucose regulation. Thus, the second aim of this review is to discuss the potential for systemic hypoxia to enhance the effects of exercise on glucose regulation.
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Thipsawat S. Intervention for Prevention of Type 2 Diabetes Mellitus Among Prediabetes: A Review of the Literature. SAGE Open Nurs 2023; 9:23779608231175581. [PMID: 37324573 PMCID: PMC10265340 DOI: 10.1177/23779608231175581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 03/16/2023] [Accepted: 04/23/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction In recent decades, the prevalence and incidence of type 2 diabetes mellitus (T2DM) have increased rapidly and represent a significant public health problem worldwide. Long-term T2DM is associated with microvascular complications such as retinopathy, nephropathy, and neuropathy. Prediabetes is a state of hyperglycemia with blood glucose levels higher than normal but lower than the diabetes threshold. Several studies have demonstrated the effectiveness of lifestyle interventions that resulted in a 40% to 70% reduction in diabetes mellitus in adults with prediabetes. These interventions focused on increased physical activity and dietary changes that were able to prevent or delay the onset of T2DM in prediabetes. However, most review studies focused on interventions to prevent T2DM in high-risk groups such as obesity. There was a limitation of reports related to prediabetes. Nevertheless, it remains a high-risk condition for the development of T2DM with a conversion rate of 5% to 10% per year. Therefore, the aim of this study was to review the current evidence on intervention studies aimed at reducing the incidence of type 2 diabetes in prediabetes. Method The researcher conducted a literature search of common online databases such as Medline, Google Scholar, and Cochrane Library between January 2011 and December 2021. Result The intervention for the prevention of T2DM in prediabetes consisted of a lifestyle intervention, a nutritional supplementation intervention, and a pharmacological intervention. Conclusion Several studies suggest that T2DM in prediabetes can be prevented by lifestyle modification and pharmacological interventions, or a combined intervention. However, further interventions may be needed to confirm this.
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Affiliation(s)
- Sopida Thipsawat
- Excellence Center of Community Health Promotion, School of Nursing, Walailak University, Nakhon Si Thammarat, Thailand
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Guan Y, Zuo F, Zhao J, Nian X, Shi L, Xu Y, Huang J, Kazumi T, Wu B. Relationships of adiponectin to regional adiposity, insulin sensitivity, serum lipids, and inflammatory markers in sedentary and endurance-trained Japanese young women. Front Endocrinol (Lausanne) 2023; 14:1097034. [PMID: 36761190 PMCID: PMC9902352 DOI: 10.3389/fendo.2023.1097034] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION This study aims to compare the differences in circulating adiponectin levels and their relationships to regional adiposity, insulin resistance, serum lipid, and inflammatory factors in young, healthy Japanese women with different physical activity statuses. METHODS Adipokines (adiponectin and leptin), full serum lipid, and inflammatory factors [white blood cell counts, C-reactive protein, tumor necrosis factor-α, tissue plasminogen activator inhibitor-1 (PAI-1)] were measured in 101 sedentary and 100 endurance-trained healthy Japanese women (aged 18-23 years). Insulin sensitivity was obtained through a quantitative insulin-sensitivity check index (QUICKI). Regional adiposity [trunk fat mass (TFM), lower-body fat mass (LFM), and arm fat mass (AFM)] was evaluated using the dual-energy X-ray absorptiometry method. RESULTS No significant difference was observed between the sedentary and trained women in terms of adiponectin levels. The LFM-to-TFM ratio and the high-density lipoprotein cholesterol (HDL-C) were the strong positive determinants for adiponectin in both groups. Triglyceride in the sedentary women was closely and negatively associated with adiponectin, as well as PAI-1 in the trained women. The QUICKI level was higher in the trained than sedentary women. However, no significant correlation between adiponectin and insulin sensitivity was detected in both groups. Furthermore, LFM was associated with a favorable lipid profile against cardiovascular diseases (CVDs) in the whole study cohort, but this association became insignificant when adiponectin was taken into account. CONCLUSIONS These findings suggest that adiponectin is primarily associated with regional adiposity and HDL-C regardless of insulin sensitivity and physical activity status in young, healthy women. The associations among adiponectin, lipid, and inflammatory factors are likely different in women with different physical activity statuses. The correlation of LFM and a favorable lipid profile against CVD and adiponectin is likely involved in this association.
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Affiliation(s)
- Yaxin Guan
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Medical Center for Endocrine and Metabolic Diseases, Kunming, Yunnan, China
| | - Fan Zuo
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Medical Center for Endocrine and Metabolic Diseases, Kunming, Yunnan, China
| | - Juan Zhao
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Medical Center for Endocrine and Metabolic Diseases, Kunming, Yunnan, China
| | - Xin Nian
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Medical Center for Endocrine and Metabolic Diseases, Kunming, Yunnan, China
| | - Li Shi
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Medical Center for Endocrine and Metabolic Diseases, Kunming, Yunnan, China
| | - Yushan Xu
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Medical Center for Endocrine and Metabolic Diseases, Kunming, Yunnan, China
| | - Jingshan Huang
- School of Computing, University of South Alabama, Mobile, AL, United States
| | - Tsutomu Kazumi
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women’s University, Nishinomiya, Japan
- Department of Food Sciences and Nutrition, School of Human Environmental Science, Mukogawa Women’s University, Nishinomiya, Japan
- Research Institute for Nutrition Sciences, Mukogawa Women’s University, Nishinomiya, Japan
| | - Bin Wu
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Province Clinical Medical Center for Endocrine and Metabolic Diseases, Kunming, Yunnan, China
- Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women’s University, Nishinomiya, Japan
- *Correspondence: Bin Wu,
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8
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Behzadi P, Ravanelli N, Gravel H, Barry H, Debray A, Chaseling GK, Jacquemet V, Neagoe PE, Nigam A, Carpentier AC, Sirois MG, Gagnon D. Acute effect of passive heat exposure on markers of cardiometabolic function in adults with type 2 diabetes mellitus. J Appl Physiol (1985) 2022; 132:1154-1166. [PMID: 35323077 DOI: 10.1152/japplphysiol.00800.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
AIM Heat therapy is a promising strategy to improve cardiometabolic health. This study evaluated the acute physiological responses to hot water immersion in adults with type 2 diabetes mellitus (T2DM). METHODS On separate days in randomized order, 13 adults with T2DM (8 males/5 females, 62 ± 12 yrs, BMI: 30.1 ± 4.6 kg/m2) were immersed in thermoneutral (34°C, 90 minutes) or hot (41°C, core temperature ≥38.5°C for 60 minutes) water. Insulin sensitivity was quantified via the minimal oral model during an oral glucose tolerance test (OGTT) performed 60 minutes after immersion. Brachial artery flow-mediated dilation (FMD) and reactive hyperemia were evaluated before and 40 minutes after immersion. Blood samples were drawn to quantify protein concentrations and mRNA levels of HSP70 and 90, and circulating concentrations of cytokines. RESULTS Relative to thermoneutral water immersion, hot water immersion increased core temperature (+1.66°C [+1.47, +1.87], P<0.01), heart rate (+34 bpm [+24, +44], P<0.01), antegrade shear rate (+96 s-1 [+57, +134], P<0.01), and IL-6 (+1.38 pg/mL [+0.31, +2.45], P=0.01). Hot water immersion did not exert an acute change in insulin sensitivity (-0.3 dl/kg/min/μU/ml [-0.9, +0.2], P=0.18), FMD (-1.0% [-3.6, +1.6], P=0.56), peak (+0.36 mL/min/mmHg [-0.71, +1.43], P=0.64) and total (+0.11 mL/min/mmHg x min [-0.46, +0.68], P=0.87) reactive hyperemia. There was also no change in eHSP70 (P=0.64), iHSP70 (P=0.06), eHSP90 (P=0.80), iHSP90 (P=0.51), IL1-RA (P=0.11), GLP-1 (P=0.59) and NFkB (P=0.56) after hot water immersion. CONCLUSION The physiological responses elicited by hot water immersion do not acutely improve markers of cardiometabolic function in adults with T2DM.
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Affiliation(s)
- Parya Behzadi
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | | | - Hugo Gravel
- Montreal Heart Institute, Montreal, Canada.,School of Kinesiology and Exercise Science, Université de Montréal, Montréal, Canada
| | - Hadiatou Barry
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | - Amelie Debray
- Montreal Heart Institute, Montreal, Canada.,Department of Medicine, Université de Montréal, Montréal, Canada
| | - Georgia K Chaseling
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | - Vincent Jacquemet
- Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | | | - Anil Nigam
- Montreal Heart Institute, Montreal, Canada.,Department of Medicine, Université de Montréal, Montréal, Canada
| | - André C Carpentier
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Canada
| | - Martin G Sirois
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | - Daniel Gagnon
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada.,School of Kinesiology and Exercise Science, Université de Montréal, Montréal, Canada
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9
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El Fatouhi D, Héritier H, Allémann C, Malisoux L, Laouali N, Riveline JP, Salathé M, Fagherazzi G. Associations Between Device-Measured Physical Activity and Glycemic Control and Variability Indices Under Free-Living Conditions. Diabetes Technol Ther 2022; 24:167-177. [PMID: 34648353 PMCID: PMC8971971 DOI: 10.1089/dia.2021.0294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Disturbances of glycemic control and large glycemic variability have been associated with increased risk of type 2 diabetes in the general population as well as complications in people with diabetes. Long-term health benefits of physical activity are well documented but less is known about the timing of potential short-term effects on glycemic control and variability in free-living conditions. Materials and Methods: We analyzed data from 85 participants without diabetes from the Food & You digital cohort. During a 2-week follow-up, device-based daily step count was studied in relationship to glycemic control and variability indices using generalized estimating equations. Glycemic indices, evaluated using flash glucose monitoring devices (FreeStyle Libre), included minimum, maximum, mean, standard deviation, and coefficient of variation of daily glucose values, the glucose management indicator, and the approximate area under the sensor glucose curve. Results: We observed that every 1000 steps/day increase in daily step count was associated with a 0.3588 mg/dL (95% confidence interval [CI]: -0.6931 to -0.0245), a 0.0917 mg/dL (95% CI: -0.1793 to -0.0042), and a 0.0022% (95% CI: -0.0043 to -0.0001) decrease in the maximum glucose values, mean glucose, and in the glucose management indicator of the following day, respectively. We did not find any association between daily step count and glycemic indices from the same day. Conclusions: Increasing physical activity level was linked to blunted glycemic excursions during the next day. Because health-related benefits of physical activity can be long to observe, such short-term physiological benefits could serve as personalized feedback to motivate individuals to engage in healthy behaviors.
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Affiliation(s)
- Douae El Fatouhi
- “Exposome, Heredity, Cancer, and Health” Team, Center of Research in Epidemiology and Population Health (CESP), Inserm U1018, Paris-Saclay University, UVSQ, Gustave Roussy, Espace Maurice Tubiana, Villejuif, France
- Address correspondence to: Douae El Fatouhi, MSc, “Exposome, Heredity, Cancer, and Health” Team, Center of Research in Epidemiology and Population Health (CESP), Inserm U1018, Paris-Saclay University, UVSQ, Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, Villejuif Cedex 94805, France
| | - Harris Héritier
- Digital Epidemiology Laboratory, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Chloé Allémann
- Digital Epidemiology Laboratory, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Laurent Malisoux
- Physical Activity, Sport and Health Research Unit, Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg
| | - Nasser Laouali
- “Exposome, Heredity, Cancer, and Health” Team, Center of Research in Epidemiology and Population Health (CESP), Inserm U1018, Paris-Saclay University, UVSQ, Gustave Roussy, Espace Maurice Tubiana, Villejuif, France
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Jean-Pierre Riveline
- Department of Diabetes and Endocrinology, Assistance Publique-Hôpitaux de Paris, Université de Paris, Lariboisière Hospital, Paris, France
- Inserm U1138, Immunity and Metabolism in Diabetes (ImMeDiab Team), Centre de Recherches des Cordeliers, Paris, France
| | - Marcel Salathé
- Digital Epidemiology Laboratory, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Guy Fagherazzi
- Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg
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Effects of Sambiloto (Andrographis paniculata) on GLP-1 and DPP-4 Concentrations between Normal and Prediabetic Subjects: A Crossover Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1535703. [PMID: 35075363 PMCID: PMC8783715 DOI: 10.1155/2022/1535703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/04/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022]
Abstract
Background. The extract of Andrographis paniculata (Burm. F.) Wall. Ex. Nees. (sambiloto) (穿心蓮 chuān xīn lián) has been reported to have an antidiabetic effect on mice models and has been used traditionally in the community. The exact mechanism of sambiloto extract in decreasing plasma glucose is unclear, so we investigated the role of sambiloto extract in the incretin pathway in healthy and prediabetic subjects. Methods. This study was a randomized, placebo-controlled, crossover, double-blind trial. It included 38 people who were healthy and 35 people who had prediabetes. All subjects were randomly assigned to receive either the intervention sambiloto extract or a placebo. All subjects were randomly assigned to receive the first intervention for 14 days. There was a washout period between subsequent interventions. The primary outcome was glucagon-like peptide 1 (GLP-1) concentration, and secondary outcomes were fasting insulin, 2-hour postprandial insulin, homeostasis model assessment of insulin resistance (HOMA-IR), fasting blood glucose, 2-hour postprandial blood glucose, dipeptidyl peptidase-4 (DPP-4), and glycated albumin before and after the intervention. Result. After the intervention, GLP-1 concentration significantly increased in prediabetes by 19.6% compared to the placebo (
). There were no significant differences in the changes of fasting insulin, 2-hour postprandial insulin, HOMA-IR, fasting blood glucose, 2-hour postprandial blood glucose, DPP-4, and glycated albumin levels after the intervention. Sambiloto extract did not inhibit the DPP-4 enzyme in healthy and prediabetic subjects. Conclusion. Sambiloto extract increased GLP-1 concentration without inhibiting the DPP-4 enzyme in prediabetic subjects. This trial is registered with ClinicalTrials.gov (ID: NCT03455049), registered on 6 March 2018—retrospectively registered (https://clinicaltrials.gov/ct2/show/NCT03455049).
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11
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Kim SH, Park M, Kim GR, Joo HJ, Jang SI. Association of Mixed Use of Electronic and Conventional Cigarettes and Exposure to Secondhand Smoke With Prediabetes. J Clin Endocrinol Metab 2022; 107:e44-e56. [PMID: 34436592 DOI: 10.1210/clinem/dgab558] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Indexed: 01/04/2023]
Abstract
CONTEXT Despite previous studies regarding the association between smoking and diabetes, the effects of electronic cigarettes and secondhand smoke (SHS) on glucose metabolism and insulin sensitivity have not been fully elucidated. OBJECTIVE To examine the association of mixed electronic and conventional cigarette use and exposure to SHS with prediabetes. DESIGN Data from the 2014-2018 Korean National Health and Nutrition Examination Survey were analyzed. SETTING Nationwide population-based. PARTICIPANTS Of 39 199 participants, 22 385 participants (9490 men, 12 895 women) without diabetes were included. The main independent variables were smoking behaviors, including exposure to SHS. INTERVENTIONS None. MAIN OUTCOME MEASURES Prediabetes (hemoglobin A1C of 5.7-6.4%). RESULTS Of 22 385 participants without diabetes, 6735 had prediabetes. Mixed cigarette use was associated with a 1.57-fold increase in the odds of prediabetes when compared with never-smoking [odds ratio (OR) = 1.57, 95% CI = 1.29-1.92] and a 1.27-fold increase when compared with conventional cigarette use only (OR = 1.27, 95% CI = 1.07-1.52). Participants who were current nonsmokers, but mixed users in the past had an increased risk of prediabetes (OR = 1.54, 95% CI = 1.04-2.13). There was no significant association between prediabetes and current nonsmoking in individuals with previous conventional cigarette use only. Among never-smokers, exposure to SHS significantly increased the risk of prediabetes (OR = 1.16, 95% CI = 1.04-1.30). CONCLUSIONS Mixed use of electronic and conventional cigarettes and exposure to SHS increased the risk of prediabetes. Further studies are required to comprehensively investigate the molecular biology underlying the effects of previous and current mixed use of electronic cigarettes and SHS on glucose metabolism.
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Affiliation(s)
- Seung Hoon Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Minah Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Gyu Ri Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hye Jin Joo
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Sung-In Jang
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
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12
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Hatamoto Y, Yoshimura E, Takae R, Komiyama T, Matsumoto M, Higaki Y, Tanaka H. The effects of breaking sedentary time with different intensity exercise bouts on energy metabolism: A randomized cross-over controlled trial. Nutr Metab Cardiovasc Dis 2021; 31:1879-1889. [PMID: 33992509 DOI: 10.1016/j.numecd.2021.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/13/2021] [Accepted: 03/02/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Breaking up sedentary periods, particularly with light activity, increases total energy expenditure (EE), and helps provide better glycemic control. However, the effects of activities of various intensities to interrupt prolonged sedentary time are unclear. The purpose of the present study was to examine potential differences in glycemic control and EE from breaking up sedentary time with short exercise bouts of different intensities. METHODS AND RESULTS Nine overweight/obesity young men underwent whole body indirect calorimetry at 19:00 on day 1 and stayed overnight. After awakening on day 2, they performed short duration jogging every 30 min over 8 h (16-time bouts in total) under 3 different conditions with the same running distance: (1) lactate threshold (LT) for 2 min, (2) 60% LT for 200 s, and (3) onset of blood lactate accumulation (OBLA) for 75 s. The 24-h EE and interstitial glucose concentration (from 8:00 to 19:00 on day 2) was continuously measured throughout the trials. The standard deviation during intervention and indexes of postprandial of the interstitial glucose concentration was significantly lower at LT and OBLA than at 60% LT (p < 0.05). The 24-h EE was not significantly different among conditions, but EE at OBLA during intervention was slightly but significantly higher than at 60% LT and LT. CONCLUSION Breaking up sedentary time with short-duration jogging at LT and with OBLA intensities may have better glycemic control and increased use of carbohydrate as a fuel, while short-duration a jogging at OBLA intensity may increase EE. TRIAL REGISTRATION UMIN000041361.
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Affiliation(s)
- Yoichi Hatamoto
- The Fukuoka University Institute for Physical Activity, 8-19-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan; Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan.
| | - Eiichi Yoshimura
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan.
| | - Rie Takae
- The Fukuoka University Institute for Physical Activity, 8-19-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan; Faculty of Nursing and Nutrition, University of Nagasaki, Siebold, 1-1-1 Manabino, Nagayo-cho, Nishi-Sonogi-gun, Nagasaki, 851-2195, Japan.
| | - Takaaki Komiyama
- Center for Education in Liberal Arts and Sciences, Osaka University, 1-17 Machikaneyama, Toyonaka, 560-0043, Osaka, Japan.
| | - Mai Matsumoto
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan.
| | - Yasuki Higaki
- The Fukuoka University Institute for Physical Activity, 8-19-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
| | - Hiroaki Tanaka
- The Fukuoka University Institute for Physical Activity, 8-19-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
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13
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Alves JM, Angelo BC, Zink J, Chow T, Yunker AG, Clark K, Luo S, Belcher BR, Herting MM, Dieli-Conwright CM, Xiang AH, Page KA. Child physical activity as a modifier of the relationship between prenatal exposure to maternal overweight/obesity and neurocognitive outcomes in offspring. Int J Obes (Lond) 2021; 45:1310-1320. [PMID: 33731834 PMCID: PMC8164988 DOI: 10.1038/s41366-021-00794-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/04/2021] [Accepted: 02/11/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND/OBJECTIVES With rising obesity rates among pregnant women, more children are exposed in utero to maternal obesity. In prior epidemiological studies, exposure to maternal obesity was associated with lower intelligence quotient (IQ) scores and worse cognitive abilities in offspring. Further studies have shown that offspring exposed to maternal obesity, exhibit differences in the white matter microstructure properties, fractional anisotropy (FA) and mean diffusivity (MD). In contrast, physical activity was shown to improve cognition and white matter microstructure during childhood. We examined if child physical activity levels modify the relationship between prenatal exposure to maternal obesity with IQ and white matter microstructure in offspring. SUBJECTS/METHODS One hundred children (59% girls) age 7-11 years underwent brain magnetic resonance imaging and IQ testing. Maternal pre-pregnancy BMI was abstracted from electronic medical records. White matter was assessed using diffusion tensor imaging with the measures, global FA, MD. The 3-day physical activity recall was used to measure moderate-to-vigorous physical activity and vigorous physical activity (VPA). Linear regression was used to test for interactions between prenatal exposure to maternal overweight/obesity and child PA levels on child IQ and global FA/MD. RESULTS The relationship between prenatal exposure to maternal overweight/obesity and child IQ and global FA varied by child VPA levels. Children exposed to mothers with overweight/obesity who engaged in more VPA had higher IQ scores and global FA compared to exposed children who engaged in less VPA. Associations were independent of child age, sex, BMI Z-score and socioeconomic status. Children born to normal-weight mothers did not differ in either IQ or global FA by time in VPA. CONCLUSIONS Our findings support findings in rodent models and suggest that VPA during childhood modifies the relationship between prenatal exposure to maternal obesity and child IQ and white matter microstructure.
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Affiliation(s)
- Jasmin M Alves
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Brendan C Angelo
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Jennifer Zink
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Ting Chow
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, 91101, USA
| | - Alexandra G Yunker
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Kristi Clark
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Shan Luo
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Britni Ryan Belcher
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Megan M Herting
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, 90032, USA
| | - Christina M Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Institute, Harvard Medical School, Boston, MA, 02215, USA
| | - Anny H Xiang
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, 91101, USA
| | - Kathleen A Page
- Division of Endocrinology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA.
- Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA.
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14
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Bittel AJ, Bittel DC, Mittendorfer B, Patterson BW, Okunade AL, Abumrad NA, Reeds DN, Cade WT. A Single Bout of Premeal Resistance Exercise Improves Postprandial Glucose Metabolism in Obese Men with Prediabetes. Med Sci Sports Exerc 2021; 53:694-703. [PMID: 33044441 PMCID: PMC7969361 DOI: 10.1249/mss.0000000000002538] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Prediabetes is a major risk factor for type 2 diabetes and cardiovascular diseases. Although resistance exercise (RE) is recommended for individuals with prediabetes, the effects of RE on postprandial glucose metabolism in this population are poorly understood. Therefore, the purpose of this study was to elucidate how RE affects postprandial glucose kinetics, insulin sensitivity, beta cell function, and glucose oxidation during the subsequent meal in sedentary men with obesity and prediabetes. METHODS We studied 10 sedentary men with obesity (body mass index, 33 ± 3 kg·m-2) and prediabetes by using a randomized, cross-over study design. After an overnight fast, participants completed either a single bout of whole-body RE (seven exercises, 3 sets of 10-12 repetitions at 80% one-repetition maximum each) or an equivalent period of rest. Participants subsequently completed a mixed meal test in conjunction with an intravenous [6,6-2H2]glucose infusion to determine basal and postprandial glucose rate of appearance (Ra) and disappearance (Rd) from plasma, insulin sensitivity, and the insulinogenic index (a measure of beta cell function). Skeletal muscle biopsies were obtained 90 min postmeal to evaluate pyruvate-supported and maximal mitochondrial respiration. Whole-body carbohydrate oxidation was assessed using indirect calorimetry. RESULTS RE significantly reduced the postprandial rise in glucose Ra and plasma glucose concentration. Postprandial insulin sensitivity was significantly greater after RE, whereas postprandial plasma insulin concentration was significantly reduced. RE had no effect on the insulinogenic index, postprandial pyruvate respiration, or carbohydrate oxidation. CONCLUSION/INTERPRETATION A single bout of RE has beneficial effects on postprandial glucose metabolism in men with obesity and prediabetes by increasing postprandial insulin sensitivity, reducing the postprandial rise in glucose Ra, and reducing postprandial plasma insulin concentration.
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Affiliation(s)
- Adam J. Bittel
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO
| | - Daniel C. Bittel
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO
| | - Bettina Mittendorfer
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO
| | - Bruce W. Patterson
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO
| | - Adewole L. Okunade
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO
| | - Nada A. Abumrad
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO
| | - Dominic N. Reeds
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO
| | - William Todd Cade
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO
- Doctor of Physical Therapy Division, Department of Orthopaedics, Duke University, Durham, NC
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15
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Zhang Q, Ding Y, Zhang J, Wang L. EFFECTS OF ACUTE EXERCISE WITH DIFFERENT INTENSITIES ON GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES MELLITUS. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2021; 17:212-218. [PMID: 34925570 PMCID: PMC8665237 DOI: 10.4183/aeb.2021.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Exercise intensity is one of the most important factors that determines the effects of exercise; however, there is little known about the acute glycemic control of different exercise intensities on patients with Type 2 Diabetes Mellitus (T2DM). Here we aimed at exploring the influence of a single bout of exercise with different intensities on blood glucose levels in T2DM patients. METHODS Fifteen subjects (54.7 ± 5.8 years old) participated in a session of walking (WG), jogging (JG), or sedentary control (CG) in a randomized order on three different days. Distances in both WG and JG were set as 2 Km with a speed set as 4~4.5 Km/h for walking and 5~6 Km/h for jogging based on pretrial test. Blood glucose levels at fasting (~6:30am), pre-exercise (~8:30am), post-exercise (~9am), 11am and 4pm were detected. RESULTS Walking and jogging reached approximately moderate and high intensity based on the immediate post-exercise heart rate and RPE scores. Blood glucose levels at fasting, pre-exercise and 4pm were not substantially different among all groups (p > 0.05). JG had a significantly lower post-exercise blood glucose level (p < 0.05) when compared with CG and WG. The blood glucose level at 11am was notably lower in WG and JG than in CG (p < 0.05). CONCLUSIONS Both a single bout of jogging and walking can lower postprandial blood glucose levels in T2DM patients. When matched for exercise distance, jogging represents a more effective strategy to immediately lower postprandial glucose levels than walking.
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Affiliation(s)
- Q.Q. Zhang
- First Affiliated Hospital of Anhui Medical University - Department of Pediatrics, Hefei, Anhui, China
- Soochow University - Medical College, School of Nursing, Suzhou, Jiangsu, China
| | - Y.J. Ding
- Soochow University - Medical College, School of Nursing, Suzhou, Jiangsu, China
- Changshu No.2 People’s Hospital - Department of Endocrinology, Changshu, Jiangsu, China
| | - J.J. Zhang
- Soochow University - Medical College, School of Nursing, Suzhou, Jiangsu, China
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital - Intensive Care Unit, Hangzhou, Zhejiang China
| | - L. Wang
- Soochow University - Medical College, School of Nursing, Suzhou, Jiangsu, China
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Sacchetti M, Haxhi J, Sgrò P, Scotto di Palumbo A, Nicolò A, Bellini A, Bazzucchi I, di Luigi L. Effects of exercise before and/or after a mixed lunch on postprandial metabolic responses in healthy male individuals. Eur J Nutr 2021; 60:3437-3447. [PMID: 33635408 DOI: 10.1007/s00394-021-02512-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 02/05/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Exercise plays an important role in preventing and treating postprandial dysmetabolism. We investigated the postprandial metabolic responses to a standard lunch when a session of aerobic exercise is performed in the early postprandial phase or divided between the pre- and postprandial period. METHODS Nine healthy volunteers consumed a standardised mixed lunch and rested for the following 3 h (Con) or performed 40 min of cycling at 65% V̇O2max after lunch (CPPEx), or two 20-min sessions, one before (SplitEx1) and the other after lunch (SplitEx2), at the same intensity. RESULTS At 1-h post-lunch, a significant reduction (P < 0.001) in glycaemia was observed for CPPEx (- 25 ± 10%) and SplitEx (- 34 ± 7%) compared to Con. Yet, a post-exercise rebound lessened the exercise effect on the glycaemic area under the curve (AUC) at 2 and 3 h. At 1 h, a significant reduction (P < 0.009) in plasma insulin (SplitEx - 53 ± 31%; CCPEx - 48 ± 20%) and C-peptide (SplitEx - 57 ± 20%; CCPEx - 47 ± 24%) was observed compared to Con. Glucose-dependent insulinotropic polypeptide (GIP) increased after the meal, without differences between conditions. Compared with SplitEx1, cortisol response was attenuated during SplitEx2 and CPPEx. At 3 hours, triglyceride AUC was significantly higher (P = 0.039) in SplitEx compared to Con (+ 19 ± 8%). CONCLUSION Forty minutes of postprandial exercise or 20 min of pre- and postprandial exercise are both effective at attenuating the glycaemic and insulinaemic response to a mixed lunch, while a higher lipaemia was found in the pre- and postprandrial exercise condition.
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Affiliation(s)
- Massimo Sacchetti
- Unit of Exercise Physiology, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro de Bosis 6, 00135, Rome, Italy.
| | - Jonida Haxhi
- Unit of Exercise Physiology, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro de Bosis 6, 00135, Rome, Italy
| | - Paolo Sgrò
- Unit of Endocrinology, Department of Movement, University of Rome "Foro Italico", Piazza Lauro de Bosis 6, 00135, Rome, Italy
| | - Alessandro Scotto di Palumbo
- Unit of Exercise Physiology, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro de Bosis 6, 00135, Rome, Italy
| | - Andrea Nicolò
- Unit of Exercise Physiology, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro de Bosis 6, 00135, Rome, Italy
| | - Alessio Bellini
- Unit of Exercise Physiology, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro de Bosis 6, 00135, Rome, Italy
| | - Ilenia Bazzucchi
- Unit of Exercise Physiology, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza Lauro de Bosis 6, 00135, Rome, Italy
| | - Luigi di Luigi
- Unit of Endocrinology, Department of Movement, University of Rome "Foro Italico", Piazza Lauro de Bosis 6, 00135, Rome, Italy
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Jevtovic F. Combination of Metformin and Exercise in Management of Metabolic Abnormalities Observed in Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2021; 14:4043-4057. [PMID: 34557007 PMCID: PMC8453852 DOI: 10.2147/dmso.s328694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/07/2021] [Indexed: 12/19/2022] Open
Abstract
Excess nutrient intake and lack of exercise characterize the problem of obesity and are common factors in insulin resistance (IR). With an increasing number of prediabetic, and type 2 diabetic populations, metformin is still the most prescribed glucose-lowering drug and is often accompanied by recommendations for regular physical exercise. Metformin, by the inhibition of complex 1 of the electron transport chain, and exercise, by increasing energy expenditure, both elicit a low cellular energy state that leads to improvements in glucose control via activation of adenosine 5' monophosphate-activated protein kinase (AMPK). An augmented stimulation of the energy-sensing enzyme AMPK by either of the two modalities leads to an increase in glycogenolysis, glucose uptake, fat oxidation, a decrease in glycogen and protein synthesis, and gluconeogenesis in muscle and the liver, which are remarked as having positive effects on metabolic pathophysiology observed in IR and type 2 diabetes mellitus (T2DM). While both modalities exploit the energy-sensing enzyme AMPK to attain glucose homeostasis, the synergistic effect of these two treatments is not distinctly supported by the literature. Further, an antagonistic dynamic has been observed in cases where metformin and exercise were combined. Reduction of insulin-sensitizing effects of exercise and an overall hindrance of exercise performance and adaptations have been reported and could suggest the possible incongruity of these two modalities. The aim of this review is to elucidate the effect that metformin and exercise have on the management of the metabolic abnormalities observed in T2DM and to provide an insight into the interaction of these two modalities.
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Affiliation(s)
- Filip Jevtovic
- Department of Kinesiology, College of Health and Human Performance, East Carolina University, Greenville, NC, USA
- Correspondence: Filip Jevtovic East Carolina University; School of Dental Medicine, Ledyard E. Ross Hall; 1851 MacGregor Downs Road, Mail Stop 701, Greenville, NC, 27834, USATel +1 616 844 8323Fax +1 252 737 7024 Email
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18
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Sargeant JA, Jelleyman C, Coull NA, Edwardson CL, Henson J, King JA, Khunti K, McCarthy M, Rowlands AV, Stensel DJ, Waller HL, Webb DR, Davies MJ, Yates T. Improvements in Glycemic Control After Acute Moderate-Intensity Continuous or High-Intensity Interval Exercise Are Greater in South Asians Than White Europeans With Nondiabetic Hyperglycemia: A Randomized Crossover Study. Diabetes Care 2021; 44:201-209. [PMID: 33158948 DOI: 10.2337/dc20-1393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 10/02/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine whether circulating metabolic responses to low-volume high-intensity interval exercise (LV-HIIE) or continuous moderate-intensity aerobic exercise (CME) differ between white Europeans and South Asians with nondiabetic hyperglycemia (NDH). RESEARCH DESIGN AND METHODS Thirteen white Europeans and 10 South Asians (combined median [interquartile range] age 67 [60-68] years, HbA1c 5.9% [5.8-6.1%] [41.0 (39.9-43.2) mmol ⋅ mol-1]) completed three 6-h conditions (sedentary control [CON], LV-HIIE, and CME) in a randomized order. Exercise conditions contained a single bout of LV-HIIE and CME, respectively (each ending at 2 h), with meals provided at 0 and 3 h. Circulating glucose (primary outcome), insulin, insulin resistance index (IRI), triglycerides, and nonesterified fatty acids were measured at 0, 0.5, 1, 2, 3, 3.5, 4, 5, and 6 h. Data were analyzed as postexercise time-averaged area under the curve (AUC) adjusted for age, sex, and preexercise AUC. RESULTS Glucose was similar in each condition and with ethnicity, with no condition-by-ethnicity interaction (P ≥ 0.28). However, insulin was lower in LV-HIIE (mean [95% CI] -44.4 [-23.7, -65.1] mU ⋅ L-1) and CME (-33.8 [-13.7, -53.9] mU ⋅ L-1) compared with CON. Insulin responses were greater in South Asians (interaction P = 0.03) such that values were similar in each ethnicity during exercise conditions, despite being 33% higher in South Asians during CON. IRI followed a similar pattern to insulin. Lipids were unaffected by exercise. CONCLUSIONS Reductions in insulin and insulin resistance after acute LV-HIIE and CME are greater in South Asians than in white Europeans with NDH. Further trials are required to examine the longer-term impact of LV-HIIE and CME on cardiometabolic health.
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Affiliation(s)
- Jack A Sargeant
- Diabetes Research Centre, University of Leicester, Leicester, U.K. .,NIHR Leicester Biomedical Research Centre, Leicester, U.K
| | - Charlotte Jelleyman
- Diabetes Research Centre, University of Leicester, Leicester, U.K.,NIHR Leicester Biomedical Research Centre, Leicester, U.K.,School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Nicole A Coull
- Diabetes Research Centre, University of Leicester, Leicester, U.K.,NIHR Leicester Biomedical Research Centre, Leicester, U.K
| | - Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester, U.K.,NIHR Leicester Biomedical Research Centre, Leicester, U.K
| | - Joseph Henson
- Diabetes Research Centre, University of Leicester, Leicester, U.K.,NIHR Leicester Biomedical Research Centre, Leicester, U.K
| | - James A King
- NIHR Leicester Biomedical Research Centre, Leicester, U.K.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, U.K
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, U.K.,NIHR Applied Research Collaboration East Midlands, Leicester, U.K.,Leicester Diabetes Centre, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, U.K
| | - Matthew McCarthy
- Diabetes Research Centre, University of Leicester, Leicester, U.K.,NIHR Leicester Biomedical Research Centre, Leicester, U.K
| | - Alex V Rowlands
- Diabetes Research Centre, University of Leicester, Leicester, U.K.,NIHR Leicester Biomedical Research Centre, Leicester, U.K
| | - David J Stensel
- NIHR Leicester Biomedical Research Centre, Leicester, U.K.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, U.K
| | - Helen L Waller
- Diabetes Research Centre, University of Leicester, Leicester, U.K.,NIHR Leicester Biomedical Research Centre, Leicester, U.K
| | - David R Webb
- Diabetes Research Centre, University of Leicester, Leicester, U.K.,NIHR Leicester Biomedical Research Centre, Leicester, U.K
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, U.K.,NIHR Leicester Biomedical Research Centre, Leicester, U.K.,Leicester Diabetes Centre, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, U.K
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, U.K.,NIHR Leicester Biomedical Research Centre, Leicester, U.K
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19
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Sellers AJ, Pallubinsky H, Rense P, Bijnens W, van de Weijer T, Moonen-Kornips E, Schrauwen P, van Marken Lichtenbelt WD. The effect of cold exposure with shivering on glucose tolerance in healthy men. J Appl Physiol (1985) 2021; 130:193-205. [DOI: 10.1152/japplphysiol.00642.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
This is the first study to examine the effect of cold-induced shivering on subsequent glucose tolerance determined under thermoneutral conditions. Plasma glucose and insulin concentrations increased during the oral glucose tolerance test post shivering. Additionally, insulin sensitivity indices suggest insulin resistance following cold exposure. These results provide evidence for an acute post-shivering response, whereby glucose metabolism has deteriorated, contrary to the results from earlier studies on cold acclimation.
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Affiliation(s)
- Adam Jake Sellers
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Hannah Pallubinsky
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Pascal Rense
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Wouter Bijnens
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Tineke van de Weijer
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Esther Moonen-Kornips
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Patrick Schrauwen
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Wouter D. van Marken Lichtenbelt
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
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20
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Munten S, Ménard L, Gagnon J, Dorman SC, Mezouari A, Gagnon DD. High-intensity interval exercise in the cold regulates acute and postprandial metabolism. J Appl Physiol (1985) 2020; 130:408-420. [PMID: 33270513 DOI: 10.1152/japplphysiol.00384.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
High-intensity interval exercise (HIIE) has been shown to be more effective than moderate-intensity exercise for increasing acute lipid oxidation and lowering blood lipids during exercise and postprandially. Exercise in cold environments is also known to enhance lipid oxidation; however, the immediate and long-term effects of HIIE exercise in cold are unknown. The purpose of this study was to examine the effects cold stress during HIIE on acute exercise metabolism and postprandial metabolism. Eleven recreationally active individuals (age: 23 ± 3 yr, weight: 80 ± 9.7 kg, V̇O2peak: 39.2 ± 5.73 mL·kg-1·min-1) performed evening HIIE sessions (10 × 60 s cycling, 90% V̇O2peak interspersed with 90 s active recovery, 30% V̇O2peak) in thermoneutral (HIIE-TN, control; 21°C) and cold environment (HIIE-CO; 0°C), following a balanced crossover design. The following morning, participants consumed a high-fat meal. Indirect calorimetry was used to assess substrate oxidation, and venous blood samples were obtained to assess changes in noncellular metabolites. During acute exercise, lipid oxidation was higher in HIIE-CO (P = 0.002) without differences in V̇O2 and energy expenditure (P ≥ 0.162) between conditions. Postprandial V̇O2, lipid and CHO oxidation, plasma insulin, and triglyceride concentrations were not different between conditions (P > 0.05). Postprandial blood LDL-C levels were higher in HIIE-CO 2 h after the meal (P = 0.003). Postprandial glucose area under curve was 49% higher in HIIE-CO versus HIIE-TN (P = 0.034). Under matched energy expenditure conditions, HIIE demonstrated higher lipid oxidation rates during exercise in the cold; but only marginally influenced postprandial lipid metabolism the following morning. In conclusion, HIIE in the cold seemed to be less favorable for postprandial lipid and glycemic responses.NEW & NOTEWORTHY This is the first known study to investigate the effects of cold ambient temperatures on acute metabolism during high-intensity interval exercise, as well as postprandial metabolism the next day. We observed that high-intensity interval exercise in a cold environment does change acute metabolism compared to a thermoneutral environment; however, the addition of a cold stimulus was less favorable for postprandial metabolic responses the following day.
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Affiliation(s)
- Stephanie Munten
- Laboratory of Environmental Exercise Physiology, School of Kinesiology and Health Sciences, Laurentian University, Sudbury, Canada.,Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, Canada
| | - Lucie Ménard
- Laboratory of Environmental Exercise Physiology, School of Kinesiology and Health Sciences, Laurentian University, Sudbury, Canada.,Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, Canada.,Northern Ontario School of Medicine, Laurentian University, Sudbury, Canada
| | - Jeffrey Gagnon
- Department of Biology, Laurentian University, Sudbury, Canada
| | - Sandra C Dorman
- Laboratory of Environmental Exercise Physiology, School of Kinesiology and Health Sciences, Laurentian University, Sudbury, Canada.,Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, Canada.,Northern Ontario School of Medicine, Laurentian University, Sudbury, Canada
| | - Ania Mezouari
- Department of Biology, Laurentian University, Sudbury, Canada
| | - Dominique D Gagnon
- Laboratory of Environmental Exercise Physiology, School of Kinesiology and Health Sciences, Laurentian University, Sudbury, Canada.,Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, Canada
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21
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The acute vs. chronic effect of exercise on insulin sensitivity: nothing lasts forever. Cardiovasc Endocrinol Metab 2020; 10:149-161. [PMID: 34386716 PMCID: PMC8352615 DOI: 10.1097/xce.0000000000000239] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/22/2020] [Indexed: 12/16/2022]
Abstract
Supplemental Digital Content is available in the text. Regular exercise causes chronic adaptations in anatomy/physiology that provide first-line defense for disease prevention/treatment (‘exercise is medicine’). However, transient changes in function that occur following each exercise bout (acute effect) are also important to consider. For example, in contrast to chronic adaptations, the effect of exercise on insulin sensitivity is predominantly rooted in a prolonged acute effect (PAE) that can last up to 72 h. Untrained individuals and individuals with lower insulin sensitivity benefit more from this effect and even trained individuals with high insulin sensitivity restore most of a detraining-induced loss following one session of resumed training. Consequently, exercise to combat insulin resistance that begins the pathological journey to cardiometabolic diseases including type 2 diabetes (T2D) should be prescribed with precision to elicit a PAE on insulin sensitivity to serve as a first-line defense prior to pharmaceutical intervention or, when such intervention is necessary, a potential adjunct to it. Video Abstract: http://links.lww.com/CAEN/A27
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22
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The effects of exercise treatment on learning and memory ability, and cognitive performance in diet-induced prediabetes animals. Sci Rep 2020; 10:15048. [PMID: 32929110 PMCID: PMC7490284 DOI: 10.1038/s41598-020-72098-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 08/18/2020] [Indexed: 11/20/2022] Open
Abstract
Changes associated with cognitive function in the high-fat high-carbohydrate diet-induced prediabetes animal model and effect of exercise remain unclear. Rats were randomly assigned to the following groups (n = 6): non-diabetic (ND), prediabetic (PD), intermittent exercising PD (PD + IE) and regular exercising PD (PD + RE). After exercise cessation, oral glucose tolerance (OGT), Novel Object Recognition Test (NORT) and Morris-Water Maze (MWM) tests were performed to assess cognitive function. After sacrifice, malonaldehyde, glutathione peroxidase, interleukin-1β and dopamine concentration in the prefrontal cortex (PFC) and hippocampus were measured. Impaired OGT response in PD animals was accompanied by poor performance on behavioural tasks. This was associated with increased oxidative stress markers and impaired dopamine neurotransmission as evidence by elevated dopamine concentration in the PFC and hippocampal tissue. Improved OGT response by exercise was coupled with improved performance on behavioural tasks, oxidative stress markers and increased interleukin-1β concentration. In regular exercise, this was further coupled with improved dopamine neurotransmission. Cognitive function was affected during prediabetes in animals. This was partly due to oxidative stress and impaired dopamine neurotransmission. Both intermittent and regular exercise improved cognitive function. This was partly mediated by improved glucose tolerance and oxidative stress as well as a subclinical increase in interleukin-1β concentration. In regular exercise, this was further mediated by improved dopamine neurotransmission.
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23
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Savikj M, Zierath JR. Train like an athlete: applying exercise interventions to manage type 2 diabetes. Diabetologia 2020; 63:1491-1499. [PMID: 32529411 PMCID: PMC7351814 DOI: 10.1007/s00125-020-05166-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/12/2020] [Indexed: 01/20/2023]
Abstract
Exercise elicits high energy demands, stimulating cardiorespiratory function and substrate mobilisation and oxidation. Repeated bouts of exercise lead to whole-body adaptations, which improve athletic performance. Distinct exercise modalities and intensities and nutritional conditions pose specific physiological challenges, subsequently inducing different adaptations to training. Athletes often modify these variables to achieve individualised training goals and maximise performance. Exercise training improves glycaemic control in individuals with type 2 diabetes; however, the precise training regimen that confers the most beneficial metabolic adaptations in this population is unknown. In this review, we discuss how modifying exercise type, intensity and modality and nutritional status affects the beneficial effects of exercise on glycaemic control in individuals with type 2 diabetes. Evidence indicates that greater improvements in glycaemic control can be achieved through combined aerobic and resistance training regimens compared with either training type alone. However, the increased frequency of training and a greater number of exercise bouts during combined programmes could be responsible for apparent advantages over a single training modality. The beneficial effects of aerobic exercise on glycaemic control seem to rise with training intensity, with superior adaptations achieved by high-intensity interval training (HIT). In addition, training with low carbohydrate availability ('training low') improves cardiorespiratory function and skeletal muscle oxidative capacity more than conventional training in healthy untrained individuals. Examinations of various training regimens are warranted to assess the safety, efficacy, feasibility and beneficial effects in the type 2 diabetes population. Just like competitive athletes, individuals with type 2 diabetes should be encouraged to adopt training regimens that improve fitness and metabolism. Graphical abstract.
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Affiliation(s)
- Mladen Savikj
- Department of Molecular Medicine and Surgery, Integrative Physiology, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Juleen R Zierath
- Department of Molecular Medicine and Surgery, Integrative Physiology, Karolinska Institutet, 171 77, Stockholm, Sweden.
- Department of Physiology and Pharmacology, Integrative Physiology, Karolinska Institutet, Stockholm, Sweden.
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Allerton DM, West DJ, Stevenson EJ. Whey protein consumption following fasted exercise reduces early postprandial glycaemia in centrally obese males: a randomised controlled trial. Eur J Nutr 2020; 60:999-1011. [PMID: 32572617 PMCID: PMC7900064 DOI: 10.1007/s00394-020-02304-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/08/2020] [Indexed: 02/07/2023]
Abstract
Purpose Acute submaximal exercise and whey protein supplementation have been reported to improve postprandial metabolic and appetite responses to a subsequent meal independently. We aimed to examine the combination of these strategies on postprandial responses to a carbohydrate-rich breakfast. Methods Twelve centrally obese males (age 41 ± 3 years, waist circumference 123.4 ± 2.9 cm), completed three trials in a single-blind, crossover design. Participants rested for 30 min (CON) or completed 30 min low–moderate-intensity treadmill walking (51 ± 1% \documentclass[12pt]{minimal}
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\begin{document}$${{\dot{V}O}}_{\text{2peak}}$$\end{document}V˙O2peak) followed immediately by ingestion of 20 g whey protein (EX + PRO) or placebo (EX). After 15 min, a standardised breakfast was consumed and blood, expired gas and subjective appetite were sampled postprandially. After 240 min, an ad libitum lunch meal was provided to assess energy intake. Results During EX + PRO, post-breakfast peak blood glucose was reduced when compared with EX and CON (EX + PRO: 7.6 ± 0.4 vs EX: 8.4 ± 0.3; CON: 8.3 ± 0.3 mmol l−1, p ≤ 0.04). Early postprandial glucose AUC0–60 min was significantly lower under EX + PRO than EX (p = 0.011), but not CON (p = 0.12). Over the full postprandial period, AUC0–240 min during EX + PRO did not differ from other trials (p > 0.05). Peak plasma insulin concentrations and AUC0–240 min were higher during EX + PRO than CON, but similar to EX. Plasma triglyceride concentrations, substrate oxidation and subjective appetite responses were similar across trials and ad libitum energy intake was not influenced by prior fasted exercise, nor its combination with whey protein supplementation (p > 0.05). Conclusion Following fasted low–moderate-intensity exercise, consuming whey protein before breakfast may improve postprandial glucose excursions, without influencing appetite or subsequent energy intake, in centrally obese males. Trial registration number NCT02714309.
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Affiliation(s)
- Dean M Allerton
- School of Biomedical, Nutritional and Sport Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Daniel J West
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Emma J Stevenson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
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25
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Eriksen AK, Brunius C, Mazidi M, Hellström PM, Risérus U, Iversen KN, Fristedt R, Sun L, Huang Y, Nørskov NP, Knudsen KEB, Kyrø C, Olsen A, Tjønneland A, Dicksved J, Landberg R. Effects of whole-grain wheat, rye, and lignan supplementation on cardiometabolic risk factors in men with metabolic syndrome: a randomized crossover trial. Am J Clin Nutr 2020; 111:864-876. [PMID: 32097450 DOI: 10.1093/ajcn/nqaa026] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 01/31/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND A whole-grain (WG)-rich diet has shown to have potential for both prevention and treatment of the metabolic syndrome (MetS), which is a cluster of risk factors that increase the risk of type 2 diabetes and cardiovascular disease. Different WGs may have different health effects. WG rye, in particular, may improve glucose homeostasis and blood lipids, possibly mediated through fermentable dietary fiber and lignans. Recent studies have also suggested a crucial role of the gut microbiota in response to WG. OBJECTIVES The aim was to investigate WG rye, alone and with lignan supplements [secoisolariciresinol diglucoside (SDG)], and WG wheat diets on glucose tolerance [oral-glucose-tolerance test (OGTT)], other cardiometabolic outcomes, enterolignans, and microbiota composition. Moreover, we exploratively evaluated the role of gut microbiota enterotypes in response to intervention diets. METHODS Forty men with MetS risk profile were randomly assigned to WG diets in an 8-wk crossover study. The rye diet was supplemented with 280 mg SDG at weeks 4-8. Effects of treatment were evaluated by mixed-effects modeling, and effects on microbiota composition and the role of gut microbiota as a predictor of response to treatment were analyzed by random forest plots. RESULTS The WG rye diet (± SDG supplements) did not affect the OGTT compared with WG wheat. Total and LDL cholesterol were lowered (-0.06 and -0.09 mmol/L, respectively; P < 0.05) after WG rye compared with WG wheat after 4 wk but not after 8 wk. WG rye resulted in higher abundance of Bifidobacterium [fold-change (FC) = 2.58, P < 0.001] compared with baseline and lower abundance of Clostridium genus compared with WG wheat (FC = 0.54, P = 0.02). The explorative analyses suggest that baseline enterotype is associated with total and LDL-cholesterol response to diet. CONCLUSIONS WG rye, alone or with SDG supplementation, compared with WG wheat did not affect glucose metabolism but caused transient LDL-cholesterol reduction. The effect of WG diets appeared to differ according to enterotype. This trial was registered at www.clinicaltrials.gov as NCT02987595.
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Affiliation(s)
- Anne K Eriksen
- Department of Molecular Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.,Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Carl Brunius
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Mohsen Mazidi
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Per M Hellström
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Kia N Iversen
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Rikard Fristedt
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Li Sun
- Department of Molecular Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Yi Huang
- Department of Animal Nutrition and Management, Swedish University of Agricultural Sciences, Uppsala, Sweden.,College of Animal Science and Technology, Guangxi University, Nanning, China
| | | | | | - Cecilie Kyrø
- Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anja Olsen
- Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Anne Tjønneland
- Unit of Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Johan Dicksved
- Department of Animal Nutrition and Management, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Rikard Landberg
- Division of Food and Nutrition Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
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26
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Armas C, Kowalsky RJ, Hearon CM. Comparison of Acute Cardiometabolic Responses in a 7-Minute Body Weight Circuit to 7-Minute HIIT Training Protocol. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2020; 13:395-409. [PMID: 32148625 PMCID: PMC7039495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
To investigate the acute cardiometabolic responses of a 7-minute bodyweight resistance exercise circuit (HICE) compared to a 7-minute high intensity interval training cycle protocol (HIIE). METHODS Twelve apparently healthy and active young adults were enrolled in a randomized crossover study (HICE vs HIIE). The 12 HICE exercises used a 30:5 second exercise to rest ratio, followed by a 3-minute cool-down and was replicated in the HIIE cycle protocol. Following each protocol, subjects were seated for the next hour. Measurements included blood pressure (BP) heart rate, blood glucose and triglycerides, taken prior to exercise, immediately after, 15, 30, 45, and 60-minutes post-exercise. Blood glucose and triglycerides were only taken, immediately after and at 60-minutes. General mixed linear modeling was used to analyze the data and Cohen's d was calculated for effect size. Post hoc analysis of individual time points used Bonferroni adjustment. RESULTS There was no significant difference in overall systolic BP between HIIE and HICE (p = 0.168). However, there was a significant difference in overall diastolic BP resulting a higher response in HIIE (p = 0.002). Immediately after exercise exhibited significant (p = 0.001) and trending, respectfully, higher values in diastolic BP for HIIE. The overall post-exercise heart rate was lower for HIIE vs HICE (p < 0.001). Blood glucose and Triglycerides had no overall difference between the two protocols (p = 0.104). CONCLUSION The HICE protocol had a similar cardiometabolic response post-exercise to HIIE but did have a reduction in diastolic BP post-exercise. However, post-exercise heart rate was higher.
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Affiliation(s)
- Cruz Armas
- Department of Health & Kinesiology, Texas A&M University-Kingsville, Kingsville, TX, USA
| | - Robert J Kowalsky
- Department of Health & Kinesiology, Texas A&M University-Kingsville, Kingsville, TX, USA
| | - Christopher M Hearon
- Department of Health & Kinesiology, Texas A&M University-Kingsville, Kingsville, TX, USA
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Impaired Insulin Profiles Following a Single Night of Sleep Restriction: The Impact of Acute Sprint Interval Exercise. Int J Sport Nutr Exerc Metab 2019; 30:139–144. [PMID: 31816598 DOI: 10.1123/ijsnem.2019-0235] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/02/2019] [Accepted: 10/18/2019] [Indexed: 11/18/2022]
Abstract
Experimental sleep restriction (SR) has demonstrated reduced insulin sensitivity in healthy individuals. Exercise is well-known to be beneficial for metabolic health. A single bout of exercise has the capacity to increase insulin sensitivity for up to 2 days. Therefore, the current study aimed to determine if sprint interval exercise could attenuate the impairment in insulin sensitivity after one night of SR in healthy males. Nineteen males were recruited for this randomized crossover study which consisted of four conditions-control, SR, control plus exercise, and sleep restriction plus exercise. Time in bed was 8 hr (2300-0700) in the control conditions and 4 hr (0300-0700) in the SR conditions. Conditions were separated by a 1-week entraining period. Participants slept at home, and compliance was assessed using wrist actigraphy. Following the night of experimental sleep, participants either conducted sprint interval exercise or rested for the equivalent duration. An oral glucose tolerance test was then conducted. Blood samples were obtained at regular intervals for measurement of glucose and insulin. Insulin concentrations were higher in SR than control (p = .022). Late-phase insulin area under the curve was significantly lower in sleep restriction plus exercise than SR (862 ± 589 and 1,267 ± 558; p = .004). Glucose area under the curve was not different between conditions (p = .207). These findings suggest that exercise improves the late postprandial response following a single night of SR.
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Abstract
PURPOSE OF REVIEW This review was designed to provide a scientific and clinical framework for the care of physically active men and women with an emphasis on the management of T2DM. RECENT FINDINGS The preventative and therapeutic benefits of physical activity (PA) on adult onset or Type 2 Diabetes Mellitus (T2DM) are well established. Individuals diagnosed with or are at risk for T2DM should be counseled and maximally supported to pursue an active or athletic lifestyle. Optimally, this translates into the adoption of an athletic lifestyle. "Masters athletes", men and women above the age of 35 who regularly train for and/or participate in competitive sport, represent a rapidly growing segment of the population. Although the high level of exercise characteristic of this population has numerous health benefits, it does not confer immunity from T2DM or cardiovascular (CV) disease. Providing effective care for men and women above the age of 35 who regularly train for and/or participate in competitive sport requires an understanding of the interplay between basic exercise physiology and the pathogenesis of insulin resistance.
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Affiliation(s)
- Erika J Parisi
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Aaron L Baggish
- Cardiovascular Performance Program, Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Yawkey Building Suite 5B, 55 Fruit Street, Boston, MA, 02114, USA.
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29
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Willis SA, Sargeant JA, Thackray AE, Yates T, Stensel DJ, Aithal GP, King JA. Effect of exercise intensity on circulating hepatokine concentrations in healthy men. Appl Physiol Nutr Metab 2019; 44:1065-1072. [DOI: 10.1139/apnm-2018-0818] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Fibroblast growth factor 21 (FGF21), follistatin and leukocyte cell-derived chemotaxin 2 (LECT2) are novel hepatokines that are modulated by metabolic stresses. This study investigated whether exercise intensity modulates the hepatokine response to acute exercise. Ten young, healthy men undertook three 8-h experimental trials: moderate-intensity exercise (MOD; 55% peak oxygen uptake), high-intensity exercise (HIGH; 75% peak oxygen uptake), and control (CON; rest), in a randomised, counterbalanced order. Exercise trials commenced with a treadmill run of varied duration to match gross exercise energy expenditure between trials (MOD vs HIGH; 2475 ± 70 vs 2488 ± 58 kJ). Circulating FGF21, follistatin, LECT2, glucagon, insulin, glucose and nonesterified fatty acids (NEFA) were measured before exercise and at 0, 1, 2, 4, and 7 h postexercise. Plasma FGF21 concentrations were increased up to 4 h postexercise compared with CON (P ≤ 0.022) with greater increases observed at 1, 2, and 4 h postexercise during HIGH versus MOD (P ≤ 0.025). Irrespective of intensity (P ≥ 0.606), plasma follistatin concentrations were elevated at 4 and 7 h postexercise (P ≤ 0.053). Plasma LECT2 concentrations were increased immediately postexercise (P ≤ 0.046) but were not significant after correcting for plasma volume shifts. Plasma glucagon (1 h; P = 0.032) and NEFA (4 and 7 h; P ≤ 0.029) responses to exercise were accentuated in HIGH versus MOD. These findings demonstrate that acute exercise augments circulating FGF21 and follistatin. Exercise-induced changes in FGF21 are intensity-dependent and may support the greater metabolic benefit of high-intensity exercise.
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Affiliation(s)
- Scott A. Willis
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
- NIHR Leicester Biomedical Research Centre, Leicester LE3 9QD, UK
| | - Jack A. Sargeant
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
- NIHR Leicester Biomedical Research Centre, Leicester LE3 9QD, UK
| | - Alice E. Thackray
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
- NIHR Leicester Biomedical Research Centre, Leicester LE3 9QD, UK
| | - Thomas Yates
- NIHR Leicester Biomedical Research Centre, Leicester LE3 9QD, UK
- Diabetes Research Centre, University of Leicester, Leicester LE5 4PW, UK
| | - David J. Stensel
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
- NIHR Leicester Biomedical Research Centre, Leicester LE3 9QD, UK
| | - Guruprasad P. Aithal
- Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham NG7 2QL, UK
| | - James A. King
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
- NIHR Leicester Biomedical Research Centre, Leicester LE3 9QD, UK
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Lecumberri Pascual E, Tejera Pérez C, Muñoz-Garach A, Javier Ampudia-Blasco F. How often patients on insulin therapy measure postprandial glycemia and modify insulin doses accordingly? From an on-line survey in insulin-treated diabetes patients in Spain. Diabetes Res Clin Pract 2019; 154:43-51. [PMID: 31226281 DOI: 10.1016/j.diabres.2019.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 06/02/2019] [Accepted: 06/13/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Controlling postprandial glycemia (PPG) is important to achieve optimal glycemic control, but few studies have evaluated how often is measured and evaluated. OBJECTIVES To evaluate how often patients on insulin therapy measure PPG and modify insulin doses accordantly. As secondary objectives, we evaluated the factors conditioning elevated PPG and associated issues. MATERIAL AND METHODS Cross-sectional observational study based on a web-based survey from an unselected sample of adult insulin-treated patients. A p-value of < 0.05 was significant. RESULTS 1251 patients (68% women, 38.9 ± 13 years [mean ± SD], body mass index (BMI) 24.2 ± 4.2 kg/m2, diabetes duration 17.4 ± 12.8 years, insulin dose 38 ± 18 IU) participated, 1104 with autoinmmune disease (AD) and 147 with non-autoinmmune diabetes (NAD). 59% of patients had HbA1c ≤ 7%, 92.7% of patients with AD and 55.8% with NAD were attended by specialists (p < 0.001). People with AD did more often blood glucose monitoring (BGM) (p < 0.0001) and used continuous glucose monitoring systems (CGMS) (p < 0.0001). 90.1% with AD and 68.0% with NAD received instructions on measuring PPG (p < 0.001), and more with AD received specific training to change the treatment (87% vs. 61.2%, p < 0.0001) and were more proactive. However, more with NAD discussed their postprandial glucose levels with their healthcare team during clinical visits (92.5% vs. 74.1%, p < 0.0001). Regarding bolus administration, 88.6% with AD and 68.7% with NAD injected the insulin bolus before meals (p < 0.001). CONCLUSIONS Patients with AD determine PPG more frequently. Diabetes type, follow-up setting, number of injections and CGMS use were the most important predictive factors for PPG measurement. Diabetes education programs should address how to best monitor PPG and appropriate corrective actions.
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Affiliation(s)
| | - Cristina Tejera Pérez
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Ferrol, La Coruña, Spain.
| | - Araceli Muñoz-Garach
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Málaga (IBIMA), Málaga, Spain; Instituto de Salud Carlos III, Madrid, Spain
| | - F Javier Ampudia-Blasco
- Diabetes Reference Unit, Endocrinology & Nutrition Department, Hospital Clínico Universitario de Valencia, Valencia, Spain; Instituto de Investigación Sanitaria INCLIVA, Spain; Medicine Department, Medicine Faculty, University of Valencia, Spain
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Son BK, Eto M, Oura M, Ishida Y, Taniguchi S, Ito K, Umeda-Kameyama Y, Kojima T, Akishita M. Low-Intensity Exercise Suppresses CCAAT/Enhancer-Binding Protein δ/Myostatin Pathway Through Androgen Receptor in Muscle Cells. Gerontology 2019; 65:397-406. [PMID: 31096217 DOI: 10.1159/000499826] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 03/24/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Androgen production following exercise has been suggested to contribute anabolic actions of muscle. However, the underlying mechanisms of the androgen receptor (AR) in androgen's action are still unclear. OBJECTIVE In the present study, we examined androgen/AR-mediated action in exercise, especially for the suppression of myostatin, a potent negative regulator of muscle mass. METHODS To examine the effects of exercise, we employed low-intensity exercise in mice and electric pulse stimulation (EPS) in C2C12 myotubes. Androgen production by C2C12 myotubes was measured by enzyme-linked immunosorbent assay. To block the action of AR, we pretreated C2C12 myotubes with flutamide. Quantitative real-time polymerase chain reaction was used to determine the expression levels of proteolytic genes including CCAAT/enhancer-binding protein delta (C/EBPδ), myostatin and muscle E3 ubiquitin ligases, as well as myogenic genes such as myogenin and PGC1α. The activation of 5'-adenosine-activated protein kinase and STAT3 was determined by Western blot analysis. RESULTS Both mRNA and protein levels of AR significantly increased in skeletal muscle of low-intensity exercised mice and C2C12 myotubes exposed to EPS. Production of testosterone and dihydrotestosterone from EPS-treated C2C12 myotubes was markedly increased. Of interest, we found that myostatin was clearly inhibited by EPS, and its inhibition was significantly abrogated when AR was blocked by flutamide. To test how AR suppresses myostatin, we examined the effects of EPS on C/EBPδ because the promoter region of myostatin has several C/EBP recognition sites. C/EBPδ expression was decreased by EPS, and this decrease was negated by flutamide. IL-6 and phospho-STAT3 (pSTAT3) expression, the downstream pathway of myostatin, were decreased by EPS and this was also reversed by flutamide. Similar downregulation of C/EBPδ, myostatin, and IL-6 was seen in skeletal muscle of low-intensity exercised mice. CONCLUSIONS Muscle AR expression and androgen production were increased by exercise and EPS treatment. As a mechanistical insight, it is suggested that AR inhibited myostatin expression transcriptionally by C/EBPδ suppression, which negatively influences IL-6/pSTAT3 expression and consequently contributes to the prevention of muscle proteolysis during exercise.
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Affiliation(s)
- Bo-Kyung Son
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, .,Institute of Gerontology, The University of Tokyo, Tokyo, Japan,
| | - Masato Eto
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Miya Oura
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuki Ishida
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sakiko Taniguchi
- Department of Veterinary Pathophysiology and Animal Health, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Koichi Ito
- Department of Veterinary Pathophysiology and Animal Health, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Yumi Umeda-Kameyama
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taro Kojima
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Blankenship JM, Chipkin SR, Freedson PS, Staudenmayer J, Lyden K, Braun B. Managing free-living hyperglycemia with exercise or interrupted sitting in type 2 diabetes. J Appl Physiol (1985) 2019; 126:616-625. [DOI: 10.1152/japplphysiol.00389.2018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Breaking up sitting with light physical activity (PA) is effective in reducing hyperglycemia in the laboratory. Whether the same effects are observed in the free-living environment remains unknown. We evaluated how daily and postprandial glycemia is impacted by 20, 40, or 60 min of activity performed as either breaks from sitting after each meal (BR) or as one continuous walk after breakfast (WALK). Thirty individuals with type 2 diabetes completed three experimental conditions [BR, WALK, and control (CON)] in a randomized crossover design. Conditions were performed in a free-living environment with strict dietary control over 7 days. Participants increased PA in BR and WALK by 20, 40, or 60 min ( n = 10 in each group) and maintained habitual levels of PA during CON. A continuous glucose monitor (iPro2) and activPAL activity monitor were worn to quantify glycemic control and PA. Using linear mixed models with repeated measures, we 1) compared postprandial glucose (PPG) across conditions and 2) assessed the relationship between activity volume and glucose responses. Whereas WALK tended to shorten the daily duration of hyperglycemia compared with CON ( P = 0.0875), BR was not different from CON. BR and WALK significantly attenuated the breakfast PPG versus CON ( P ≤ 0.05), but lunch and dinner PPG were unaffected by BR and WALK. In conclusion, continuous walking was more effective than breaks from sitting in lowering daily hyperglycemia for the group, but both conditions lowered breakfast PPG. In contrast to tightly controlled laboratory studies, breaks from sitting did not lower hyperglycemia in the free-living environment. NEW & NOTEWORTHY Our “ecolabical” approach is new and noteworthy. This approach combines the external validity of the free-living environment (ecological) with the control of key confounding variables in the laboratory and allows for highly translatable findings by minimizing confounding variables. We found that both postmeal continuous walking and short breaks from sitting similarly attenuated the postprandial glucose (PPG) response to breakfast. Unlike previous laboratory studies, neither condition (walk after breakfast or postmeal breaks) significantly impacted PPG at lunch or dinner.
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Affiliation(s)
| | - Stuart R. Chipkin
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Patty S. Freedson
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts
| | - John Staudenmayer
- Department of Mathematics and Statistics, University of Massachusetts Amherst, Amherst, Massachusetts
| | | | - Barry Braun
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado
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Raman A, Peiffer JJ, Hoyne GF, Lawler NG, Currie AJ, Fairchild TJ. Effect of exercise on acute postprandial glucose concentrations and interleukin-6 responses in sedentary and overweight males. Appl Physiol Nutr Metab 2018; 43:1298-1306. [PMID: 29856928 DOI: 10.1139/apnm-2018-0160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2023]
Abstract
This study examined the effect of 2 forms of exercise on glucose tolerance and the concurrent changes in markers associated with the interleukin (IL)-6 pathways. Fifteen sedentary, overweight males (29.0 ± 3.1 kg/m2) completed 2 separate, 3-day trials in randomised and counterbalanced order. An oral glucose tolerance test (OGTT; 75 g) was performed at the same time on each day of the trial. Day 2 of each trial consisted of a single 30-min workload-matched bout of either high-intensity intermittent exercise (HIIE; alternating 100% and 50% of peak oxygen uptake) or continuous moderate-intensity exercise (CME; 60 % of peak oxygen uptake) completed 1 h prior to the OGTT. Venous blood samples were collected before, immediately after, 1 h after, and 25 h after exercise for measurement of insulin, C-peptide, IL-6, and the soluble IL-6 receptors (sIL-6R; soluble glycoprotein 130 (sgp130)). Glucose area under the curve (AUC) was calculated from capillary blood samples collected throughout the OGTT. Exercise resulted in a modest (4.4%; p = 0.003) decrease in the glucose AUC when compared with the pre-exercise AUC; however, no differences were observed between exercise conditions (p = 0.65). IL-6 was elevated immediately after and 1 h after exercise, whilst sgp130 and sIL-6R concentrations were reduced immediately after exercise. In summary, exercise was effective in reducing glucose AUC, which was attributed to improvements that took place between 60 and 120 min into the OGTT, and was in parallel with an increased ratio of IL-6 to sIL-6R, which accords with an increased activation via the "classical" IL-6 signalling pathway. Our findings suggest that acute HIIE did not improve glycaemic response when compared with CME.
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Affiliation(s)
- Aaron Raman
- a School of Psychology and Exercise Science, Murdoch University, Murdoch 6150, Western Australia, Australia
| | - Jeremiah J Peiffer
- a School of Psychology and Exercise Science, Murdoch University, Murdoch 6150, Western Australia, Australia
| | - Gerard F Hoyne
- b School of Health Sciences, Murdoch University, Western Australia, Fremantle 6160, Australia
| | - Nathan G Lawler
- a School of Psychology and Exercise Science, Murdoch University, Murdoch 6150, Western Australia, Australia
| | - Andrew J Currie
- c School of Veterinary and Life Sciences, University of Notre Dame Australia, Fremantle Campus, Murdoch 6150, Australia
| | - Timothy J Fairchild
- a School of Psychology and Exercise Science, Murdoch University, Murdoch 6150, Western Australia, Australia
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Bourne JE, Sauchelli S, Perry R, Page A, Leary S, England C, Cooper AR. Health benefits of electrically-assisted cycling: a systematic review. Int J Behav Nutr Phys Act 2018; 15:116. [PMID: 30463581 PMCID: PMC6249962 DOI: 10.1186/s12966-018-0751-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 11/08/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Electrically assisted bicycles (e-bikes) have been highlighted as a method of active travel that could overcome some of the commonly reported barriers to cycle commuting. The objective of this systematic review was to assess the health benefits associated with e-cycling. METHOD A systematic literature review of studies examining physical activity, cardiorespiratory, metabolic and psychological outcomes associated with e-cycling. Where possible these outcomes were compared to those from conventional cycling and walking. Seven electronic databases, clinical trial registers, grey literature and reference lists were searched up to November 2017. Hand searching occurred until June 2018. Experimental or observational studies examining the impact of e-cycling on physical activity and/or health outcomes of interest were included. E-bikes used must have pedals and require pedalling for electric assistance to be provided. RESULTS Seventeen studies (11 acute experiments, 6 longitudinal interventions) were identified involving a total of 300 participants. There was moderate evidence that e-cycling provided physical activity of at least moderate intensity, which was lower than the intensity elicited during conventional cycling, but higher than that during walking. There was also moderate evidence that e-cycling can improve cardiorespiratory fitness in physically inactive individuals. Evidence of the impact of e-cycling on metabolic and psychological health outcomes was inconclusive. Longitudinal evidence was compromised by weak study design and quality. CONCLUSION E-cycling can contribute to meeting physical activity recommendations and increasing physical fitness. As such, e-bikes offer a potential alternative to conventional cycling. Future research should examine the long-term health impacts of e-cycling using rigorous research designs.
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Affiliation(s)
- Jessica E. Bourne
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Sarah Sauchelli
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Rachel Perry
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Angie Page
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Sam Leary
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Clare England
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Ashley R. Cooper
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
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Effects of acute ingestion of whey protein with or without prior aerobic exercise on postprandial glycemia in type 2 diabetics. Eur J Appl Physiol 2018; 118:1959-1968. [PMID: 29980851 DOI: 10.1007/s00421-018-3931-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 06/29/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE Acute protein co-ingestion or a single bout of aerobic exercise can attenuate postprandial glycemia, but their combined effect has not been investigated in type 2 diabetics. METHODS Using a randomised crossover design, male type 2 diabetics (n = 8) [mean (95% CI); age, 55.0 (45.2, 64.8) year; BMI, 33.7 (25.6, 41.8) kg·m- 2; 2 h glucose 14.0 (12.5, 15.5) mM] completed (1) 75 g oral glucose tolerance test (OGTT) (CON); (2) OGTT supplemented with 0.33 g·kg BM- 1 of whey protein concentrate (PRO); or OGTT supplemented with PRO but preceded by a bout of aerobic cycling exercise (PRO + EX). Postprandial venous blood samples were collected for glucose, insulin, C-peptide and glucagon. RESULTS Despite a fold-increase of 1.90 (1.26, 2.56; p < 0.05) in postprandial insulin compared to CON, PRO failed to attenuate postprandial glycemia measured by 2 h glucose area under the curve. During PRO + EX, plasma glucose was elevated by 1.51 (0.5, 2.5) mM and 1.3 (0.3, 2.3) mM at 15 and 30 min, respectively, compared to CON, but was lower by 1.60 (0.6, 2.6) mM and 1.5 (0.5, 2.5) mM at 90 and 120 min, respectively (all p < 0.01). The additive effect of exercise and protein ingestion resulted in a fold-increase of 1.67 (1.35, 2.00; p < 0.05) in postprandial glucagon compared to CON. CONCLUSION In type 2 diabetics, prior aerobic exercise altered the humoral response to co-ingestion of whey protein with a carbohydrate load, but neither protein ingestion alone nor when preceded by prior exercise attenuated postprandial glycemia.
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McCarthy M, Edwardson CL, Davies MJ, Henson J, Rowlands A, King JA, Bodicoat DH, Khunti K, Yates T. Breaking up sedentary time with seated upper body activity can regulate metabolic health in obese high-risk adults: A randomized crossover trial. Diabetes Obes Metab 2017; 19:1732-1739. [PMID: 28544202 DOI: 10.1111/dom.13016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 05/16/2017] [Accepted: 05/18/2017] [Indexed: 11/28/2022]
Abstract
AIMS To investigate the impact of performing short bouts of seated upper body activity on postprandial blood glucose and insulin levels during prolonged sitting. METHODS Participants undertook two 7.5-hour experimental conditions in randomized order: (1) prolonged sitting only and (2) sitting, interspersed with 5 minutes of seated arm ergometry every 30 minutes. Blood samples were obtained while fasting and throughout the postprandial period after ingestion of two standardized meals. The incremental area under the curve (iAUC) was calculated for glucose and insulin throughout each experimental condition. A paired samples t-test was used to assess the difference in iAUC data between conditions for glucose (primary outcome) and insulin (secondary outcome). RESULTS Thirteen obese adults (7 women, 6 men; mean ± standard deviation [s.d.] age: 66 ± 6 years; body mass index 33.8 ± 3.8 kg/m2 ) completed this investigation. Compared with the prolonged sitting-only condition, the implementation of seated arm ergometry every 30 minutes significantly reduced mean blood glucose iAUC (from 7.4 mmol/L/h [95% confidence interval {CI} 5.2, 9.5] to 3.1 mmol/L/h [95% CI 1.3, 5.0]; P = .001). Significant reductions in mean insulin iAUC (from 696 mU/L/h [95% CI 359, 1032] to 554 mU/L/h [95% CI 298, 811]; P = .047) were also observed. CONCLUSION Performing short bouts of arm ergometry during prolonged sitting attenuated postprandial glycaemia despite maintaining a seated posture. This may have clinical significance for those with weight-bearing difficulty who may struggle with postural change.
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Affiliation(s)
- Matthew McCarthy
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research, Leicester, Biomedical Research Centre, Leicester Diabetes Centre, Leicester, UK
- Department of Health Sciences, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Charlotte L Edwardson
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research, Leicester, Biomedical Research Centre, Leicester Diabetes Centre, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research, Leicester, Biomedical Research Centre, Leicester Diabetes Centre, Leicester, UK
- Leicester Diabetes Centre, Leicester General Hospital, University Hospitals of Leicester, Leicester, UK
| | - Joseph Henson
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research, Leicester, Biomedical Research Centre, Leicester Diabetes Centre, Leicester, UK
| | - Alex Rowlands
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research, Leicester, Biomedical Research Centre, Leicester Diabetes Centre, Leicester, UK
| | - James A King
- National Institute for Health Research, Leicester, Biomedical Research Centre, Leicester Diabetes Centre, Leicester, UK
| | - Danielle H Bodicoat
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research, Leicester, Biomedical Research Centre, Leicester Diabetes Centre, Leicester, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care - East Midlands, Leicester Diabetes Centre, Leicester, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care - East Midlands, Leicester Diabetes Centre, Leicester, UK
- Leicester Diabetes Centre, Leicester General Hospital, University Hospitals of Leicester, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
- National Institute for Health Research, Leicester, Biomedical Research Centre, Leicester Diabetes Centre, Leicester, UK
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Martins SO, Folasire OF, Irabor AE. PREVALENCE AND PREDICTORS OF PREDIABETES AMONG ADMINISTRATIVE STAFF OF A TERTIARY HEALTH CENTRE, SOUTHWESTERN NIGERIA. Ann Ib Postgrad Med 2017; 15:114-123. [PMID: 29556166 PMCID: PMC5846173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Prediabetes is a condition in which individuals have blood glucose levels higher than normal but not high enough to be classified as diabetes mellitus. Inadequate moderate-intensity physical activity, amidst other risk factors, is a well-documented risk factor for prediabetes. Hospital administrative staff can be particularly vulnerable to prediabetes because of the greater number of hours spent in a sitting or sedentary position during administrative duties. The aim of this study was to find the prevalence of prediabetes and to determine its predictors among administrative staff of a tertiary health centre in southwestern Nigeria. METHOD This was a descriptive cross-sectional study carried out among 300 administrative staff of the University College Hospital, Ibadan over a period of three months. Data was collected using a semi-structured questionnaire that was adapted from the generic WHO-STEPs instrument approach to surveillance of chronic non-communicable diseases risk factors. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 17. Descriptive analyses were performed to estimate the prevalence of prediabetes while the independent predictors of prediabetes were investigated using multinomial logistic regression model. The level of statistical significance was set at p < 0.05. RESULTS The mean age of participants was 51.2 ± 5.3 years. There were 164 (54.7%) males and 136 (45.3%) females that participated in the study. The prevalence of prediabetes was 22.3%. Based on the final multivariable multinomial model, the independent predictors of prediabetes included; male sex (OR= 1.24; 95% CI= 1.082 - 2.460), positive family history of diabetes mellitus (OR= 1.57; 95% CI= 1.088 - 2.611), alcohol intake (OR= 1.13; 95% CI= 0.688 - 1.543) and inadequate moderate-intensity physical activity (OR= 1.49; 95% CI= 1.027 - 2.936). CONCLUSION There was a high prevalence of prediabetes among the administrative staff of University College Hospital, Ibadan. Regular screening of hospital employees for prediabetes is highly recommended. Work-place exercise should be advocated to improve moderate-intensity physical activity among hospital employees.
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Affiliation(s)
- S O Martins
- Department of Family Medicine, University College Hospital, Ibadan, Nigeria
| | - O F Folasire
- Department of Family Medicine, University College Hospital, Ibadan, Nigeria
| | - A E Irabor
- Department of Family Medicine, University College Hospital, Ibadan, Nigeria
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Anwar S, Shikalgar N. Prevention of type 2 diabetes mellitus in polycystic ovary syndrome: A review. Diabetes Metab Syndr 2017; 11 Suppl 2:S913-S917. [PMID: 28711517 DOI: 10.1016/j.dsx.2017.07.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 07/01/2017] [Indexed: 01/28/2023]
Abstract
Polycystic ovary syndrome (PCOS) is recognized as one of the most common endocrinopathies in women of reproductive age, associated with metabolic sequelae which includes increased risk factors for impaired glucose tolerance (IGT), type 2 diabetes mellitus (DM2) and cardiovascular disease (CVD). The adverse effects of DM2 affects a woman throughout her lifespan. Health care expenditure of DM2 highlights the need for prevention through appropriate screening, diagnosis and intervention. Lifestyle modification (LSM) programs that include diet and/or physical activity are suggested for patients characterized as prediabetic to delay the onset of adult DM2. Diet (i.e. low carbohydrate), combination of aerobic and resistance exercise with high intensity interval training (HIT) 150 to 175min/week with resistance exercise 2 to 3days/week and weight loss may be valuable supporters in the fight against IR, IGT and DM2 associated with PCOS.
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Affiliation(s)
- Safa Anwar
- Department of Physical Therapy, College of Applied Medical Sciences, Buraydah Private Colleges, Qassim, Saudi Arabia.
| | - Nigar Shikalgar
- Department of Physical Therapy, College of Applied Medical Sciences, Buraydah Private Colleges, Qassim, Saudi Arabia
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Ferjan S, Janez A, Jensterle M. DPP4 INHIBITOR SITAGLIPTIN AS A POTENTIAL TREATMENT OPTION IN METFORMIN-INTOLERANT OBESE WOMEN WITH POLYCYSTIC OVARY SYNDROME: A PILOT RANDOMIZED STUDY. Endocr Pract 2017; 24:69-77. [PMID: 29144805 DOI: 10.4158/ep-2017-0027] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Metformin has an established role in the management of polycystic ovary syndrome (PCOS). Some patients cannot tolerate it due to associated gastrointestinal adverse events. The present study evaluated the dipeptidyl peptidase 4 inhibitor sitagliptin as a potential treatment option in metformin-intolerant PCOS. METHODS We conducted a 12-week, prospective, randomized, open-label study with 30 obese metformin-intolerant women with PCOS (age 35.0 ± 7.2 years; body mass index, 36.9 ± 5.5 kg/m2). After metformin withdrawal, they were randomized to lifestyle intervention and sitagliptin 100 mg daily (SITA) or lifestyle intervention alone as controls (CON). All participants underwent anthropometric and endocrine measurements and oral glucose tolerance testing. Model-derived indexes of insulin resistance and beta-cell function were calculated. RESULTS SITA improved beta-cell function as assessed by the homeostasis model assessment for beta-cell function index (HOMA-B) of 45.9 ± 35.8 ( P = .001), modified beta-cell function index (MBCI) of 7.9 ± 7 ( P = .002), and quantitative insulin-sensitivity check index (QUICKI) of -0.03 ± 0.03 ( P = .002). By contrast, beta-cell function decreased in CON. The between-group differences were significant for HOMA-B ( P = 0.001), MBCI ( P = .010), and QUICKI ( P = .025). The conversion rate to impaired glucose homeostasis was prevented in SITA: 3 of 15 subjects had impaired glucose tolerance (IGT) before and after the study. In CON, none had type 2 diabetes (T2D), and 4 had IGT at the beginning. After 12 weeks, IGT was observed in 2 and T2D in 3 subjects. CONCLUSION SITA improved beta-cell function and prevented a conversion to IGT and T2D in metformin-intolerant obese PCOS patients. ABBREVIATIONS BMI = body mass index; DPP-4 = dipeptidyl peptidase-4; DXA = dual energy X-ray absorptiometry; GIP = glucose-dependent insulinotropic peptide; GLP-1 = glucagon-like peptide-1; HOMA-B = homeostasis model assessment for beta-cell function; HOMA-IR = homeostasis model assessment of insulin resistance; IAI = insulin action index; IGT = impaired glucose tolerance; IR = insulin resistance; MBCI = modified beta-cell function index; OGTT = oral glucose tolerance test; QUICKI = quantitative insulin sensitivity check index; PCOS = polycystic ovary syndrome; SHBG = sex hormone-binding globulin; T2D = type 2 diabetes.
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Shambrook P, Kingsley MI, Wundersitz DW, Xanthos PD, Wyckelsma VL, Gordon BA. Glucose response to exercise in the post-prandial period is independent of exercise intensity. Scand J Med Sci Sports 2017; 28:939-946. [PMID: 29059510 DOI: 10.1111/sms.12999] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2017] [Indexed: 12/25/2022]
Abstract
This study investigated the acute glucose response to low-intensity, moderate-intensity, and high-intensity interval exercise compared to no-exercise in healthy insufficiently active males using a four-arm, randomized, crossover design. Ten males (age: 37.3 ± 7.3 years, BMI: 29.3 ± 6.5 kg·m-2 ) completed four 30-minute interventions at weekly intervals comprising low-intensity exercise (LIE) at ~35% V˙O2 R, moderate-intensity exercise (MIE) at ~50% V˙O2 R, high-intensity interval exercise (HIIE) at ~80% V˙O2 R, and a no-exercise control. Participants performed cycle ergometer exercise 30 minutes after finishing breakfast. Glucose response was assessed using a continuous glucose monitor under free-living conditions with dietary intake replicated. A significant effect for intensity on energy expenditure was identified (P < .001) with similar energy cost in MIE (mean ± SD: 869 ± 148 kJ) and HIIE (806 ± 145 kJ), which were both greater than LIE (633 ± 129 kJ). The pattern of glucose response between the interventions over time was different (P = .02). Glucose was lower 25 minutes into each of the HIIE, MIE and LIE trials respectively (mean difference ± SD: -0.7 ± 1.1; -0.9 ± 1.1; -0.6 ± 0.9 mmol·L-1 ; P < .05) than in the no-exercise trial. Glucose response was not different between exercise intensities (P > .05). Twenty-four-hour AUC was not affected by exercise intensity (P = .75). There was a significant effect for exercise enjoyment (P = .02), with LIE (69 ± 4) preferred less than HIIE (mean ± SD: 84 ± 14; P = .02), MIE (73 ± 5; P = .03), and no-exercise (75 ± 4; P = .03). Exercise at any intensity 30 minutes after a meal affects glycemic regulation equally in insufficiently active males. Moderate to vigorous exercise intensities were preferred, and therefore, the exercise guidelines appear appropriate for the prevention of cardiometabolic disease.
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Affiliation(s)
- P Shambrook
- Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - M I Kingsley
- Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - D W Wundersitz
- Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - P D Xanthos
- Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - V L Wyckelsma
- Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, Australia
| | - B A Gordon
- Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
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Hatamoto Y, Goya R, Yamada Y, Yoshimura E, Nishimura S, Higaki Y, Tanaka H. Effect of exercise timing on elevated postprandial glucose levels. J Appl Physiol (1985) 2017; 123:278-284. [DOI: 10.1152/japplphysiol.00608.2016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 04/10/2017] [Accepted: 04/11/2017] [Indexed: 12/20/2022] Open
Abstract
There is no consensus regarding optimal exercise timing for reducing postprandial glucose (PPG). The purpose of the present study was to determine the most effective exercise timing. Eleven participants completed four different exercise patterns 1) no exercise; 2) preprandial exercise (jogging); 3) postprandial exercise; and 4) brief periodic exercise intervention (three sets of 1-min jogging + 30 s of rest, every 30 min, 20 times total) in a random order separated by a minimum of 5 days. Preprandial and postprandial exercise consisted of 20 sets of intermittent exercise (1 min of jogging + 30 s rest per set) repeated 3 times per day. Total daily exercise volume was identical for all three exercise patterns. Exercise intensities were 62.4 ± 12.9% V̇o2peak. Blood glucose concentrations were measured continuously throughout each trial for 24 h. After breakfast, peak blood glucose concentrations were lower with brief periodic exercise (99 ± 6 mg/dl) than those with preprandial and postprandial exercise (109 ± 10 and 115 ± 14 mg/dl, respectively, P < 0.05, effect size = 0.517). After lunch, peak glucose concentrations were lower with brief periodic exercise than those with postprandial exercise (97 ± 5 and 108 ± 8 mg/dl, P < 0.05, effect size = 0.484). After dinner, peak glucose concentrations did not significantly differ among exercise patterns. Areas under the curve over 24 h and 2 h postprandially did not differ among exercise patterns. These findings suggest that brief periodic exercise may be more effective than preprandial and postprandial exercise at attenuating PPG in young active individuals. NEW & NOTEWORTHY This was the first study to investigate the effect of different exercise timing (brief periodic vs. preprandial vs. postprandial exercise) on postprandial glucose (PPG) attenuation in active healthy men. We demonstrated that brief periodic exercise attenuated peak PPG levels more than preprandial and postprandial exercise, particularly in the morning. Additionally, PPG rebounded soon after discontinuing postprandial exercise. Thus, brief periodic exercise may be better than preprandial and postprandial exercise at attenuating PPG levels.
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Affiliation(s)
- Yoichi Hatamoto
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
| | - Ryoma Goya
- Graduate School of Sports and Health Science, Fukuoka University, Fukuoka, Japan
| | - Yosuke Yamada
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
- Department of Nutritional Science, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan; and
| | - Eichi Yoshimura
- Department of Food and Health Sciences, Prefectural University of Kumamoto Faculty of Environmental and Symbiotic Sciences, Kumamoto, Japan
| | - Sena Nishimura
- Graduate School of Sports and Health Science, Fukuoka University, Fukuoka, Japan
| | - Yasuki Higaki
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
- Graduate School of Sports and Health Science, Fukuoka University, Fukuoka, Japan
| | - Hiroaki Tanaka
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
- Graduate School of Sports and Health Science, Fukuoka University, Fukuoka, Japan
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Rynders CA, Blanc S, DeJong N, Bessesen DH, Bergouignan A. Sedentary behaviour is a key determinant of metabolic inflexibility. J Physiol 2017; 596:1319-1330. [PMID: 28543022 DOI: 10.1113/jp273282] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/22/2017] [Indexed: 01/14/2023] Open
Abstract
Metabolic flexibility is defined as the ability to adapt substrate oxidation rates in response to changes in fuel availability. The inability to switch between the oxidation of lipid and carbohydrate appears to be an important feature of chronic disorders such as obesity and type 2 diabetes. Laboratory assessment of metabolic flexibility has traditionally involved measurement of the respiratory quotient (RQ) by indirect calorimetry during the fasted to fed transition (e.g. mixed meal challenge) or during a hyperinsulinaemic-euglycaemic clamp. Under these controlled experimental conditions, 'metabolic inflexibility' is characterized by lower fasting fat oxidation (higher fasting RQ) and/or an impaired ability to oxidize carbohydrate during feeding or insulin-stimulated conditions (lower postprandial or clamp RQ). This experimental paradigm has provided fundamental information regarding the role of substrate oxidation in the development of obesity and insulin resistance. However, the key determinants of metabolic flexibility among relevant clinical populations remain unclear. Herein, we propose that habitual physical activity levels are a primary determinant of metabolic flexibility. We present evidence demonstrating that high levels of physical activity predict metabolic flexibility, while physical inactivity and sedentary behaviours trigger a state of metabolic 'inflexibility', even among individuals who meet physical activity recommendations. Furthermore, we describe alternative experimental approaches to studying the concept of metabolic flexibility across a range of activity and inactivity. Finally, we address the promising use of strategies that aim to reduce sedentary behaviours as therapy to improve metabolic flexibility and reduce weight gain risk.
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Affiliation(s)
- Corey A Rynders
- Division of Geriatric Medicine, University of Colorado, School of Medicine, Aurora, CO, USA
| | - Stephane Blanc
- Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, CNRS, Strasbourg, France.,UMR 7178 Centre National de la Recherche Scientifique (CNRS), Strasbourg, France
| | - Nathan DeJong
- Division of Endocrinology, Metabolism and Diabetes and Anschutz Health and Wellness Center, University of Colorado, School of Medicine, Aurora, CO, USA
| | - Daniel H Bessesen
- Division of Endocrinology, Metabolism and Diabetes and Anschutz Health and Wellness Center, University of Colorado, School of Medicine, Aurora, CO, USA.,Denver Health Medical Center, Denver, CO, USA
| | - Audrey Bergouignan
- Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, CNRS, Strasbourg, France.,UMR 7178 Centre National de la Recherche Scientifique (CNRS), Strasbourg, France.,Division of Endocrinology, Metabolism and Diabetes and Anschutz Health and Wellness Center, University of Colorado, School of Medicine, Aurora, CO, USA
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Abstract
The FATZO/Pco mouse is the result of a cross of the C57BL/6J and AKR/J strains. The crossing of these two strains and the selective inbreeding for obesity, insulin resistance and hyperglycemia has resulted in an inbred strain exhibiting obesity in the presumed presence of an intact leptin pathway. Routinely used rodent models for obesity and diabetes research have a monogenic defect in leptin signaling that initiates obesity. Given that obesity and its sequelae in humans are polygenic in nature and not associated with leptin signaling defects, the FATZO mouse may represent a more translatable rodent model for study of obesity and its associated metabolic disturbances. The FATZO mouse develops obesity spontaneously when fed a normal chow diet. Glucose intolerance with increased insulin levels are apparent in FATZO mice as young as 6 weeks of age. These progress to hyperglycemia/pre-diabetes and frank diabetes with decreasing insulin levels as they age. The disease in these mice is multi-faceted, similar to the metabolic syndrome apparent in obese individuals, and thus provides a long pre-diabetic state for determining the preventive value of new interventions. We have assessed the utility of this new model for the pre-clinical screening of agents to stop or slow progression of the metabolic syndrome to severe diabetes. Our assessment included: 1) characterization of the spontaneous development of disease, 2) comparison of metabolic disturbances of FATZO mice to control mice and 3) validation of the model with regard to the effectiveness of current and emerging anti-diabetic agents; rosiglitazone, metformin and semaglutide. CONCLUSION Male FATZO mice spontaneously develop significant metabolic disease when compared to normal controls while maintaining hyperglycemia in the presence of high leptin levels and hyperinsulinemia. The disease condition responds to commonly used antidiabetic agents.
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Bird SR, Hawley JA. Update on the effects of physical activity on insulin sensitivity in humans. BMJ Open Sport Exerc Med 2017; 2:e000143. [PMID: 28879026 PMCID: PMC5569266 DOI: 10.1136/bmjsem-2016-000143] [Citation(s) in RCA: 289] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 01/04/2023] Open
Abstract
PURPOSE AND METHODS This review presents established knowledge on the effects of physical activity (PA) on whole-body insulin sensitivity (SI) and summarises the findings of recent (2013-2016) studies. DISCUSSION AND CONCLUSIONS Recent studies provide further evidence to support the notion that regular PA reduces the risk of insulin resistance, metabolic syndrome and type 2 diabetes, and SI improves when individuals comply with exercise and/or PA guidelines. Many studies indicate a dose response, with higher energy expenditures and higher exercise intensities, including high intensity interval training (HIIT), producing greater benefits on whole-body SI, although these findings are not unanimous. Aerobic exercise interventions can improve SI without an associated increase in cardiorespiratory fitness as measured by maximal or peak oxygen consumption. Both aerobic and resistance exercise can induce improvements in glycaemic regulation, with some suggestions that exercise regimens including both may be more efficacious than either exercise mode alone. Some studies report exercise-induced benefits to SI that are independent of habitual diet and weight loss, while others indicate an association with fat reduction, hence the debate over the relative importance of PA and weight loss continues. During exercise, muscle contraction stimulated improvements in SI are associated with increases in AMPK activity, which deactivates TCB1D1, promoting GLUT4 translocation to the cell membrane and thereby increasing glucose uptake. Postexercise, increases in Akt deactivate TCB1D4 and thereby increase GLUT4 translocation to the cell membrane. The reduction in intramuscular saturated fatty acids and concomitant reductions in ceramides, but not diacylglycerols, provide a potential link between intramuscular lipid content and SI. Increased skeletal muscle capillarisation provides another independent adaptation through which SI is improved, as does enhanced β cell activity. Recent studies are combining exercise interventions with dietary and feeding manipulations to investigate the potential for augmenting the exercise-induced improvements in SI and glycaemic control.
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Affiliation(s)
- Stephen R Bird
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - John A Hawley
- Mary MaKillop Institute for Health Research, Centre for Exercise and Nutrition, Australian Catholic University, Melbourne, Victoria, Australia.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Malin SK, Rynders CA, Weltman JY, Roberts LJ, Barrett EJ, Weltman A. Endothelial function following glucose ingestion in adults with prediabetes: Role of exercise intensity. Obesity (Silver Spring) 2016; 24:1515-21. [PMID: 27221649 PMCID: PMC4925188 DOI: 10.1002/oby.21522] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 03/11/2016] [Accepted: 03/17/2016] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To determine whether high intensity exercise (HIE) would improve endothelial function more than an isocaloric bout of moderate intensity exercise (MIE) following glucose ingestion in adults with prediabetes. METHODS Twelve subjects with prediabetes completed all three conditions: time-course matched control and isocaloric exercise (∼200 kcal) at moderate (MIE; at lactate threshold) and high intensity (HIE; 75% of difference between lactate threshold and VO2 peak). Brachial artery flow-mediated dilation (FMD) was measured before exercise (baseline), within 30 min postexercise, and 1 and 2 hr following a 75 g oral glucose tolerance test (OGTT). Plasma F2-isoprostanes were also assessed during the protocol (i.e., baseline to 2 hr OGTT) as a biomarker of oxidative stress. RESULTS MIE reduced postexercise F2-isoprostanesAUC compared with time-course matched control and HIE. Although exercise had no statistical effect on FMD postexercise or during the OGTT, elevations in FMDAUC after MIE and HIE were associated with reduced postexercise F2-isoprostanesAUC . CONCLUSIONS Exercise at either intensity had no effect on FMD immediately postexercise following glucose administration. However, individuals with reduced oxidative stress responses to exercise had greater exercise-induced improvement in FMD. Further work is required to identify the mechanism by which exercise alters oxidative stress to enhance endothelial function.
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Affiliation(s)
- Steven K. Malin
- Department of Kinesiology, University of Virginia, Charlottesville VA
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville VA
- Exercise Physiology Core Laboratory, University of Virginia, Charlottesville VA
| | - Corey A. Rynders
- Division of Geriatric Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Judy Y. Weltman
- Exercise Physiology Core Laboratory, University of Virginia, Charlottesville VA
| | - L. Jackson Roberts
- Department of Pharmacology and Medicine, Vanderbilt University, Nashville TN
| | - Eugene J. Barrett
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville VA
| | - Arthur Weltman
- Department of Kinesiology, University of Virginia, Charlottesville VA
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville VA
- Exercise Physiology Core Laboratory, University of Virginia, Charlottesville VA
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Younus A, Aneni EC, Spatz ES, Osondu CU, Roberson L, Ogunmoroti O, Malik R, Ali SS, Aziz M, Feldman T, Virani SS, Maziak W, Agatston AS, Veledar E, Nasir K. A Systematic Review of the Prevalence and Outcomes of Ideal Cardiovascular Health in US and Non-US Populations. Mayo Clin Proc 2016; 91:649-70. [PMID: 27040086 DOI: 10.1016/j.mayocp.2016.01.019] [Citation(s) in RCA: 172] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 12/30/2015] [Accepted: 01/27/2016] [Indexed: 11/29/2022]
Abstract
Several population-based studies have examined the prevalence and trends of the American Heart Association's ideal cardiovascular health (CVH) metrics as well as its association with cardiovascular disease (CVD)-related morbidity and mortality and with non-CVD outcomes. However, no efforts have been made to aggregate these studies. Accordingly, we conducted a systematic review to synthesize available data on the distribution and outcomes associated with ideal CVH metrics in both US and non-US populations. We conducted a systematic search of relevant studies in the MEDLINE and CINAHL databases, as well as the Cochrane Register of Controlled Trials (CENTRAL). Search terms used included "life's simple 7", "AHA 2020" and "ideal cardiovascular health". We included articles published in English Language from January 1, 2010, to July 31, 2015. Of the 14 US cohorts, the prevalence of 6 to 7 ideal CVH metrics ranged from as low as 0.5% in a population of African Americans to 12% in workers in a South Florida health care organization. Outside the United States, the lowest prevalence was found in an Iranian study (0.3%) and the highest was found in a large Chinese corporation (15%). All 6 mortality studies reported a graded inverse association between the increasing number of ideal CVH metrics and the all-cause and CVD-related mortality risk. A similar relationship between ideal CVH metrics and incident cardiovascular events was found in 12 of 13 studies. Finally, an increasing number of ideal CVH metrics was associated with a lower prevalence and incidence of non-CVD outcomes such as cancer, depression, and cognitive impairment. The distribution of ideal CVH metrics in US and non-US populations is similar, with low proportions of persons achieving 6 or more ideal CVH metrics. Considering the strong association of CVH metrics with both CVD and non-CVD outcomes, a coordinated global effort for improving CVH should be considered a priority.
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Affiliation(s)
- Adnan Younus
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL
| | - Ehimen C Aneni
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL; Department of Internal Medicine, Mount Sinai Medical Center, Miami, FL
| | - Erica S Spatz
- The Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT
| | - Chukwuemeka U Osondu
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL
| | - Lara Roberson
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL
| | - Oluseye Ogunmoroti
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL
| | - Rehan Malik
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL
| | - Shozab S Ali
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL
| | - Muhammad Aziz
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL
| | - Theodore Feldman
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL
| | - Salim S Virani
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, and Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL
| | - Arthur S Agatston
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL
| | - Emir Veledar
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL
| | - Khurram Nasir
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, FL; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL; Department of Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL; Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD; Miami Cardiac and Vascular Institute, Miami, FL.
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Grote S, Almstedt HC, Tarleton HP. Cardiometabolic Health Among Cancer Survivors: A 13-Week Pilot Study of a Combined Aerobic and Resistance Training Program. Oncol Nurs Forum 2016; 43:306-15. [PMID: 27105192 DOI: 10.1188/16.onf.306-315] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To explore the feasibility of combined aerobic and resistance training (CART) as a safe method of improving cardiometabolic health among cancer survivors.
. DESIGN Descriptive and longitudinal pilot study for exercise intervention.
. SETTING University campus in Los Angeles, California.
. SAMPLE A multiethnic population of cancer survivors (N = 11) was recruited by convenience sampling and physician referral.
. METHODS Consenting participants were prescribed CART for one hour per day, three days per week for 13 weeks.
. MAIN RESEARCH VARIABLES Components of cardiometabolic health were measured, including resting heart rate (HRrest), blood pressure, body mass index, waist circumference, body fat percentage, and android fat percentage at baseline and after 13 weeks of training. Fasting blood glucose, insulin, adiponectin, leptin, tumor necrosis factor alpha, and C-reactive protein (CRP) also were assessed at baseline and after 13 weeks of training.
. FINDINGS More than half of the participants reported living with at least two other chronic diseases or conditions in addition to a cancer diagnosis. Five of six African American and Hispanic participants reported the presence of at least two risk factors for metabolic syndrome, compared to one of five Caucasian participants. After 13 weeks of training, participants experienced an average decrease in waist circumference. Decrease in waist circumference was associated with a decrease in CRP. A relationship also was suggested between number of exercise sessions attended and improvement in HRrest.
. CONCLUSIONS A CART intervention among cancer survivors should continue to be explored in a larger sample to establish efficacy and effectiveness at improving cardiometabolic health. Because of the higher risk of comorbidity among cancer survivors in comparison to cancer-free adults, improving cardiometabolic health is as important as monitoring cancer recurrence. A need exists for increased attention to the post-treatment cardiometabolic health of cancer survivors and also for examining potential cardiometabolic health disparities among non-Caucasian cancer survivors.
. IMPLICATIONS FOR NURSING CART may be a plausible alternative to reduce the risk of metabolic syndrome and improve cardiometabolic health among cancer survivors. Additional studies that continue to explore the efficacy and effectiveness of CART may provide more information to help nurses and physicians determine whether the cancer survivorship care plan should include an exercise-based alternative to intervene on cardiometabolic health.
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Malin SK, Rynders CA, Weltman JY, Barrett EJ, Weltman A. Exercise Intensity Modulates Glucose-Stimulated Insulin Secretion when Adjusted for Adipose, Liver and Skeletal Muscle Insulin Resistance. PLoS One 2016; 11:e0154063. [PMID: 27111219 PMCID: PMC4844153 DOI: 10.1371/journal.pone.0154063] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 04/07/2016] [Indexed: 12/14/2022] Open
Abstract
Little is known about the effects of exercise intensity on compensatory changes in glucose-stimulated insulin secretion (GSIS) when adjusted for adipose, liver and skeletal muscle insulin resistance (IR). Fifteen participants (8F, Age: 49.9±3.6yr; BMI: 31.0±1.5kg/m2; VO2peak: 23.2±1.2mg/kg/min) with prediabetes (ADA criteria, 75g OGTT and/or HbA1c) underwent a time-course matched Control, and isocaloric (200kcal) exercise at moderate (MIE; at lactate threshold (LT)), and high-intensity (HIE; 75% of difference between LT and VO2peak). A 75g OGTT was conducted 1 hour post-exercise/Control, and plasma glucose, insulin, C-peptide and free fatty acids were determined for calculations of skeletal muscle (1/Oral Minimal Model; SMIR), hepatic (HOMAIR), and adipose (ADIPOSEIR) IR. Insulin secretion rates were determined by deconvolution modeling for GSIS, and disposition index (DI; GSIS/IR; DISMIR, DIHOMAIR, DIADIPOSEIR) calculations. Compared to Control, exercise lowered SMIR independent of intensity (P<0.05), with HIE raising HOMAIR and ADIPOSEIR compared with Control (P<0.05). GSIS was not reduced following exercise, but DIHOMAIR and DIADIPOSEIR were lowered more following HIE compared with Control (P<0.05). However, DISMIR increased in an intensity based manner relative to Control (P<0.05), which corresponded with lower post-prandial blood glucose levels. Taken together, pancreatic insulin secretion adjusts in an exercise intensity dependent manner to match the level of insulin resistance in skeletal muscle, liver and adipose tissue. Further work is warranted to understand the mechanism by which exercise influences the cross-talk between tissues that regulate blood glucose in people with prediabetes.
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Affiliation(s)
- Steven K Malin
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States of America
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville, VA, United States of America
- Exercise Physiology Core Laboratory, University of Virginia, Charlottesville, VA, United States of America
| | - Corey A Rynders
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Judy Y Weltman
- Exercise Physiology Core Laboratory, University of Virginia, Charlottesville, VA, United States of America
| | - Eugene J Barrett
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville, VA, United States of America
| | - Arthur Weltman
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States of America
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville, VA, United States of America
- Exercise Physiology Core Laboratory, University of Virginia, Charlottesville, VA, United States of America
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Malin SK, Liu Z, Barrett EJ, Weltman A. Exercise resistance across the prediabetes phenotypes: Impact on insulin sensitivity and substrate metabolism. Rev Endocr Metab Disord 2016; 17:81-90. [PMID: 27106830 DOI: 10.1007/s11154-016-9352-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Prediabetes is a heterogeneous term that encompasses different origins of insulin resistance and insulin secretion that contribute to distinct patterns of hyperglycemia. In fact, prediabetes is an umbrella term that characterizes individuals at high risk for developing type 2 diabetes (T2D) and/or cardiovascular disease (CVD). Based on current definitions there are at least 3 distinct phenotypes of prediabetes: impaired fasting glucose (IFG), impaired glucose tolerant (IGT), or the combination of both (IFG + IGT). Each phenotype is clinically relevant as they are uniquely recognized as having different levels of risk for progressing to T2D and CVD. Herein, we discuss the underlying pathophysiology that characterizes IFG, IGT and the combination, as well as examine how some of these phenotypes appear resistant to traditional exercise interventions. We propose that substrate metabolism differences between the prediabetes phenotypes may be a unifying mechanism that explains the inter-subject variation in response to exercise seen across obese, metabolic syndrome, pre-diabetic and T2D patients in the current literature. Ultimately, a better understanding of the pathophysiologic mechanisms that govern disturbances responsible for fasting vs. postprandial hyperglycemia and the combination of both is important for designing optimal and personalized exercise treatment strategies that treat and prevent hyperglycemia and CVD risk.
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Affiliation(s)
- Steven K Malin
- Applied Metabolism & Physiology Laboratory, Department of Kinesiology, University of Virginia, 210 Emmet St., 225A Memorial Gymnasium, Charlottesville, VA, USA.
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville, VA, USA.
| | - Zhenqi Liu
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville, VA, USA
| | - Eugene J Barrett
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville, VA, USA
| | - Arthur Weltman
- Applied Metabolism & Physiology Laboratory, Department of Kinesiology, University of Virginia, 210 Emmet St., 225A Memorial Gymnasium, Charlottesville, VA, USA
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville, VA, USA
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RYNDERS COREYA, WELTMAN JUDYY, MALIN STEVENK, JIANG BOYI, BRETON MARC, BARRETT EUGENEJ, WELTMAN ARTHUR. Comparing Simple Insulin Sensitivity Indices to the Oral Minimal Model Postexercise. Med Sci Sports Exerc 2016; 48:66-72. [DOI: 10.1249/mss.0000000000000728] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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