1
|
Noone J, Mucinski JM, DeLany JP, Sparks LM, Goodpaster BH. Understanding the variation in exercise responses to guide personalized physical activity prescriptions. Cell Metab 2024; 36:702-724. [PMID: 38262420 DOI: 10.1016/j.cmet.2023.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 01/25/2024]
Abstract
Understanding the factors that contribute to exercise response variation is the first step in achieving the goal of developing personalized exercise prescriptions. This review discusses the key molecular and other mechanistic factors, both extrinsic and intrinsic, that influence exercise responses and health outcomes. Extrinsic characteristics include the timing and dose of exercise, circadian rhythms, sleep habits, dietary interactions, and medication use, whereas intrinsic factors such as sex, age, hormonal status, race/ethnicity, and genetics are also integral. The molecular transducers of exercise (i.e., genomic/epigenomic, proteomic/post-translational, transcriptomic, metabolic/metabolomic, and lipidomic elements) are considered with respect to variability in physiological and health outcomes. Finally, this review highlights the current challenges that impede our ability to develop effective personalized exercise prescriptions. The Molecular Transducers of Physical Activity Consortium (MoTrPAC) aims to fill significant gaps in the understanding of exercise response variability, yet further investigations are needed to address additional health outcomes across all populations.
Collapse
Affiliation(s)
- John Noone
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA
| | | | - James P DeLany
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA
| | - Lauren M Sparks
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA
| | - Bret H Goodpaster
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA.
| |
Collapse
|
2
|
Carrillo BJP, Cope E, Gurel S, Traslosheros A, Kenny A, Michot-Duval O, Mody N, Delibegovic M, Philip S, Thies F, Blana D, Gabriel BM. Morning exercise and pre-breakfast metformin interact to reduce glycaemia in people with type 2 diabetes: a randomized crossover trial. J Physiol 2024. [PMID: 38522033 DOI: 10.1113/jp285722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/29/2024] [Indexed: 03/25/2024] Open
Abstract
Exercise is recommended in the treatment of type 2 diabetes and can improve insulin sensitivity. However, previous evidence suggests that exercise at different times of the day in people with type 2 diabetes may have opposing outcomes on glycaemia. Metformin is the most commonly prescribed initial pharmacological intervention in type 2 diabetes, and may alter adaptions to exercise. It is unknown if there is an interaction between metformin and diurnal exercise outcomes. We aimed to investigate glycaemic outcomes of moderate intensity morning vs. evening exercise in people with type 2 diabetes being prescribed metformin monotherapy. In this study, nine males and nine females with type 2 diabetes undergoing metformin monotherapy (age 61 ± 8.2 years, mean ± SD) completed a 16-week crossover trial including 2-week baseline recording, 6 weeks randomly assigned to a morning exercise (07.00-10.00 h) or evening exercise (16.00-19.00 h) and a 2-week wash-out period. Exercise arms consisted of 30 min of walking at 70% of estimated max heart rate every other day. Glucose levels were measured with continuous glucose monitors and activity measured by wrist-worn monitors. Food-intake was recorded by 4-day food diaries during baseline, first and last 2 weeks of each exercise arm. There was no difference in exercise intensity, total caloric intake or total physical activity between morning and evening arms. As primary outcomes, acute (24 h) glucose area under the curve (AUC), was lower (P = 0.02) after acute morning exercise (180.6 ± 68.4 mmol/l) compared to baseline (210.3 ± 76.7 mmol/l); and there were no differences identified for glucose (mmol/l) between baseline, morning and evening exercise at any specific time point when data were analysed with two-way ANOVA. As secondary outcomes, acute glucose AUC was significantly lower (P = 0.01) in participants taking metformin before breakfast (152.5 ± 29.95 mmol/l) compared with participants taking metformin after breakfast (227.2 ± 61.51 mmol/l) only during the morning exercise arm; and during weeks 5-6 of the exercise protocol, glucose AUC was significantly lower (P = 0.04) for participants taking metformin before breakfast (168.8 ± 15.8 mmol/l), rather than after breakfast (224.5 ± 52.0 mmol/l), only during morning exercise. Our data reveal morning moderate exercise acutely lowers glucose levels in people with type 2 diabetes being prescribed metformin. This difference appears to be driven by individuals that consumed metformin prior to breakfast rather than after breakfast. This beneficial effect upon glucose levels of combined morning exercise and pre-breakfast metformin persisted through the final 2 weeks of the trial. Our findings suggest that morning moderate intensity exercise combined with pre-breakfast metformin intake may benefit the management of glycaemia in people with type 2 diabetes. KEY POINTS: Morning moderate exercise acutely lowers glucose levels in people with type 2 diabetes being prescribed metformin. This difference appears to be driven by individuals that consumed metformin prior to breakfast rather than after breakfast. Morning exercise combined with pre-breakfast metformin persistently reduced glucose compared to morning exercise combined with post-breakfast metformin through the final week (week 6) of the intervention. Our study suggests it may be possible to make simple changes to the time that people with type 2 diabetes take metformin and perform exercise to improve their blood glucose.
Collapse
Affiliation(s)
- Brenda J Peña Carrillo
- Aberdeen Cardiovascular and Diabetes Centre, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Emily Cope
- Aberdeen Cardiovascular and Diabetes Centre, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Sati Gurel
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Andres Traslosheros
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Amber Kenny
- Aberdeen Cardiovascular and Diabetes Centre, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Oscar Michot-Duval
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Nimesh Mody
- Aberdeen Cardiovascular and Diabetes Centre, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Mirela Delibegovic
- Aberdeen Cardiovascular and Diabetes Centre, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Sam Philip
- NHS Grampian Diabetes Research Unit, Diabetes Centre, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Frank Thies
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Dimitra Blana
- Centre for Health Data Science, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Brendan M Gabriel
- Aberdeen Cardiovascular and Diabetes Centre, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
- Department of Physiology and Pharmacology, Integrative Physiology, The Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
3
|
Brinkmann C. Road map for personalized exercise medicine in T2DM. Trends Endocrinol Metab 2023; 34:789-798. [PMID: 37730486 DOI: 10.1016/j.tem.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/20/2023] [Accepted: 08/21/2023] [Indexed: 09/22/2023]
Abstract
The number of patients with type 2 diabetes mellitus (T2DM) is rising at an alarming rate. Regular physical activity and exercise are cornerstones in the therapy of T2DM. While a one-size-fits-all approach fails to account for many between-subject differences, the use of personalized exercise medicine has the potential of optimizing health outcomes. Here, a road map for personalized exercise therapy targeted at patients with T2DM is presented. It considers secondary complications, glucose management, response heterogeneity, and other relevant factors that might influence the effectiveness of exercise as medicine, taking exercise-medication-diet interactions, as well as feasibility and acceptance into account. Furthermore, the potential of artificial intelligence and machine learning-based applications in assisting sports therapists to find appropriate exercise programs is outlined.
Collapse
Affiliation(s)
- Christian Brinkmann
- Institute of Cardiovascular Research and Sport Medicine, Department of Preventive and Rehabilitative Sport Medicine, German Sport University Cologne, Cologne, Germany; Department of Fitness & Health, IST University of Applied Sciences, Düsseldorf, Germany.
| |
Collapse
|
4
|
Morales-Palomo F, Moreno-Cabañas A, Alvarez-Jimenez L, Mora-Gonzalez D, Ortega JF, Mora-Rodriguez R. Efficacy of morning versus afternoon aerobic exercise training on reducing metabolic syndrome components: A randomized controlled trial. J Physiol 2023. [PMID: 38015017 DOI: 10.1113/jp285366] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/16/2023] [Indexed: 11/29/2023] Open
Abstract
A supervised intense aerobic exercise program improves the health of individuals with metabolic syndrome (MetS). However, it is unclear whether the timing of training within the 24 h day would influence those health benefits. The present study aimed to determine the influence of morning vs. afternoon exercise on body composition, cardiometabolic health and components of MetS. One hundred thirty-nine individuals with MetS were block randomized into morning (AMEX; n = 42) or afternoon (PMEX; n = 59) exercise training groups, or a non-training control group (Control; n = 38). Exercise training was comprised of 48 supervised high-intensity interval sessions distributed over 16 weeks. Body composition, cardiorespiratory fitness (assessed byV ̇ O 2 max ${\dot V_{{{\mathrm{O}}_{\mathrm{2}}}{\mathrm{max}}}}$ ), maximal fat oxidation (FOmax ), blood pressure and blood metabolites were assessed before and after the intervention. Compared with the non-training Control, both exercise groups improved similarly body composition (-0.7% fat loss; P = 0.002), waist circumference (-2.1 cm; P < 0.001), diastolic blood pressure (-3.8 mmHg; P = 0.004) andV ̇ O 2 max ${\dot V_{{{\mathrm{O}}_{\mathrm{2}}}{\mathrm{max}}}}$ (3.5 mL kg-1 min-1 ; P < 0.001) with no differences between training groups. AMEX, in comparison with PMEX, reduced systolic blood pressure (-4% vs. -1%; P = 0.019), plasma fasting insulin concentration (-12% vs. -5%; P = 0.001) and insulin resistance (-14% vs. -4%; P = 0.006). Furthermore, MetS Z score was further reduced in the AMEX compared to PMEX (-52% vs. -19%; P = 0.021) after training. In summary, high-intensity aerobic exercise training in the morning in comparison to training in the afternoon is somewhat more efficient at reducing cardiometabolic risk factors (i.e. systolic blood pressure and insulin sensitivity). KEY POINTS: The effect of exercise time of day on health promotion is an area that has gained interest in recent years; however, large-scale, randomized-control studies are scarce. People with metabolic syndrome (MetS) are at risk of developing cardiometabolic diseases and reductions in this risk with exercise training can be precisely gauged using a compound score sensitive to subtle evolution in each MetS component (i.e. Z score). Supervised aerobic exercise for 16 weeks (morning and afternoon), without dietary restriction, improved cardiorespiratory and metabolic fitness, body composition and mean arterial pressure compared to a non-exercise control group. However, training in the morning, without changes in exercise dose or intensity, reduced systolic blood pressure and insulin resistance further compared to when training in the afternoon. Thus, high-intensity aerobic exercise training in the morning is somewhat more efficient in improving the health of individuals with metabolic syndrome.
Collapse
Affiliation(s)
- Felix Morales-Palomo
- Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain
| | - Alfonso Moreno-Cabañas
- Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain
- Centre for Nutrition, Exercise, and Metabolism, University of Bath, Bath, UK
- Department for Health, University of Bath, Bath, UK
| | | | - Diego Mora-Gonzalez
- Department of Nursing, Physiotherapy and Occupational therapy, University of Castilla-La Mancha, Toledo, Spain
| | - Juan F Ortega
- Exercise Physiology Lab at Toledo, University of Castilla-La Mancha, Toledo, Spain
| | | |
Collapse
|
5
|
Chacko E. Minimizing Negative Effects on Glycemia of Pre- and Post-Meal Exercise for People With Diabetes: A Personal Case Report and Review of the Literature. Clin Diabetes 2023; 41:311-321. [PMID: 37092166 PMCID: PMC10115764 DOI: 10.2337/cd22-0076] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
6
|
Martínez-Montoro JI, Benítez-Porres J, Tinahones FJ, Ortega-Gómez A, Murri M. Effects of exercise timing on metabolic health. Obes Rev 2023; 24:e13599. [PMID: 37416977 DOI: 10.1111/obr.13599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/12/2023] [Accepted: 06/12/2023] [Indexed: 07/08/2023]
Abstract
The increasing prevalence of metabolic syndrome is associated with major health and socioeconomic consequences. Currently, physical exercise, together with dietary interventions, is the mainstay of the treatment of obesity and related metabolic complications. Although exercise training includes different modalities, with variable intensity, duration, volume, or frequency, which may have a distinct impact on several characteristics related to metabolic syndrome, the potential effects of exercise timing on metabolic health are yet to be fully elucidated. Remarkably, promising results with regard to this topic have been reported in the last few years. Similar to other time-based interventions, including nutritional therapy or drug administration, time-of-day-based exercise may become a useful approach for the management of metabolic disorders. In this article, we review the role of exercise timing in metabolic health and discuss the potential mechanisms that could drive the metabolic-related benefits of physical exercise performed in a time-dependent manner.
Collapse
Affiliation(s)
- José Ignacio Martínez-Montoro
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain
- Faculty of Medicine, University of Málaga, Málaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Benítez-Porres
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain
- Physical Education and Sport, Faculty of Medicine, University of Málaga, Málaga, Spain
| | - Francisco J Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain
- Faculty of Medicine, University of Málaga, Málaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Almudena Ortega-Gómez
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Mora Murri
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, Málaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y la Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Heart Area Clinical Management Unit, Virgen de la Victoria University Hospital, Málaga, Spain
| |
Collapse
|
7
|
Galan-Lopez P, Casuso RA. Metabolic Adaptations to Morning Versus Afternoon Training: A Systematic Review and Meta-analysis. Sports Med 2023; 53:1951-1961. [PMID: 37458979 DOI: 10.1007/s40279-023-01879-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND Some physiological responses such as circulating glucose as well as muscle performance show a circadian rhythmicity. In the present study we aimed to quantitatively synthesize the data comparing the metabolic adaptations induced by morning and afternoon training. METHODS PubMed, SCOPUS, and Web of Science databases were systematically searched for studies comparing the metabolic adaptations (> 2 weeks) between morning and afternoon training. A meta-analysis was performed using random-effects models with DerSimonian-Laird methods for fasting blood glucose, hemoglobin A1c (HbAc1), homeostatic model assessment (HOMA), insulin, triglycerides, total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). RESULTS We identified 9 studies with 11 different populations (n = 450 participants). We found that afternoon exercise was more effective at reducing circulating triglycerides [standardized mean difference (SMD) - 0.32; 95% confidence interval (CI) - 0.616 to - 0.025] than morning training. Moreover, afternoon tended to decrease fasting blood glucose (SMD - 0.24; 95% CI - 0.478 to 0.004) to a greater extent than morning training. CONCLUSION Metabolic adaptations to exercise may be dependent on the time of day. Morning training does not show superior effects to afternoon exercise in any of the analyzed outcomes. However, afternoon training is more effective at reducing circulating triglyceride levels and perhaps at reducing fasting blood glucose than morning training. The study was preregistered at PROSPERO (CRD42021287860).
Collapse
Affiliation(s)
- Pablo Galan-Lopez
- Department of Communication and Education, Universidad Loyola Andalucía, Seville, Spain
| | - Rafael A Casuso
- Faculty of Health Sciences, Universidad Loyola Andalucía, Córdoba, Spain.
| |
Collapse
|
8
|
Qian J, Xiao Q, Walkup MP, Coday M, Erickson ML, Unick J, Jakicic JM, Hu K, Scheer FA, Middelbeek RJ. Association of Timing of Moderate-to-Vigorous Physical Activity With Changes in Glycemic Control Over 4 Years in Adults With Type 2 Diabetes From the Look AHEAD Trial. Diabetes Care 2023; 46:1417-1424. [PMID: 37226675 PMCID: PMC10300518 DOI: 10.2337/dc22-2413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/22/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVE We aimed to determine the association of the time-of-day of bout-related moderate-to-vigorous physical activity (bMVPA) with changes in glycemic control across 4 years in adults with overweight/obesity and type 2 diabetes. RESEARCH DESIGN AND METHODS Among 2,416 participants (57% women; mean age, 59 years) with 7-day waist-worn accelerometry recording at year 1 or 4, we assigned bMVPA timing groups based on the participants' temporal distribution of bMVPA at year 1 and recategorized them at year 4. The time-varying exposure of bMVPA (≥10-min bout) timing was defined as ≥50% of bMVPA occurring during the same time period (morning, midday, afternoon, or evening), <50% of bMVPA in any time period (mixed), and ≤1 day with bMVPA per week (inactive). RESULTS HbA1c reduction at year 1 varied among bMVPA timing groups (P = 0.02), independent of weekly bMVPA volume and intensity. The afternoon group had the greatest HbA1c reduction versus inactive (-0.22% [95%CI -0.39%, -0.06%]), the magnitude of which was 30-50% larger than the other groups. The odds of discontinuation versus maintaining or initiating glucose-lowering medications at year 1 differed by bMVPA timing (P = 0.04). The afternoon group had the highest odds (odds ratio 2.13 [95% CI 1.29, 3.52]). For all the year-4 bMVPA timing groups, there were no significant changes in HbA1c between year 1 and 4. CONCLUSIONS bMVPA performed in the afternoon is associated with improvements in glycemic control in adults with diabetes, especially within the initial 12 months of an intervention. Experimental studies are needed to examine causality.
Collapse
Affiliation(s)
- Jingyi Qian
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Qian Xiao
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX
| | | | - Mace Coday
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | | | - Jessica Unick
- Weight Control and Diabetes Research Center, Miriam Hospital, Providence, RI
| | - John M. Jakicic
- Division of Physical Activity and Weight Management, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Kun Hu
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Frank A.J.L. Scheer
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | | | | |
Collapse
|
9
|
Soares ALDS, Machado-Lima A, Brech GC, Greve JMD, Dos Santos JR, Inojossa TR, Rogero MM, Salles JEN, Santarem-Sobrinho JM, Davis CL, Alonso AC. The Influence of Whey Protein on Muscle Strength, Glycemic Control and Functional Tasks in Older Adults with Type 2 Diabetes Mellitus in a Resistance Exercise Program: Randomized and Triple Blind Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105891. [PMID: 37239618 DOI: 10.3390/ijerph20105891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/24/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVES To evaluate the effect of whey protein (WP) supplementation associated with resistance training (RT) on glycemic control, functional tasks, muscle strength, and body composition in older adults living with type 2 diabetes mellitus (T2DM). Secondly, to evaluate the safety of the protocol for renal function. METHODS The population comprised twenty-six older men living with T2DM (68.5 ± 11.5 years old). The participants were randomly assigned to the Protein Group (PG) and the Control Group (CG). The handgrip test and evolution of exercise loads, according to the Omni Resistance Exercise Scale, evaluated muscle strength. Functional tasks were assessed by force platform in three different protocols: Sit-to-Stand, Step/Quick Turn, and Step Up/Over. Body composition was evaluated by bioimpedance and glycemic control and renal function were assessed by biochemical analyses. Both groups performed RT for 12 weeks, twice a week, prioritizing large muscle groups. Protein supplementation was 20 g of whey protein isolate and the CG was supplemented with an isocaloric drink, containing 20 g of maltodextrin. RESULTS There was a significant difference in muscle strength, according to the evolution of the exercise loads, but it was not confirmed in the handgrip test. However, there was no significant difference between the groups, regarding performance in functional tasks, glycemic control, or body composition. Renal function showed no alteration. CONCLUSION The intake of 20 g of WP in older male adults living with T2DM did not increase the effect of RT on muscle strength, functional tasks, and glycemic control. The intervention was proven safe regarding renal function.
Collapse
Affiliation(s)
- André Luiz de Seixas Soares
- Program in Aging Sciences, Universidade São Judas Tadeu (USJT), São Paulo 03166-000, SP, Brazil
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Adriana Machado-Lima
- Program in Aging Sciences, Universidade São Judas Tadeu (USJT), São Paulo 03166-000, SP, Brazil
- Laboratory Study of Movement, Instituto de Ortopedia e Traumatologia do Hospital das Clínicas (IOT-HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo 05402-000, SP, Brazil
| | - Guilherme Carlos Brech
- Program in Aging Sciences, Universidade São Judas Tadeu (USJT), São Paulo 03166-000, SP, Brazil
- Laboratory Study of Movement, Instituto de Ortopedia e Traumatologia do Hospital das Clínicas (IOT-HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo 05402-000, SP, Brazil
| | - Júlia Maria D'Andréa Greve
- Laboratory Study of Movement, Instituto de Ortopedia e Traumatologia do Hospital das Clínicas (IOT-HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo 05402-000, SP, Brazil
| | - Joselma Rodrigues Dos Santos
- Laboratory Study of Movement, Instituto de Ortopedia e Traumatologia do Hospital das Clínicas (IOT-HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo 05402-000, SP, Brazil
| | - Thiago Resende Inojossa
- Laboratory Study of Movement, Instituto de Ortopedia e Traumatologia do Hospital das Clínicas (IOT-HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo 05402-000, SP, Brazil
| | - Marcelo Macedo Rogero
- Department of Nutrition, Faculty of Public Health, FMSUP, São Paulo 01151-000, SP, Brazil
| | - João Eduardo Nunes Salles
- Department of Internal Medicine, The Discipline of Endocrinology, Santa Casa of São Paulo Medical School, São Paulo 01224-001, SP, Brazil
| | | | - Catherine L Davis
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Angelica Castilho Alonso
- Program in Aging Sciences, Universidade São Judas Tadeu (USJT), São Paulo 03166-000, SP, Brazil
- Laboratory Study of Movement, Instituto de Ortopedia e Traumatologia do Hospital das Clínicas (IOT-HC), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo 05402-000, SP, Brazil
| |
Collapse
|
10
|
Bruggisser F, Knaier R, Roth R, Wang W, Qian J, Scheer FAJL. Best Time of Day for Strength and Endurance Training to Improve Health and Performance? A Systematic Review with Meta-analysis. SPORTS MEDICINE - OPEN 2023; 9:34. [PMID: 37208462 DOI: 10.1186/s40798-023-00577-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 04/30/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Current recommendations for physical exercise include information about the frequency, intensity, type, and duration of exercise. However, to date, there are no recommendations on what time of day one should exercise. The aim was to perform a systematic review with meta-analysis to investigate if the time of day of exercise training in intervention studies influences the degree of improvements in physical performance or health-related outcomes. METHODS The databases EMBASE, PubMed, Cochrane Library, and SPORTDiscus were searched from inception to January 2023. Eligibility criteria were that the studies conducted structured endurance and/or strength training with a minimum of two exercise sessions per week for at least 2 weeks and compared exercise training between at least two different times of the day using a randomized crossover or parallel group design. RESULTS From 14,125 screened articles, 26 articles were included in the systematic review of which seven were also included in the meta-analyses. Both the qualitative synthesis and the quantitative synthesis (i.e., meta-analysis) provide little evidence for or against the hypothesis that training at a specific time of day leads to more improvements in performance-related or health-related outcomes compared to other times. There was some evidence that there is a benefit when training and testing occur at the same time of day, mainly for performance-related outcomes. Overall, the risk of bias in most studies was high. CONCLUSIONS The current state of research provides evidence neither for nor against a specific time of the day being more beneficial, but provides evidence for larger effects when there is congruency between training and testing times. This review provides recommendations to improve the design and execution of future studies on this topic. REGISTRATION PROSPERO (CRD42021246468).
Collapse
Affiliation(s)
- Fabienne Bruggisser
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Raphael Knaier
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Department of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.
| | - Ralf Roth
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Wei Wang
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Division of Sleep and Circadian Disorders, Department of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Jingyi Qian
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Department of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Frank A J L Scheer
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Department of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.
| |
Collapse
|
11
|
Riddell MC, Turner LV, Patton SR. Is There an Optimal Time of Day for Exercise? A Commentary on When to Exercise for People Living With Type 1 or Type 2 Diabetes. Diabetes Spectr 2023; 36:146-150. [PMID: 37193212 PMCID: PMC10182965 DOI: 10.2337/dsi22-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Exercise is a cornerstone of diabetes self-care because of its association with many health benefits. Several studies that have explored the best time of day to exercise to inform clinical recommendations have yielded mixed results. For example, for people with prediabetes or type 2 diabetes, there may be benefits to timing exercise to occur after meals, whereas people with type 1 diabetes may benefit from performing exercise earlier in the day. One common thread is the health benefits of consistent exercise, suggesting that the issue of exercise timing may be secondary to the goal of helping people with diabetes establish an exercise routine that best fits their life.
Collapse
Affiliation(s)
- Michael C. Riddell
- School of Kinesiology and Health Science and Muscle Health Research Centre, York University, Toronto, Ontario, Canada
- Corresponding author: Michael C. Riddell,
| | - Lauren V. Turner
- School of Kinesiology and Health Science and Muscle Health Research Centre, York University, Toronto, Ontario, Canada
| | - Susana R. Patton
- Center for Healthcare Delivery Science, Nemours Children’s Specialty Clinic, Jacksonville, FL
| |
Collapse
|
12
|
Schumacher LM, Kalala S, Thomas JG, Raynor HA, Rhodes RE, Bond DS. Consistent exercise timing as a strategy to increase physical activity: A feasibility study. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2023; 8:e000227. [PMID: 38107165 PMCID: PMC10722958 DOI: 10.1249/tjx.0000000000000227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Introduction/Purpose Observational research suggests that consistent exercise timing could be leveraged to promote moderate-to-vigorous physical activity (MVPA) among adults with obesity. However, the feasibility and acceptability of prescribed consistent exercise timing in a free-living setting is unknown. The purpose of this study was to assess the feasibility and acceptability of prescribed consistent exercise timing in a free-living setting among inactive adults with obesity (primary) and to compare MVPA timing prescriptions and characterize exercise barriers/facilitators (secondary). Methods Using a within-subjects design, inactive adults with obesity (n=15) were randomized in counterbalanced order to three 3-wk exercise timing conditions separated by 2-wk washout periods: 1) consistent morning, 2) consistent evening, and 3) choice timing (control). Feasibility was assessed using prespecified benchmarks. Acceptability and preferred timing were assessed with questionnaires post-intervention. Secondarily, exercise timing and MVPA were assessed via accelerometry and nightly surveys and barriers/facilitators were assessed with nightly surveys. Results All feasibility benchmarks were achieved (e.g., timing adherence = 69.9% via accelerometry and 87.4% via self-report (target: ≥60%)). Consistent exercise timing was acceptable (mean rating = 3.7 of 5 (target: ≥3.5)). Choice was the most popular prescription. There were medium- to large-sized effects (partial η2 of 0.09-0.16) of condition on MVPA; MVPA was higher during the morning and evening conditions versus choice condition. Facilitators were similar across conditions, while some barriers were time specific. Conclusion Prescribed exercise timing in a free-living setting appears feasible and acceptable. While choice timing was most preferred, consistent timing appeared most effective for increasing MVPA. Data warrant larger trials to test the efficacy and mechanisms of consistent exercise timing as a translational strategy for promoting MVPA. Pending findings from a fully powered randomized trial, practitioners interested in promoting MVPA among their patients or clients could consider encouraging exercise at a consistent time day-to-day.
Collapse
Affiliation(s)
- Leah M. Schumacher
- Department of Kinesiology, College of Public Health, Temple University, Philadelphia, PA
| | - Siddhartha Kalala
- Weight Control & Diabetes Research Center, The Miriam Hospital, Providence, RI
| | - J. Graham Thomas
- Weight Control & Diabetes Research Center, The Miriam Hospital, Providence, RI
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI
| | - Hollie A. Raynor
- Department of Nutrition, The University of Tennessee Knoxville, Knoxville, TN
| | - Ryan E. Rhodes
- School of Exercise Science, Physical and Health Education University of Victoria, Victoria, BC, Canada
| | - Dale S. Bond
- Departments of Surgery and Research, Hartford Hospital/Hartford HealthCare, Hartford, CT
| |
Collapse
|
13
|
van der Velde JHPM, Boone SC, Winters-van Eekelen E, Hesselink MKC, Schrauwen-Hinderling VB, Schrauwen P, Lamb HJ, Rosendaal FR, de Mutsert R. Timing of physical activity in relation to liver fat content and insulin resistance. Diabetologia 2023; 66:461-471. [PMID: 36316401 PMCID: PMC9892088 DOI: 10.1007/s00125-022-05813-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/08/2022] [Indexed: 02/05/2023]
Abstract
AIMS/HYPOTHESIS We hypothesised that the insulin-sensitising effect of physical activity depends on the timing of the activity. Here, we examined cross-sectional associations of breaks in sedentary time and timing of physical activity with liver fat content and insulin resistance in a Dutch cohort. METHODS In 775 participants of the Netherlands Epidemiology of Obesity (NEO) study, we assessed sedentary time, breaks in sedentary time and different intensities of physical activity using activity sensors, and liver fat content by magnetic resonance spectroscopy (n=256). Participants were categorised as being most active in the morning (06:00-12:00 hours), afternoon (12:00-18:00 hours) or evening (18:00-00:00 hours) or as engaging in moderate-to-vigorous-physical activity (MVPA) evenly distributed throughout the day. Most active in a certain time block was defined as spending the majority (%) of total daily MVPA in that block. We examined associations between sedentary time, breaks and timing of MVPA with liver fat content and HOMA-IR using linear regression analyses, adjusted for demographic and lifestyle factors including total body fat. Associations of timing of MVPA were additionally adjusted for total MVPA. RESULTS The participants (42% men) had a mean (SD) age of 56 (4) years and a mean (SD) BMI of 26.2 (4.1) kg/m2. Total sedentary time was not associated with liver fat content or insulin resistance, whereas the amount of breaks in sedentary time was associated with higher liver fat content. Total MVPA (-5%/h [95% CI -10%/h, 0%/h]) and timing of MVPA were associated with reduced insulin resistance but not with liver fat content. Compared with participants who had an even distribution of MVPA throughout the day, insulin resistance was similar (-3% [95% CI -25%, 16%]) in those most active in morning, whereas it was reduced in participants who were most active in the afternoon (-18% [95% CI -33%, -2%]) or evening (-25% [95% CI -49%, -4%]). CONCLUSIONS/INTERPRETATION The number of daily breaks in sedentary time was not associated with lower liver fat content or reduced insulin resistance. Moderate-to-vigorous activity in the afternoon or evening was associated with a reduction of up to 25% in insulin resistance. Further studies should assess whether timing of physical activity is also important for the occurrence of type 2 diabetes.
Collapse
Affiliation(s)
| | - Sebastiaan C Boone
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Matthijs K C Hesselink
- Department of Nutrition and Movement Sciences, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Vera B Schrauwen-Hinderling
- Department of Nutrition and Movement Sciences, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Patrick Schrauwen
- Department of Nutrition and Movement Sciences, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Hildo J Lamb
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|
14
|
Exercise-induced responses in matrix metalloproteinases and osteopontin are not moderated by exercise format in males with overweight or obesity. Eur J Appl Physiol 2023; 123:1115-1124. [PMID: 36648516 PMCID: PMC10119240 DOI: 10.1007/s00421-023-05133-3] [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: 07/02/2022] [Accepted: 01/01/2023] [Indexed: 01/18/2023]
Abstract
PURPOSE Matrix metalloproteinase-2 (MMP-2) and -3 (MMP-3), and osteopontin (OPN) are associated with adipose-tissue expansion and development of metabolic disease. The purpose of the current study was to assess the circulating concentration of these markers, along with adiponectin and glucose concentrations, in response to acute exercise in individuals with overweight or obesity. METHODS Fourteen sedentary males with overweight or obesity (29.0 ± 3.1 kg/m2) completed two separate, 3-day trials in randomised and counterbalanced order. An oral glucose tolerance test (OGTT) was performed on each day of the trial. Day two of each trial consisted of a single 30 min workload-matched bout of either high-intensity interval exercise (HIIE; alternating 100% and 50% of peak pulmonary oxygen uptake, [Formula: see text]O2peak) or continuous moderate intensity (CME; 60% [Formula: see text]O2peak) cycling completed 1 h prior to the OGTT. Glucose and physical activity were continuously monitored, while MMP-2, MMP-3, OPN and adiponectin were measured pre-, 0 h post-, 1 h post- and 25 h post-exercise. RESULTS Exercise transiently increased MMP-3 and decreased OPN (both p < 0.01), but not MMP-2 or adiponectin. There were no differences in the response of inflammatory markers to the different exercise formats. Exercise increased mean daily glucose concentration and area under the glucose curve during the OGTT on Day 2 and Day 3 (main effect of time; p < 0.05). CONCLUSION Acute cycling exercise decreased OPN, which is consistent with longer term improvements in cardiometabolic health and increased MMP-3, which is consistent with its role in tissue remodelling. Interestingly, exercise performed prior to the morning OGTT augmented the glucose concentrations in males. TRIAL REGISTRATION ACTRN12613001086752.
Collapse
|
15
|
Brooker PG, Gomersall SR, King NA, Leveritt MD. The efficacy of morning versus evening exercise for weight loss: A randomized controlled trial. Obesity (Silver Spring) 2023; 31:83-95. [PMID: 36502286 PMCID: PMC10108225 DOI: 10.1002/oby.23605] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/20/2022] [Accepted: 09/13/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the influence of morning versus evening exercise on weight loss, cardiometabolic health, and components of energy balance. METHODS A total of 100 inactive adults with overweight or obesity were randomized to morning exercise (AMEx; 06:00-09:00), evening exercise (PMEx; 16:00-19:00), or wait-list control (CON). AMEx and PMEx were prescribed 250 min·wk-1 of self-paced aerobic exercise for 12 weeks. Anthropometry and body composition, physical activity, and dietary intake were assessed at baseline, 6 weeks, and 12 weeks. Cardiorespiratory fitness (V̇O2 peak), resting metabolic rate, and blood markers were assessed at baseline and 12 weeks. Body composition and V̇O2 peak were also measured at 3- and 6-month follow-up. RESULTS AMEx and PMEx lost weight during the intervention (mean [SD], AMEx, -2.7 [2.5] kg, p < 0.001; PMEx, -3.1 [3.4] kg, p < 0.001). V̇O2 peak significantly increased in both intervention groups, and these changes were different from CON (AMEx, +4.7 mL·kg-1 ·min-1 , p = 0.034; PMEx, +4.2 mL·kg-1 ·min-1 , p = 0.045). There were no between-group differences for resting metabolic rate or physical activity. At 12 weeks, total energy intake was significantly reduced in both AMEx and PMEx versus CON (AMEx, -3974 kJ, p < 0.001; PMEx, -3165 kJ, p = 0.001). CONCLUSIONS Adults with overweight and obesity experience modest weight loss in response to an exercise program, but there does not appear to be an optimal time to exercise.
Collapse
Affiliation(s)
- Paige G Brooker
- School of Human Movement and Nutrition Sciences, Faculty of Health & Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Sjaan R Gomersall
- School of Human Movement and Nutrition Sciences, Faculty of Health & Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
- School of Health & Rehabilitation Sciences, Faculty of Health & Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Neil A King
- School of Exercise & Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Michael D Leveritt
- School of Human Movement and Nutrition Sciences, Faculty of Health & Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
16
|
Abstract
Circadian rhythms drive our daily behaviors to coincide with the earth's rotation on an approximate 24-h cycle. The circadian clock mechanism present in nearly every cell is responsible for our circadian rhythms and is comprised of a transcriptional-translational feedback loop in mammals. The central clock resides in the hypothalamus responding to external light cues, whereas peripheral clocks receive signals from the central clock and are also sensitive to cues from feeding and activity. Of the peripheral clocks, the skeletal muscle clock is particularly sensitive to exercise which has shown to be an important time-cue with the ability to influence and adjust the muscle clock phase in response to exercise timing. Since the skeletal muscle clock is also involved in the expression of tissue-specific gene expression-including glucoregulatory genes-this might suggest a role for exercise timing as a therapeutic strategy in metabolic diseases, like type 2 diabetes. Notably, those with type 2 diabetes have accompanied disruptions in their skeletal muscle clock mechanism which may also be related to the increased risk of type 2 diabetes seen among shift workers. Therefore, the direct influence of exercise on the skeletal muscle clock might support the use of exercise timing to provide disease-mitigating effects. Here, we highlight the potential use of time-of-day exercise as a chronotherapeutic tool within circadian medicine to improve the metabolic profile of type 2 diabetes and support long-term glycemic control, potentially working through the skeletal muscle clock and circadian physiology.
Collapse
Affiliation(s)
- Ryan A. Martin
- Department of Physiology and Functional Genomics, University of Florida, Gainesville, Florida, USA
- Myology Institute, University of Florida, Gainesville, Florida, USA
| | - Karyn A. Esser
- Department of Physiology and Functional Genomics, University of Florida, Gainesville, Florida, USA
- Myology Institute, University of Florida, Gainesville, Florida, USA
| |
Collapse
|
17
|
Liu H, Liu S, Wang K, Zhang T, Yin L, Liang J, Yang Y, Luo J. Time-Dependent Effects of Physical Activity on Cardiovascular Risk Factors in Adults: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14194. [PMID: 36361072 PMCID: PMC9655086 DOI: 10.3390/ijerph192114194] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/22/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Physical activity is an important non-drug-related method to prevent and treat cardiovascular diseases, but how exercise duration affects the cardiovascular metabolic risk factors in adults remains uncertain. This review systematically examines the time-dependent effects of physical activity on cardiovascular risk factors in adults and aims to further the understanding of the temporal therapeutics of exercise. METHODS Following the PRISMA guidelines, the PubMed, Web of Science, EMBASE, and CNKI databases were systematically searched for relevant scientific studies from January 2000 to June 2022. RESULTS A total of 16 studies met the inclusion criteria and were included in the systematic review. The sample size ranged from 11-275 participants who were diagnosed with obesity, hypertension, diabetes mellitus type 2 (T2DM), and Coronary Heart Disease (CAD), while the subjects in four studies did not report any metabolic or cardiovascular disease. Four studies conducted trials of acute exercise interventions, while the remaining intervention periods ranged from 12 days to 12 weeks. The exercise interventions included aerobic training, resistance training, aerobic training that was combined with resistance training, compound exercise, and high-intensity interval exercise, and the training frequency varied from 2-5 times/week. CONCLUSIONS Overall, this review found some evidence that the cardiovascular risk factors in adults may be time-dependent in response to physical activity. However, it is limited by the small sample size for each of the outcomes and several methodological issues, leading to poor comparability between studies. A randomized controlled trial with a larger sample size is supposed to be designed for the relevant population to completely test whether synchronizing the exercise time point in the day with the individual's circadian rhythm can amplify the benefits of the exercise for improving cardiovascular health.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Jiong Luo
- Correspondence: ; Tel.: +86-131-0899-1439
| |
Collapse
|
18
|
Menek MY, Budak M. Effect of exercises according to the circadian rhythm in type 2 diabetes: Parallel-group, single-blind, crossover study. Nutr Metab Cardiovasc Dis 2022; 32:1742-1752. [PMID: 35606229 DOI: 10.1016/j.numecd.2022.04.017] [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: 11/06/2021] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIM To evaluate the effectiveness of structured exercise appropriate the circadian rhythm in terms of blood sample test (BST), functionality and quality of life (QoL) in individuals with type 2 diabetes. METHODS AND RESULTS This was a parallel-group, single-blind, crossover study. Thirty individuals with type 2 diabetes aged 35-65 years were enrolled in the study and allocated into 2 groups as the Morning Chronotype (MC) Group (n = 15) and the Evening Chronotype (EC) Group (n = 15) using Morningness-Eveningness Questionnaire which was used to determine the chronotypes. Participants were evaluated in terms of BST, functionality and QoL at the beginning of the study (T0), at 6 (T1), 12 (T2), and 18 (T3) weeks after the study started. A structured exercise program for 3 days a week over 6 weeks was applied in accordance with the chronotypes (T1-T2) and cross-controlled for the chronotypes (T2-T3). Significant differences were found in favor of the exercise given at the appropriate time for the chronotype in all parameters in both groups within groups (T0-T1-T2-T3) (p < 0.05). In the time∗group interactions, exercise in accordance with the appropriate chronotype in both groups provided the highest statistical improvement in all parameters (p < 0.05). CONCLUSION It was concluded that structured exercise performed at the appropriate time for chronotype improves HbA1c, fasting blood glucose, HDL-LDL cholesterol, triglyceride, total cholesterol, functionality and quality of life in type 2 diabetes. This variation in blood values was observed to reflect the quantitative effects of exercise administered according to the circadian rhythm in individuals with type 2 diabetes. TRIAL REGISTRATION ClinicalTrials.gov (NCT04427488). The protocol of the study was registered at ClinicalTrials.gov (NCT04427488).
Collapse
Affiliation(s)
- Merve Yilmaz Menek
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Istanbul Medipol University, Istanbul, Turkey.
| | - Miray Budak
- Department of Ergotherapy, Faculty of Health Science, Istanbul Medipol University, Istanbul, Turkey.
| |
Collapse
|
19
|
Brito LC, Marin TC, Azevêdo L, Rosa-Silva JM, Shea SA, Thosar SS. Chronobiology of Exercise: Evaluating the Best Time to Exercise for Greater Cardiovascular and Metabolic Benefits. Compr Physiol 2022; 12:3621-3639. [PMID: 35766829 DOI: 10.1002/cphy.c210036] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Physiological function fluctuates across 24 h due to ongoing daily patterns of behaviors and environmental changes, including the sleep/wake, rest/activity, light/dark, and daily temperature cycles. The internal circadian system prepares the body for these anticipated behavioral and environmental changes, helping to orchestrate optimal cardiovascular and metabolic responses to these daily changes. In addition, circadian disruption, caused principally by exposure to artificial light at night (e.g., as occurs with night-shift work), increases the risk for both cardiovascular and metabolic morbidity and mortality. Regular exercise is a countermeasure against cardiovascular and metabolic risk, and recent findings suggest that the cardiovascular benefits on blood pressure and autonomic control are greater with evening exercise compared to morning exercise. Moreover, exercise can also reset the timing of the circadian system, which raises the possibility that appropriate timing of exercise could be used to counteract circadian disruption. This article introduces the overall functional relevance of the human circadian system and presents the evidence surrounding the concepts that the time of day that exercise is performed can modulate the cardiovascular and metabolic benefits. Further work is needed to establish exercise as a tool to appropriately reset the circadian system following circadian misalignment to preserve cardiovascular and metabolic health. © 2022 American Physiological Society. Compr Physiol 12:3621-3639, 2022.
Collapse
Affiliation(s)
- Leandro C Brito
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil.,Chronobiology Applied & Exercise Physiology Research Group, School of Arts, Science and Humanities, University of São Paulo, São Paulo, São Paulo, Brazil.,Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, Oregon, USA
| | - Thais C Marin
- Chronobiology Applied & Exercise Physiology Research Group, School of Arts, Science and Humanities, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Luan Azevêdo
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Julia M Rosa-Silva
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Steven A Shea
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, Oregon, USA.,OHSU-PSU School of Public Health Oregon Health & Science University, Portland, Oregon, USA
| | - Saurabh S Thosar
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, Oregon, USA.,OHSU-PSU School of Public Health Oregon Health & Science University, Portland, Oregon, USA.,School of Nursing, Oregon Health & Science University, Portland, Oregon, USA.,Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA
| |
Collapse
|
20
|
Arciero PJ, Ives SJ, Mohr AE, Robinson N, Escudero D, Robinson J, Rose K, Minicucci O, O'Brien G, Curran K, Miller VJ, He F, Norton C, Paul M, Sheridan C, Beard S, Centore J, Dudar M, Ehnstrom K, Hoyte D, Mak H, Yarde A. Morning Exercise Reduces Abdominal Fat and Blood Pressure in Women; Evening Exercise Increases Muscular Performance in Women and Lowers Blood Pressure in Men. Front Physiol 2022; 13:893783. [PMID: 35711313 PMCID: PMC9194552 DOI: 10.3389/fphys.2022.893783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/02/2022] [Indexed: 12/25/2022] Open
Abstract
The ideal exercise time of day (ETOD) remains elusive regarding simultaneous effects on health and performance outcomes, especially in women. Purpose: Given known sex differences in response to exercise training, this study quantified health and performance outcomes in separate cohorts of women and men adhering to different ETOD. Methods: Thirty exercise-trained women (BMI = 24 ± 3 kg/m2; 42 ± 8 years) and twenty-six men (BMI = 25.5 ± 3 kg/m2; 45 ± 8 years) were randomized to multimodal ETOD in the morning (0600–0800 h, AM) or evening (1830–2030 h, PM) for 12 weeks and analyzed as separate cohorts. Baseline (week 0) and post (week 12) muscular strength (1-RM bench/leg press), endurance (sit-ups/push-ups) and power (squat jumps, SJ; bench throws, BT), body composition (iDXA; fat mass, FM; abdominal fat, Abfat), systolic/diastolic blood pressure (BP), respiratory exchange ratio (RER), profile of mood states (POMS), and dietary intake were assessed. Results: Twenty-seven women and twenty men completed the 12-week intervention. No differences at baseline existed between groups (AM vs PM) for both women and men cohorts. In women, significant interactions (p < 0.05) existed for 1RM bench (8 ± 2 vs 12 ± 2, ∆kg), pushups (9 ± 1 vs 13 ± 2, ∆reps), BT (10 ± 6 vs 45 ± 28, ∆watts), SJ (135 ± 6 vs 39 ± 8, ∆watts), fat mass (−1.0 ± 0.2 vs −0.3 ± 0.2, ∆kg), Abfat (−2.6 ± 0.3 vs −0.9 ± 0.5, ∆kg), diastolic (−10 ± 1 vs−5 ± 5, ∆mmHg) and systolic (−12.5 ± 2.7 vs 2.3 ± 3, mmHg) BP, AM vs PM, respectively. In men, significant interactions (p < 0.05) existed for systolic BP (−3.5 ± 2.6 vs −14.9 ± 5.1, ∆mmHg), RER (−0.01 ± 0.01 vs −0.06 ± 0.01, ∆VCO2/VO2), and fatigue (−0.8 ± 2 vs −5.9 ± 2, ∆mm), AM vs PM, respectively. Macronutrient intake was similar among AM and PM groups. Conclusion: Morning exercise (AM) reduced abdominal fat and blood pressure and evening exercise (PM) enhanced muscular performance in the women cohort. In the men cohort, PM increased fat oxidation and reduced systolic BP and fatigue. Thus, ETOD may be important to optimize individual exercise-induced health and performance outcomes in physically active individuals and may be independent of macronutrient intake.
Collapse
Affiliation(s)
- Paul J Arciero
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Stephen J Ives
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Alex E Mohr
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Nathaniel Robinson
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Daniela Escudero
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Jake Robinson
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Kayla Rose
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Olivia Minicucci
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Gabriel O'Brien
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Kathryn Curran
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Vincent J Miller
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Feng He
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States.,Department of Kinesiology, California State University, Chico, CA, United States
| | - Chelsea Norton
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Maia Paul
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Caitlin Sheridan
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Sheriden Beard
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Jessica Centore
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Monique Dudar
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Katy Ehnstrom
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Dakembay Hoyte
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Heather Mak
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| | - Aaliyah Yarde
- Human Nutrition and Metabolism Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, United States
| |
Collapse
|
21
|
Hetherington-Rauth M, Magalhães JP, Rosa GB, Correia IR, Carneiro T, Oliveira EC, Sardinha LB. Morning versus afternoon physical activity and health-related outcomes in individuals with type 2 diabetes. Diabetes Obes Metab 2022; 24:1172-1175. [PMID: 35212107 DOI: 10.1111/dom.14676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/10/2022] [Accepted: 02/20/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Megan Hetherington-Rauth
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - João P Magalhães
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Gil B Rosa
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Inês R Correia
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Tomás Carneiro
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Estela C Oliveira
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| |
Collapse
|
22
|
Chang CR, Astell-Burt T, Russell BM, Francois ME. Personalising activity to target peak hyperglycaemia and improve cardiometabolic health in people with type 2 diabetes: protocol for a randomised controlled trial. BMJ Open 2022; 12:e057183. [PMID: 35351723 PMCID: PMC8966572 DOI: 10.1136/bmjopen-2021-057183] [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] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The benefits of physical activity for glycaemic control in type 2 diabetes (T2D) are well-known. However, whether established glycaemic and cardiovascular benefits can be maximised by exercising at a certain time of day is unknown. Given postprandial glucose peaks contribute to worsening glycated haemoglobin (HbA1c) and cardiovascular risk factors, and that exercise immediately lowers blood glucose, prescribing exercise at a specific time of day to attenuate peak hyperglycaemia may improve glycaemic control and reduce the burden of cardiovascular disease in people with T2D. METHODS AND ANALYSIS A single-centre randomised controlled trial will be conducted by the University of Wollongong, Australia. Individuals with T2D (n=70, aged 40-75 years, body mass index (BMI): 27-40 kg/m2) will be recruited and randomly allocated (1:1), stratified for sex and insulin, to one of three groups: (1) exercise at time of peak hyperglycaemia (ExPeak, personalised), (2) exercise not at time of peak hyperglycaemia (NonPeak) or (3) waitlist control (WLC, standard care). The trial will be 5 months, comprising an 8-week intervention and 3-month follow-up. Primary outcome is the change in HbA1c preintervention to postintervention. Secondary outcomes include vascular function (endothelial function and arterial stiffness), metabolic control (blood lipids and inflammation) and body composition (anthropometrics and dual-energy X-ray absorptiometry (DEXA)). Tertiary outcomes will examine adherence. ETHICS AND DISSEMINATION The joint UOW and ISLHD Ethics Committee approved protocol (2019/ETH09856) prospectively registered at the Australian New Zealand Clinical Trials Registry. Written informed consent will be obtained from all eligible individuals prior to commencement of the trial. Study results will be published as peer-reviewed articles, presented at national/international conferences and media reports. TRIAL REGISTRATION NUMBER ACTRN12619001049167.
Collapse
Affiliation(s)
- Courtney R Chang
- School of Medicine, Faculty of Science, Medicine and Health,University of Wollongong, Wollongong, New South Wales, Australia
| | - Thomas Astell-Burt
- Faculty of Health and Behavioural Sciences, School of Science and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Brooke M Russell
- School of Medicine, Faculty of Science, Medicine and Health,University of Wollongong, Wollongong, New South Wales, Australia
| | - Monique E Francois
- School of Medicine, Faculty of Science, Medicine and Health,University of Wollongong, Wollongong, New South Wales, Australia
| |
Collapse
|
23
|
Zhu W. Exercise is medicine for type 2 diabetes: An interview with Dr. Sheri R. Colberg. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:179-183. [PMID: 35066215 PMCID: PMC9068737 DOI: 10.1016/j.jshs.2022.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/14/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Weimo Zhu
- Shanghai University of Sport, Shanghai 200438, China; Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
| |
Collapse
|
24
|
Hu S, Wang S, Qi C, Gu S, Shi C, Mao L, Fan G. Cost-Utility Analysis of Once-Weekly Semaglutide, Dulaglutide, and Exenatide for Type 2 Diabetes Patients Receiving Metformin-Based Background Therapy in China. Front Pharmacol 2022; 13:831364. [PMID: 35250578 PMCID: PMC8894868 DOI: 10.3389/fphar.2022.831364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/31/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction: The substantial financial burden associated with type 2 diabetes (T2D) over a lifetime cannot be neglected. Therefore, the objective of this study was to evaluate the pharmacoeconomic value of three once-weekly GLP-1 RAs, namely subcutaneous semaglutide (sc. SEMA), dulaglutide (DULA), and extended-release exenatide (e-r EXEN), in treating patients with T2D that cannot be controlled with metformin-based background therapy, and to find a suitable price reduction for non-cost-effective medications, to provide reasonable recommendations to the administration for adjusting drug prices. Methods: The baseline characteristics of the simulation patient cohort were sourced from a comprehensive meta-analysis synthesizing 453 trials evaluating 21 hypoglycemic agents from nine categories of drugs. The UKPDS OM2 was applied to project the long-term effectiveness and costs from a Chinese health care provider’s perspective. After cost-utility analysis, the reasonable price adjustment of non-cost-effective options was explored via binary search. Uncertainty was measured by means of sensitivity analysis. Results: After a 40-year simulation, the sc. SEMA, DULA, and e-r EXEN groups yielded 9.6315, 9.5968, and 9.5895 quality-adjusted life years (QALYs), respectively. In terms of expenditure, the total costs for the sc. SEMA, DULA, and e-r EXEN groups were $42012.47, $24931.27, and $40264.80, respectively. DULA was dominant over e-r EXEN due to the higher QALYs and lower total costs. The ICURs of sc. SEMA vs. DULA and sc. SEMA vs. e-r EXEN were $492994.72/QALY and $41622.69/QALY (ICUR > λ), respectively, indicating that sc. SEMA was not more cost-effective than DULA or e-r EXEN. The INMB and absolute NMB yielded the same conclusions which were robust to one-way, scenario, and probabilistic sensitivity analyses. After several assumptions in the binary search, sc. SEMA and e-r EXEN appear to become cost-effective when their annual costs are decreased by 57.67% and 70.34%, respectively, with DULA as a counterpart. Conclusion: From the cost-utility analysis, DULA appears to be the most cost-effective option among sc. SEMA, DULA, and e-r EXEN for the treatment of patients with T2D receiving metformin-based background therapy. With a 57.67% or 70.34% reduction in cost, sc. SEMA or e-r EXEN, respectively, would become as cost-effective as DULA in China.
Collapse
|
25
|
Creasy SA, Wayland L, Panter SL, Purcell SA, Rosenberg R, Willis EA, Shiferaw B, Grau L, Breit MJ, Bessesen DH, Melanson EL, Catenacci VA. Effect of Morning and Evening Exercise on Energy Balance: A Pilot Study. Nutrients 2022; 14:816. [PMID: 35215466 PMCID: PMC8877501 DOI: 10.3390/nu14040816] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/09/2022] [Accepted: 02/11/2022] [Indexed: 12/14/2022] Open
Abstract
The purpose of this study was to evaluate the feasibility and acceptability of randomizing adults with overweight and obesity (BMI 25-40 kg/m2) to morning (06:00-10:00) or evening (15:00-19:00) aerobic exercise. Participants completed four exercise sessions per week in the morning (AM, n = 18) or evening (PM, n = 15). The exercise program was 15 weeks and progressed from 70 to 80% heart rate maximum and 750-2000 kcal/week. Bodyweight, body composition, total daily energy expenditure (TDEE), energy intake (EI), sleep, sedentary behavior (SB), non-exercise physical activity (NEPA), and maximal aerobic capacity were assessed at baseline and week 15. Study retention was 94% and adherence to the supervised exercise program was ≥90% in both groups. Weight change was -0.9 ± 2.8 kg and -1.4 ± 2.3 kg in AM and PM, respectively. AM and PM increased TDEE (AM: 222 ± 399 kcal/day, PM: 90 ± 150 kcal/day). EI increased in AM (99 ± 198 kcal/day) and decreased in PM (-21 ± 156 kcal/day) across the intervention. It is feasible to randomize adults with overweight and obesity to morning or evening aerobic exercise with high levels of adherence. Future trials are needed to understand how the timing of exercise affects energy balance and body weight regulation.
Collapse
Affiliation(s)
- Seth A. Creasy
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (S.L.P.); (S.A.P.); (R.R.); (M.J.B.); (D.H.B.); (E.L.M.); (V.A.C.)
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - Liza Wayland
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - Shelby L. Panter
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (S.L.P.); (S.A.P.); (R.R.); (M.J.B.); (D.H.B.); (E.L.M.); (V.A.C.)
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - Sarah A. Purcell
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (S.L.P.); (S.A.P.); (R.R.); (M.J.B.); (D.H.B.); (E.L.M.); (V.A.C.)
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - Rebecca Rosenberg
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (S.L.P.); (S.A.P.); (R.R.); (M.J.B.); (D.H.B.); (E.L.M.); (V.A.C.)
| | - Erik A. Willis
- Center for Health Promotion Disease Prevention, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, USA;
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, USA
| | - Bethelhem Shiferaw
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (B.S.); (L.G.)
| | - Laura Grau
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (B.S.); (L.G.)
| | - Matthew J. Breit
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (S.L.P.); (S.A.P.); (R.R.); (M.J.B.); (D.H.B.); (E.L.M.); (V.A.C.)
| | - Daniel H. Bessesen
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (S.L.P.); (S.A.P.); (R.R.); (M.J.B.); (D.H.B.); (E.L.M.); (V.A.C.)
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
- Division of Endocrinology, Denver Health Medical Center, Denver, CO 80204, USA
| | - Edward L. Melanson
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (S.L.P.); (S.A.P.); (R.R.); (M.J.B.); (D.H.B.); (E.L.M.); (V.A.C.)
- Eastern Colorado VA Geriatric Research, Education, and Clinical Center, Aurora, CO 80045, USA
- Division of Geriatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Victoria A. Catenacci
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (S.L.P.); (S.A.P.); (R.R.); (M.J.B.); (D.H.B.); (E.L.M.); (V.A.C.)
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| |
Collapse
|
26
|
Kanaley JA, Colberg SR, Corcoran MH, Malin SK, Rodriguez NR, Crespo CJ, Kirwan JP, Zierath JR. Exercise/Physical Activity in Individuals with Type 2 Diabetes: A Consensus Statement from the American College of Sports Medicine. Med Sci Sports Exerc 2022; 54:353-368. [PMID: 35029593 PMCID: PMC8802999 DOI: 10.1249/mss.0000000000002800] [Citation(s) in RCA: 188] [Impact Index Per Article: 94.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
ABSTRACT This consensus statement is an update of the 2010 American College of Sports Medicine position stand on exercise and type 2 diabetes. Since then, a substantial amount of research on select topics in exercise in individuals of various ages with type 2 diabetes has been published while diabetes prevalence has continued to expand worldwide. This consensus statement provides a brief summary of the current evidence and extends and updates the prior recommendations. The document has been expanded to include physical activity, a broader, more comprehensive definition of human movement than planned exercise, and reducing sedentary time. Various types of physical activity enhance health and glycemic management in people with type 2 diabetes, including flexibility and balance exercise, and the importance of each recommended type or mode are discussed. In general, the 2018 Physical Activity Guidelines for Americans apply to all individuals with type 2 diabetes, with a few exceptions and modifications. People with type 2 diabetes should engage in physical activity regularly and be encouraged to reduce sedentary time and break up sitting time with frequent activity breaks. Any activities undertaken with acute and chronic health complications related to diabetes may require accommodations to ensure safe and effective participation. Other topics addressed are exercise timing to maximize its glucose-lowering effects and barriers to and inequities in physical activity adoption and maintenance.
Collapse
Affiliation(s)
- Jill A Kanaley
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO
| | - Sheri R Colberg
- Human Movement Sciences Department, Old Dominion University, Norfolk, VA
| | | | - Steven K Malin
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ
| | - Nancy R Rodriguez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT
| | - Carlos J Crespo
- Oregon Health and Science University-Portland State University School of Public Health, Portland, OR
| | - John P Kirwan
- Pennington Biomedical Research Center, Baton Rouge, LA
| | - Juleen R Zierath
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, SWEDEN
| |
Collapse
|
27
|
McClean C, Davison GW. Circadian Clocks, Redox Homeostasis, and Exercise: Time to Connect the Dots? Antioxidants (Basel) 2022; 11:antiox11020256. [PMID: 35204138 PMCID: PMC8868136 DOI: 10.3390/antiox11020256] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/11/2022] [Accepted: 01/18/2022] [Indexed: 12/14/2022] Open
Abstract
Compelling research has documented how the circadian system is essential for the maintenance of several key biological processes including homeostasis, cardiovascular control, and glucose metabolism. Circadian clock disruptions, or losses of rhythmicity, have been implicated in the development of several diseases, premature ageing, and are regarded as health risks. Redox reactions involving reactive oxygen and nitrogen species (RONS) regulate several physiological functions such as cell signalling and the immune response. However, oxidative stress is associated with the pathological effects of RONS, resulting in a loss of cell signalling and damaging modifications to important molecules such as DNA. Direct connections have been established between circadian rhythms and oxidative stress on the basis that disruptions to circadian rhythms can affect redox biology, and vice versa, in a bi-directional relationship. For instance, the expression and activity of several key antioxidant enzymes (SOD, GPx, and CAT) appear to follow circadian patterns. Consequently, the ability to unravel these interactions has opened an exciting area of redox biology. Exercise exerts numerous benefits to health and, as a potent environmental cue, has the capacity to adjust disrupted circadian systems. In fact, the response to a given exercise stimulus may also exhibit circadian variation. At the same time, the relationship between exercise, RONS, and oxidative stress has also been scrutinised, whereby it is clear that exercise-induced RONS can elicit both helpful and potentially harmful health effects that are dependent on the type, intensity, and duration of exercise. To date, it appears that the emerging interface between circadian rhythmicity and oxidative stress/redox metabolism has not been explored in relation to exercise. This review aims to summarise the evidence supporting the conceptual link between the circadian clock, oxidative stress/redox homeostasis, and exercise stimuli. We believe carefully designed investigations of this nexus are required, which could be harnessed to tackle theories concerned with, for example, the existence of an optimal time to exercise to accrue physiological benefits.
Collapse
|
28
|
Kim HK, Furuhashi S, Takahashi M, Chijiki H, Nanba T, Inami T, Radak Z, Sakamoto S, Shibata S. Late-afternoon endurance exercise is more effective than morning endurance exercise at improving 24-h glucose and blood lipid levels. Front Endocrinol (Lausanne) 2022; 13:957239. [PMID: 35928886 PMCID: PMC9343590 DOI: 10.3389/fendo.2022.957239] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Glucose and lipid tolerance reportedly exhibit diurnal variations, being lower in the evening than in the morning. Therefore, the effects of exercise on glucose and blood lipid levels at different times of the day may differ. This study aimed to investigate the effects of short-term endurance exercise intervention in the morning versus late afternoon on 24-h blood glucose variability and blood lipid levels. METHODS Twelve healthy young men participated in a randomized crossover trial. The participants were assigned to morning (09:00-11:00) or late afternoon (16:00-18:00) endurance exercise for a week, consisting of supervised exercise sessions on Mondays, Wednesdays, and Fridays. In the morning and evening trials, the participants walked for 60 min on a treadmill at approximately 60% of maximal oxygen uptake (VO2max). Following a 2-week wash-out period, the participants performed the exercise training regimen at another time point. Continuous glucose monitoring was used to evaluate blood glucose fluctuations during each 24-h trial period. Blood samples were collected before and after each intervention to examine blood lipid and hormonal responses. RESULTS Examination of the area under the curve (AUC) of the glucose level changes for 24 h after the late afternoon versus morning exercise intervention revealed significantly lower values for the former versus the latter (P < 0.01). The AUC of glucose level changes after each meal was also lower after the late afternoon versus morning intervention, and significantly lower values were observed in the late afternoon versus morning trial for breakfast and dinner (P < 0.05, P < 0.01). In addition, a significant decrease in triglycerides (TG) and TG/high-density lipoprotein cholesterol (HDL-C) was noted after versus before the late afternoon intervention (P < 0.05). CONCLUSIONS These results suggest that late afternoon endurance exercise is more effective than morning endurance exercise at improving 24-h glucose and triglyceride levels.
Collapse
Affiliation(s)
- Hyeon-Ki Kim
- Faculty of Science and Engineering, Waseda University, Tokyo, Japan
- Institute of Physical Education, Keio University, Yokohama, Japan
- *Correspondence: Hyeon-Ki Kim,
| | - Shota Furuhashi
- Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
| | - Masaki Takahashi
- Institute for Liberal Arts, Tokyo Institute of Technology, Tokyo, Japan
| | - Hanako Chijiki
- Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
| | - Takuya Nanba
- Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
| | - Takayuki Inami
- Institute of Physical Education, Keio University, Yokohama, Japan
| | - Zsolt Radak
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- Research Center for Molecular Exercise Science, University of Physical Education, Budapest, Hungary
| | - Shizuo Sakamoto
- Faculty of Sport Sciences, Surugadai University, Saitama, Japan
| | | |
Collapse
|
29
|
Ma T, Xie YJ, Bennett T, Lee CD. Time-of-day moderate-to-vigorous physical activity and all-cause mortality in individuals with type 2 diabetes. J Sports Sci 2021; 40:614-620. [PMID: 34818995 DOI: 10.1080/02640414.2021.2009163] [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: 10/19/2022]
Abstract
There is no clear evidence for the best time of day for physical activity in benefitting health among individuals with type 2 diabetes. This study was aimed to examine whether there is an optimal time of day for physical activity to increase longevity. In this cohort study of 904 patients with type 2 diabetes, we fitted a Cox model with restricted cubic spline to examine the association of moderate-to-vigorous physical activity (MVPA) and time of day with all-cause mortality. Compositional data analysis was used to examine the association of time spent in sedentary behaviour (SB), light-intensity physical activity (LIPA), morning MVPA, and evening MVPA with all-cause mortality. MVPA was inversely associated with all-cause mortality in a curvilinear manner (P-value for nonlinearity<0.0001). The interaction between MVPA and time of day was not significant (P-value for interaction=0.11). Substituting evening MVPA with morning MVPA was not associated with appreciable changes in all-cause mortality. There is no evidence that the time of day moderates the association of MVPA with all-cause mortality. Patients with higher levels of MVPA had lower mortality regardless of the timing of MVPA. Patients with type 2 diabetes should engage in regular physical activity whenever possible.
Collapse
Affiliation(s)
- Tongyu Ma
- Health Sciences Department, Franklin Pierce University, Rindge, NH, USA
| | - Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Thomas Bennett
- Health Sciences Department, Franklin Pierce University, Rindge, NH, USA
| | - Chong-Do Lee
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| |
Collapse
|
30
|
Coletta AM, Playdon MC, Baron KG, Wei M, Kelley K, Vaklavas C, Beck A, Buys SS, Chipman J, Ulrich CM, Walker D, White S, Oza S, Zingg RW, Hansen PA. The association between time-of-day of habitual exercise training and changes in relevant cancer health outcomes among cancer survivors. PLoS One 2021; 16:e0258135. [PMID: 34637457 PMCID: PMC8509995 DOI: 10.1371/journal.pone.0258135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/17/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To assess the relationship between time-of-day of exercise training and changes in relevant cancer health outcomes among cancer survivors. METHODS Retrospective analysis of data collected from 2016-2019 from a hospital-based exercise oncology program. Descriptive statistics were calculated for demographic, clinical, and exercise timing characteristics (e.g. AM, PM, or mix) among survivors with available data for exercise training time (n = 233). For the total sample and a breast cancer sub-analysis, univariate analysis of covariance, adjusted for age, was carried out by exercise training time, for change in the following outcomes collected during the program's assessment sessions: cardiorespiratory fitness and muscular endurance (human performance variables), physical function, anthropometrics, self-reported fatigue, and quality of life (QoL). Change in body mass index (BMI) and body weight was included in the breast cancer analysis. RESULTS Overall, 37.3% of survivors habitually engaged in AM exercise (e.g. ≥ 75% AM training), 34.3% in PM exercise, and 28.3% in a mix of AM and PM exercise training throughout the program. Median time in the program was 17 weeks. Significant improvements in most human performance and physical function variables were observed in the total sample regardless of exercise training time-of-day. Among breast cancer survivors, PM but not AM or mixed was associated with improvements in fitness, and lower-body muscular endurance and function. Mixed exercise timing was linked with greater increase in waist circumference (total sample: 3.02cm, 95%CI 1.55, 4.49; breast cancer: 3.57cm 95%CI 0.96, 6.18), body weight (breast cancer: 1.6kg, 95%CI 0.3, 2.8) and BMI (breast cancer: 0.6kg/m2, 95%CI 0.1, 1.0). AM and PM exercise, but not mixed, was associated with improvements in fatigue and QoL. CONCLUSION Time-of-day of exercise training may differentially impact changes in human performance and physical function variables. Mixed exercise training time may result in less favorable outcomes related of weight management variables among cancer survivors.
Collapse
Affiliation(s)
- Adriana M. Coletta
- Department of Health & Kinesiology, The University of Utah, Salt Lake City, UT, United States of America
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
| | - Mary C. Playdon
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
- Department of Nutrition and Integrative Physiology, The University of Utah, Salt Lake City, UT, United States of America
| | - Kelly G. Baron
- Department of Family and Preventive Medicine, The University of Utah, Salt Lake City, UT, United States of America
| | - Mei Wei
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
- Department of Internal Medicine, The University of Utah, Salt Lake City, UT, United States of America
| | - Kristen Kelley
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
- Department of Internal Medicine, The University of Utah, Salt Lake City, UT, United States of America
| | - Christos Vaklavas
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
- Department of Internal Medicine, The University of Utah, Salt Lake City, UT, United States of America
| | - Anna Beck
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
- Department of Internal Medicine, The University of Utah, Salt Lake City, UT, United States of America
| | - Saundra S. Buys
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
- Department of Internal Medicine, The University of Utah, Salt Lake City, UT, United States of America
| | - Jonathan Chipman
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
- Department of Population Health Sciences, The University of Utah, Salt Lake City, UT, United States of America
| | - Cornelia M. Ulrich
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
- Department of Population Health Sciences, The University of Utah, Salt Lake City, UT, United States of America
| | - Darren Walker
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
| | - Shelley White
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
| | - Sonal Oza
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
- Division of Physical Medicine and Rehabilitation, The University of Utah, Salt Lake City, UT, United States of America
| | - Rebecca W. Zingg
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
- Division of Physical Medicine and Rehabilitation, The University of Utah, Salt Lake City, UT, United States of America
| | - Pamela A. Hansen
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, United States of America
- Division of Physical Medicine and Rehabilitation, The University of Utah, Salt Lake City, UT, United States of America
| |
Collapse
|
31
|
Moholdt T, Parr EB, Devlin BL, Debik J, Giskeødegård G, Hawley JA. The effect of morning vs evening exercise training on glycaemic control and serum metabolites in overweight/obese men: a randomised trial. Diabetologia 2021; 64:2061-2076. [PMID: 34009435 PMCID: PMC8382617 DOI: 10.1007/s00125-021-05477-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/09/2021] [Indexed: 01/01/2023]
Abstract
AIMS/HYPOTHESIS We determined whether the time of day of exercise training (morning vs evening) would modulate the effects of consumption of a high-fat diet (HFD) on glycaemic control, whole-body health markers and serum metabolomics. METHODS In this three-armed parallel-group randomised trial undertaken at a university in Melbourne, Australia, overweight/obese men consumed an HFD (65% of energy from fat) for 11 consecutive days. Participants were recruited via social media and community advertisements. Eligibility criteria for participation were male sex, age 30-45 years, BMI 27.0-35.0 kg/m2 and sedentary lifestyle. The main exclusion criteria were known CVD or type 2 diabetes, taking prescription medications, and shift-work. After 5 days, participants were allocated using a computer random generator to either exercise in the morning (06:30 hours), exercise in the evening (18:30 hours) or no exercise for the subsequent 5 days. Participants and researchers were not blinded to group assignment. Changes in serum metabolites, circulating lipids, cardiorespiratory fitness, BP, and glycaemic control (from continuous glucose monitoring) were compared between groups. RESULTS Twenty-five participants were randomised (morning exercise n = 9; evening exercise n = 8; no exercise n = 8) and 24 participants completed the study and were included in analyses (n = 8 per group). Five days of HFD induced marked perturbations in serum metabolites related to lipid and amino acid metabolism. Exercise training had a smaller impact than the HFD on changes in circulating metabolites, and only exercise undertaken in the evening was able to partly reverse some of the HFD-induced changes in metabolomic profiles. Twenty-four-hour glucose concentrations were lower after 5 days of HFD compared with the participants' habitual diet (5.3 ± 0.4 vs 5.6 ± 0.4 mmol/l, p = 0.001). There were no significant changes in 24 h glucose concentrations for either exercise group but lower nocturnal glucose levels were observed in participants who trained in the evening, compared with when they consumed the HFD alone (4.9 ± 0.4 vs 5.3 ± 0.3 mmol/l, p = 0.04). Compared with the no-exercise group, peak oxygen uptake improved after both morning (estimated effect 1.3 ml min-1 kg-1 [95% CI 0.5, 2.0], p = 0.003) and evening exercise (estimated effect 1.4 ml min-1 kg-1 [95% CI 0.6, 2.2], p = 0.001). Fasting blood glucose, insulin, cholesterol, triacylglycerol and LDL-cholesterol concentrations decreased only in participants allocated to evening exercise training. There were no unintended or adverse effects. CONCLUSIONS/INTERPRETATION A short-term HFD in overweight/obese men induced substantial alterations in lipid- and amino acid-related serum metabolites. Improvements in cardiorespiratory fitness were similar regardless of the time of day of exercise training. However, improvements in glycaemic control and partial reversal of HFD-induced changes in metabolic profiles were only observed when participants exercise trained in the evening. TRIAL REGISTRATION anzctr.org.au registration no. ACTRN12617000304336. FUNDING This study was funded by the Novo Nordisk Foundation (NNF14OC0011493).
Collapse
Affiliation(s)
- Trine Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
- Women's Clinic, St Olavs Hospital, Trondheim, Norway.
| | - Evelyn B Parr
- Exercise & Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Fitzroy, VIC, Australia
| | - Brooke L Devlin
- Exercise & Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Fitzroy, VIC, Australia
- Department of Dietetics, Nutrition and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Julia Debik
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Guro Giskeødegård
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - John A Hawley
- Exercise & Nutrition Research Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Fitzroy, VIC, Australia.
| |
Collapse
|
32
|
Teo SYM, Kanaley JA, Guelfi KJ, Dimmock JA, Jackson B, Fairchild TJ. Effects of diurnal exercise timing on appetite, energy intake and body composition: A parallel randomized trial. Appetite 2021; 167:105600. [PMID: 34284064 DOI: 10.1016/j.appet.2021.105600] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 07/11/2021] [Accepted: 07/12/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To determine the effect of diurnal exercise timing on appetite, energy intake and body composition in individuals with overweight or obesity. METHODS Forty sedentary, individuals with overweight or obesity (17 males, 23 females; age: 51 ± 13 years; BMI: 30.9 ± 4.2 kg/m2) were randomly allocated to complete a 12-week supervised multi-modal exercise training program performed either in the morning (amEX) or evening (pmEX). Outcome measures included appetite in response to a standardised test meal, daily energy intake (EI), body weight and body composition. Measures of dietary behaviour were assessed at baseline and post-intervention, along with habitual physical activity, sleep quality and sleep quantity. Significance was set at p ≤ .05 and Hedge's g effect sizes were calculated. RESULTS Regardless of timing, exercise training increased perceived fullness (AUC; g = 0.82-1.67; both p < .01), decreased daily EI (g = 0.73-0.93; both p < .01) and body-fat (g = 0.29-0.32; both p <. 01). The timing of exercise did not change the daily EI or body-fat response to training (all p ≥ .27), however, perceived fullness increased in the amEX group (p ≤ .01). DISINHIBITION: (g = 0.35-1.95; p ≤ .01) and Hunger (g = 0.05-0.4; p = .02) behaviours decreased following exercise training, with Disinhibition demonstrating greater improvements in the pmEX group (p = .01). Objective and subjective sleep quantity increased with training (all p ≤ .01), but sleep quality was not reported to change. CONCLUSIONS Multi-modal exercise training improved body composition and some appetite outcomes, although changes were inconsistent and largely independent of exercise-timing. In the absence of dietary manipulation, the effect of diurnal exercise timing on appetite and body composition appear trivial compared to the overall benefits of exercise participation.
Collapse
Affiliation(s)
- Shaun Y M Teo
- Discipline of Exercise Science, Murdoch University, Australia; The Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute, Australia.
| | - Jill A Kanaley
- Department of Nutrition & Exercise Physiology, University of Missouri, USA.
| | - Kym J Guelfi
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Australia.
| | | | - Ben Jackson
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Australia; Telethon Kids Institute, Australia.
| | - Timothy J Fairchild
- Discipline of Exercise Science, Murdoch University, Australia; The Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute, Australia.
| |
Collapse
|
33
|
Remchak MME, Piersol KL, Bhatti S, Spaeth AM, Buckman JF, Malin SK. Considerations for Maximizing the Exercise "Drug" to Combat Insulin Resistance: Role of Nutrition, Sleep, and Alcohol. Nutrients 2021; 13:1708. [PMID: 34069950 PMCID: PMC8157556 DOI: 10.3390/nu13051708] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/24/2021] [Accepted: 05/13/2021] [Indexed: 01/12/2023] Open
Abstract
Insulin resistance is a key etiological factor in promoting not only type 2 diabetes mellitus but also cardiovascular disease (CVD). Exercise is a first-line therapy for combating chronic disease by improving insulin action through, in part, reducing hepatic glucose production and lipolysis as well as increasing skeletal muscle glucose uptake and vasodilation. Just like a pharmaceutical agent, exercise can be viewed as a "drug" such that identifying an optimal prescription requires a determination of mode, intensity, and timing as well as consideration of how much exercise is done relative to sitting for prolonged periods (e.g., desk job at work). Furthermore, proximal nutrition (nutrient timing, carbohydrate intake, etc.), sleep (or lack thereof), as well as alcohol consumption are likely important considerations for enhancing adaptations to exercise. Thus, identifying the maximal exercise "drug" for reducing insulin resistance will require a multi-health behavior approach to optimize type 2 diabetes and CVD care.
Collapse
Affiliation(s)
- Mary-Margaret E. Remchak
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA; (M.-M.E.R.); (K.L.P.); (A.M.S.); (J.F.B.)
| | - Kelsey L. Piersol
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA; (M.-M.E.R.); (K.L.P.); (A.M.S.); (J.F.B.)
| | - Sabha Bhatti
- Division of Cardiovascular Medicine, Rutgers University, New Brunswick, NJ 08901, USA;
| | - Andrea M. Spaeth
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA; (M.-M.E.R.); (K.L.P.); (A.M.S.); (J.F.B.)
| | - Jennifer F. Buckman
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA; (M.-M.E.R.); (K.L.P.); (A.M.S.); (J.F.B.)
- Center of Alcohol Studies, Rutgers University, Piscataway, NJ 08854, USA
| | - Steven K. Malin
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA; (M.-M.E.R.); (K.L.P.); (A.M.S.); (J.F.B.)
- Division of Endocrinology, Metabolism & Nutrition, Rutgers University, New Brunswick, NJ 08901, USA
- New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ 08901, USA
- Institute of Translational Medicine and Science, Rutgers University, New Brunswick, NJ 08901, USA
| |
Collapse
|
34
|
Erickson ML, Zhang H, Mey JT, Kirwan JP. Exercise Training Impacts Skeletal Muscle Clock Machinery in Prediabetes. Med Sci Sports Exerc 2020; 52:2078-2085. [PMID: 32496736 PMCID: PMC7494535 DOI: 10.1249/mss.0000000000002368] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE Disruption of the skeletal muscle molecular clock leads to metabolic disease, whereas exercise may be restorative, leading to improvements in metabolic health. The purpose of this study was to evaluate the effects of a 12-wk exercise intervention on skeletal muscle molecular clock machinery in adults with obesity and prediabetes, and determine whether these changes were related to exercise-induced improvements in metabolic health. METHODS Twenty-six adults (age, 66 ± 4.5 yr; body mass index (BMI), 34 ± 3.4 kg·m; fasting plasma glucose, 105 ± 15 mg·dL) participated in a 12-wk exercise intervention and were fully provided isoenergetic diets. Body composition (dual x-ray absorptiometry), abdominal adiposity (computed tomography scans), peripheral insulin sensitivity (euglycemic-hyperinsulinemic clamp), exercise capacity (maximal oxygen consumption), and skeletal muscle molecular clock machinery (vastus lateralis biopsy) were assessed at baseline and after intervention. Gene and protein expression of skeletal muscle BMAL1, CLOCK, CRY1/2, and PER 1/2 were measured by quantitative real-time polymerase chain reaction and Western blot, respectively. RESULTS Body composition (BMI, dual x-ray absorptiometry, computed tomography), peripheral insulin sensitivity (glucose disposal rate), and exercise capacity (maximal oxygen consumption) all improved (P < 0.005) with exercise training. Skeletal muscle BMAL1 gene (fold change, 1.62 ± 1.01; P = 0.027) and PER2 protein expression (fold change, 1.35 ± 0.05; P = 0.02) increased, whereas CLOCK, CRY1/2, and PER1 were unchanged. The fold change in BMAL1 correlated with post-glucose disposal rate (r = 0.43, P = 0.044), BMI (r = -0.44, P = 0.042), and body weight changes (r = -0.44, P = 0.039) expressed as percent delta. CONCLUSIONS Exercise training impacts skeletal muscle molecular clock machinery in a clinically relevant cohort of adults with obesity and prediabetes. Skeletal muscle BMAL1 gene expression may improve insulin sensitivity. Future studies are needed to determine the physiological significance of exercise-induced alterations in skeletal muscle clock machinery.
Collapse
Affiliation(s)
- Melissa L. Erickson
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - Hui Zhang
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
- Department of Physiology and Biophysics, Case Western University, Cleveland, OH
| | - Jacob T. Mey
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - John P. Kirwan
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
- Department of Physiology and Biophysics, Case Western University, Cleveland, OH
| |
Collapse
|
35
|
Schumacher LM, Thomas JG, Raynor HA, Rhodes RE, Bond DS. Consistent Morning Exercise May Be Beneficial for Individuals With Obesity. Exerc Sport Sci Rev 2020; 48:201-208. [PMID: 32658039 DOI: 10.1249/jes.0000000000000226] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This review explores the hypothesis that a consistent exercise time, especially consistent morning exercise, improves exercise adherence and weight management for individuals with overweight or obesity. We discuss data supporting this premise, identify limitations of current research, and outline directions for future research on exercise timing to more robustly evaluate our thesis.
Collapse
Affiliation(s)
- Leah M Schumacher
- Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, RI
| | - J Graham Thomas
- Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, RI
| | - Hollie A Raynor
- Department of Nutrition, The University of Tennessee Knoxville, Knoxville, TN
| | - Ryan E Rhodes
- School of Exercise Science, Physical & Health Education/Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Dale S Bond
- Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, RI
| |
Collapse
|
36
|
Mancilla R, Krook A, Schrauwen P, Hesselink MKC. Diurnal Regulation of Peripheral Glucose Metabolism: Potential Effects of Exercise Timing. Obesity (Silver Spring) 2020; 28 Suppl 1:S38-S45. [PMID: 32475086 PMCID: PMC7496481 DOI: 10.1002/oby.22811] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 12/18/2022]
Abstract
Diurnal oscillations in energy metabolism are linked to the activity of biological clocks and contribute to whole-body glucose homeostasis. Postprandially, skeletal muscle takes up approximately 80% of circulatory glucose and hence is a key organ in maintenance of glucose homeostasis. Dysregulation of molecular clock components in skeletal muscle disrupts whole-body glucose homeostasis. Next to light-dark cycles, nonphotic cues such as nutrient intake and physical activity are also potent cues to (re)set (dys)regulated clocks. Physical exercise is one of the most potent ways to improve myocellular insulin sensitivity. Given the role of the biological clock in glucose homeostasis and the power of exercise to improve insulin sensitivity, one can hypothesize that there might be an optimal time for exercise to maximally improve insulin sensitivity and glucose homeostasis. In this review, we aim to summarize the available information related to the interaction of diurnal rhythm, glucose homeostasis, and physical exercise as a nonphotic cue to correct dysregulation of human glucose metabolism.
Collapse
Affiliation(s)
- Rodrigo Mancilla
- Department of Nutrition and Movement SciencesNUTRIM School for Nutrition and Translational Research in MetabolismMaastricht University Medical Centre+MaastrichtThe Netherlands
| | - Anna Krook
- Department of Physiology and PharmacologySection for Integrative PhysiologyKarolinska InstitutetStockholmSweden
| | - Patrick Schrauwen
- Department of Nutrition and Movement SciencesNUTRIM School for Nutrition and Translational Research in MetabolismMaastricht University Medical Centre+MaastrichtThe Netherlands
| | - Matthijs K. C. Hesselink
- Department of Nutrition and Movement SciencesNUTRIM School for Nutrition and Translational Research in MetabolismMaastricht University Medical Centre+MaastrichtThe Netherlands
| |
Collapse
|
37
|
Does Exercise Timing Affect 24-Hour Glucose Concentrations in Adults With Type 2 Diabetes? A Follow Up to the Exercise-Physical Activity and Diabetes Glucose Monitoring Study. Can J Diabetes 2020; 44:711-718.e1. [PMID: 32878737 DOI: 10.1016/j.jcjd.2020.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/17/2020] [Accepted: 05/21/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES It is well known that exercise can improve the glycemic profile in individuals with type 2 diabetes (T2D). However, the optimal timing of exercise is often debated. Our aim in this study was to compare the effects of exercise performed at different times of the day and different timing in relation to meals on 24-hour glucose profiles in people with T2D. METHODS Fourteen individuals with T2D were recruited and wore continuous glucose monitors for 12 days. During the 12 days, participants completed 4 conditions according to a randomized, crossover design: i) morning (fasting) exercise (MorEx), ii) afternoon exercise (AftEx), iii) evening exercise (EveEx) and iv) seated control. Exercise consisted of 50 minutes of walking at 5.0 km/h. RESULTS Eight men and 6 women (age, 65±9.0 years; T2D duration, 10.5±6.8 years; mean glycated hemoglobin, 6.7±0.6%) were included in the analysis. Mean 24-hour continuously monitored glucose was 7.4±0.7 mmol/L, 7.3±0.7 mmol/L, 7.5±0.8 mmol/L and 7.5±0.7 mmol/L in the MorEx, AftEx, EveEx and control conditions, respectively, with no significant differences among the 4 conditions (p=0.55). MorEx had a lower respiratory exchange ratio compared with AftEx and EveEx (p<0.01). The decrease in glucose during exercise was less pronounced for MorEx compared with AftEx (p<0.05). CONCLUSIONS Fifty minutes of walking at 3 different times of day and at different timing in relation to meals did not lower 24-hour glucose concentrations in people with T2D. The reasons why exercise was not effective at lowering glucose remain unclear.
Collapse
|
38
|
Teo SYM, Kanaley JA, Guelfi KJ, Fairchild TJ. Response. Med Sci Sports Exerc 2020; 52:1236. [DOI: 10.1249/mss.0000000000002266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
39
|
Russell BM, Francois ME. Toward Personalizing Exercise to Support Circadian Entrainment of Glycemia in Type 2 Diabetes. Med Sci Sports Exerc 2020; 52:1235. [PMID: 32301902 DOI: 10.1249/mss.0000000000002265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Brooke M Russell
- School of Medicine, Faculty of Science, Medicine and Health; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong NSW, AUSTRALIA
| | | |
Collapse
|