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Kim HK, Kimura Y, Takahashi M, Nakaoka T, Yamada Y, Ono R, Shibata S. Morning physical activity may be more beneficial for blood lipids than afternoon physical activity in older adults: a cross-sectional study. Eur J Appl Physiol 2024:10.1007/s00421-024-05526-y. [PMID: 38874620 DOI: 10.1007/s00421-024-05526-y] [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: 02/09/2024] [Accepted: 05/30/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND The effect of differences in daily physical activity patterns on blood lipids has not been determined. This study examines the effects of the differences in free-living daily physical activity patterns (amount and intensity) on blood lipid levels in older adults. METHODS This cross-sectional study included 51 older participants (71.8 ± 0.6 years, men = 8, women = 43). A triaxial accelerometer was used to assess physical activity patterns. The time from awakening to bedtime for each participant was used for group classification based on the amount (number of steps) and intensity (moderate-to-vigorous physical activity, MVPA) of physical activity. The morning step group (M Step) was defined as those who took more steps in the morning, and the afternoon step group (A Step) was defined as those who took more steps in the afternoon. The same method was used for MVPA (morning MVPA: M MVPA; afternoon MVPA: A MVPA). Blood samples were collected at the start of the study to determine blood lipid levels. RESULTS Number of steps taken showed a trend toward lower low-density lipoprotein cholesterol (LDL-C) levels in the M Step group compared with the A Step group. The LDL/high-density lipoprotein (HDL) ratio was significantly lower in the M Step group than the A Step group (p < 0.05). The M MVPA group also had higher HDL-C levels and significantly lower LDL/HDL ratios than the A MVPA group (p < 0.05). CONCLUSIONS These results suggest that compared with afternoon physical activity, daily morning physical activity (amount and intensity) is more effective in improving blood lipid levels.
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Affiliation(s)
- Hyeon-Ki Kim
- National Institute of Biomedical Innovation, Health and Nutrition, 3-17 Senriokashimmachi, Settsu-shi, Osaka, 566-0002, Japan.
| | - Yuga Kimura
- School of Advance Science and Engineering, Waseda University, Tokyo, Japan
| | - Masaki Takahashi
- Institute for Liberal Arts, Tokyo Institute of Technology, Tokyo, Japan
| | - Takashi Nakaoka
- Japan Organization of Occupational Health and Safety, Kanagawa, Japan
| | - Yosuke Yamada
- National Institute of Biomedical Innovation, Health and Nutrition, 3-17 Senriokashimmachi, Settsu-shi, Osaka, 566-0002, Japan
| | - Rei Ono
- National Institute of Biomedical Innovation, Health and Nutrition, 3-17 Senriokashimmachi, Settsu-shi, Osaka, 566-0002, Japan
| | - Shigenobu Shibata
- Faculty of Science and Engineering, Waseda University, Tokyo, Japan
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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2
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Christie HE, Winter M, Meyer BJ, Francois ME. Diagnosis to Delivery: A Randomized Clinical Trial of Postmeal Walking in Women with Gestational Diabetes. Med Sci Sports Exerc 2024; 56:860-867. [PMID: 38233988 DOI: 10.1249/mss.0000000000003382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE The aim of this study was to determine whether advice to perform postmeal walking could be an effective and feasible alternate to standard care continuous walking for the management of gestational diabetes (GDM). METHODS Forty women with GDM were randomized between 28 and 30 wk of gestation into either standard care (CTL; 30-min continuous walking, most days per week) or standard care with advice to PMW (daily 10-min walks after three main meals) for ~7 wk. The primary outcome for this randomized controlled trial was postprandial glucose assessed by continuous glucose monitors. Continuous glucose monitor and ActivPAL inclinometers (physical activity parameters) were each worn for 7 d at ~28 and ~35 wk gestation. Delivery outcomes were also collected. A linear mixed model compared the changes across time between groups. RESULTS Twenty-six women (PMW: n = 12, CTL: n = 14; age 34 ± 5 y) completed the trial. Mean 3 h postprandial glucose at dinner was higher in the PMW versus CTL group at baseline and across the intervention (main effect group, P = 0.04). Twenty-four hours, nocturnal, and fasting glucose were similar between groups. The PMW group spent ~57 min·d -1 more time sedentary and ~11 min·d -1 less time stepping versus CTL (main effect group: P = 0.02 and 0.05). Adherence to the prescribed 30 min·d -1 of physical activity was high, regardless of whether accumulated as 3 × 10-min or one single bout of walking. CONCLUSIONS Distributing activity as 10-min bouts after main meals did not improve postprandial glucose outcomes compared with standard-care control. More research on the optimal duration and intensity of postmeal walks to improve postprandial responses are needed. Strategies that mitigate sedentary time and increase the minutes of physical activity accumulated across the day in pregnancy are also warranted.
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Affiliation(s)
| | - Meagan Winter
- Illawarra Shoalhaven Local Health District Diabetes Service, Wollongong, New South Wales, AUSTRALIA
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3
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Bellini A, Scotto di Palumbo A, Nicolò A, Bazzucchi I, Sacchetti M. Exercise Prescription for Postprandial Glycemic Management. Nutrients 2024; 16:1170. [PMID: 38674861 PMCID: PMC11053955 DOI: 10.3390/nu16081170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/22/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
The detrimental impacts of postprandial hyperglycemia on health are a critical concern, and exercise is recognized a pivotal tool in enhancing glycemic control after a meal. However, current exercise recommendations for managing postprandial glucose levels remain fairly broad and require deeper clarification. This review examines the existing literature aiming to offer a comprehensive guide for exercise prescription to optimize postprandial glycemic management. Specifically, it considers various exercise parameters (i.e., exercise timing, type, intensity, volume, pattern) for crafting exercise prescriptions. Findings predominantly indicate that moderate-intensity exercise initiated shortly after meals may substantially improve glucose response to a meal in healthy individuals and those with type 2 diabetes. Moreover, incorporating short activity breaks throughout the exercise session may provide additional benefits for reducing glucose response.
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Affiliation(s)
| | | | | | - Ilenia Bazzucchi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro De Bosis 6, 00135 Rome, Italy; (A.B.); (A.S.d.P.); (A.N.); (M.S.)
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4
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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.
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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.
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5
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Brian MS, Chaudhry BA, D'Amelio M, Waite EE, Dennett JG, O'Neill DF, Feairheller DL. Post-meal exercise under ecological conditions improves post-prandial glucose levels but not 24-hour glucose control. J Sports Sci 2024; 42:728-736. [PMID: 38858835 PMCID: PMC11240283 DOI: 10.1080/02640414.2024.2363688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 05/28/2024] [Indexed: 06/12/2024]
Abstract
We investigated whether post-meal walking (PMW) improved post-prandial glucose and 24h glucose control under free-living conditions among physically inactive young women. METHODS Young women (Age: 20±1years; percent body fat: 28.2 ± 12%; BMI: 23.8 ± 4.2kg·m-1) completed a randomised crossover study to assess if PMW confers benefit. On the PMW day, women completed three bouts of brisk walks, and on the Control day they were instructed to follow normal habitual activities. Continuous glucose monitors captured post-prandial and 24h glucose, and physical activity monitors tracked physical activity throughout the study. RESULTS PMW walking increased total daily step count (Control = 9,159 ± 2,962 steps vs. PMW = 14,611±3,891 steps, p<0.001) and activity scores (Control=33.87±1.16 METs·h vs. PMW = 36.11±1.58 METs·h, p < 0.001). PMW led to lower 3h average post-prandial glucose (main effect of condition, p=0.011) and 3h post-prandial area under curve glucose responses (main effect of condition, p = 0.027) compared to the control condition. Post hoc analysis revealed the largest decline occurred after dinner (3h average glucose Control = 7.55±1.21 mmol/L vs. PMW = 6.71 ± 0.80mmol/L, p = 0.039), when insulin sensitivity is typically diminished. Despite improvements in post-prandial glucose control, this did not translate to improvements in 24h glucose control (p > 0.05). CONCLUSION Physically inactive and metabolically healthy young women, PMW improves post-prandial glucose but not 24h glucose control.
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Affiliation(s)
- Michael S Brian
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| | - Bilal A Chaudhry
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| | - Maison D'Amelio
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| | - Emily E Waite
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| | - John G Dennett
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
| | | | - Deborah L Feairheller
- Department of Kinesiology, University of New Hampshire, Durham, NH, USA
- Department of Kinesiology, California State University San Marcos, San Marcos, CA, USA
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Skurk T, Bosy-Westphal A, Grünerbel A, Kabisch S, Keuthage W, Kronsbein P, Müssig K, Nussbaumer H, Pfeiffer AFH, Simon MC, Tombek A, Weber KS, Rubin D. Dietary Recommendations for Persons with Type 2 Diabetes Mellitus. Exp Clin Endocrinol Diabetes 2024; 132:182-215. [PMID: 38286422 DOI: 10.1055/a-2166-6772] [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] [Indexed: 01/31/2024]
Affiliation(s)
- Thomas Skurk
- ZIEL Institute for Food & Health, Technical University of Munich, Freising, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition, Faculty of Agriculture and Nutritional Sciences, Christian-Albrechts University of Kiel, Kiel, Germany
| | | | - Stefan Kabisch
- German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany
- German Center for Diabetes Research (DZD), Munich, Germany
| | - Winfried Keuthage
- Specialist Practice for Diabetes and Nutritional Medicine, Münster, Germany
| | - Peter Kronsbein
- Faculty of Nutrition and Food Sciences, Niederrhein University of Applied Sciences, Mönchengladbach Campus, Mönchengladbach, Germany
| | - Karsten Müssig
- Department of Internal Medicine, Gastroenterology and Diabetology, Niels Stensen Hospitals, Franziskus Hospital Harderberg, Georgsmarienhütte, Germany
| | | | - Andreas F H Pfeiffer
- Department of Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Marie-Christine Simon
- Institute of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Astrid Tombek
- Diabetes Centre Bad Mergentheim, Bad Mergentheim, Germany
| | - Katharina S Weber
- Institute for Epidemiology, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Diana Rubin
- Vivantes Hospital Spandau, Berlin, Germany
- Vivantes Humboldt Hospital, Berlin, Germany
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7
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Zhu X, Zhang X, Zhou C, Li B, Huang Y, Li C, Gu C, Ma M, Zhao S, Fan Y, Xu X, Chang J, Chen H, Zheng Z. Walking pace and microvascular complications among individuals with type 2 diabetes: A cohort study from the UK Biobank. Scand J Med Sci Sports 2024; 34:e14501. [PMID: 37740713 DOI: 10.1111/sms.14501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/08/2023] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
INTRODUCTION Walking pace is associated with various health-related outcomes. The aim of this study was to investigate the association between self-reported walking pace and the incidences of diabetic microvascular complications among participants with type 2 diabetes (T2D). METHODS Self-reported walking pace was classified as brisk, average, or slow. The outcomes were the incidences of diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy. COX proportional hazards models adjusted for sociodemographic, lifestyle, and health-related factors were used to estimate hazard ratios (HRs) and 95% CIs. RESULTS A total of 14 518 participants with T2D in the UK Biobank (mean age 59.7 ± 7.0 years, 5028 [34.6%] women) were included. During a median follow-up of 12.5 (interquartile range: 11.6-13.4) years, 2980 participants developed diabetic microvascular complications. After adjusting for confounding factors, and compared with brisk walkers, slow walkers had a multivariable-adjusted HR of 1.98 (95% CI 1.58, 2.47) for composite diabetic microvascular complications, 1.54 (95% CI 1.11, 2.14) for diabetic retinopathy, 3.26 (95% CI 2.08, 5.11) for diabetic neuropathy, and 2.32 (95% CI 1.91, 2.82) for diabetic nephropathy. Average walking pace was associated with a higher risk for diabetic nephropathy (HR 1.51, 95 CI% 1.27-1.79) compared with brisk walking. Additionally, ≥1 diabetic microvascular complication occurred in 447 (14.7%) of participants with brisk walking pace, 1702 (19.5%) with average walking pace, and 831 (30.4%) with slow walking pace. Time from study recruitment to first diagnosis was shorter in participants who reported a slow walking pace, compared with brisk or average walkers. Among participants who had diabetic nephropathy as their first diagnosis, slow walking pace was associated with subsequent risk of a second diabetic microvascular complication (HR 3.88, 95 CI% 2.27-6.60). CONCLUSIONS Self-reported slow walking pace is associated with a higher risk of diabetic microvascular complications among participants with T2D in this population-based cohort study.
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Affiliation(s)
- Xinyu Zhu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Xinyu Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Chuandi Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Bo Li
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Yikeng Huang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Chenxin Li
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Chufeng Gu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Mingming Ma
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Shuzhi Zhao
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Ying Fan
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Jian Chang
- Shanghai General Hospital, Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Haibing Chen
- Department of Endocrinology and Metabolism, Shanghai 10th People's Hospital, Tongji University, Shanghai, China
| | - Zhi Zheng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
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Mesinovic J, Fyfe JJ, Talevski J, Wheeler MJ, Leung GK, George ES, Hunegnaw MT, Glavas C, Jansons P, Daly RM, Scott D. Type 2 Diabetes Mellitus and Sarcopenia as Comorbid Chronic Diseases in Older Adults: Established and Emerging Treatments and Therapies. Diabetes Metab J 2023; 47:719-742. [PMID: 37709502 PMCID: PMC10695715 DOI: 10.4093/dmj.2023.0112] [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: 04/14/2023] [Accepted: 08/12/2023] [Indexed: 09/16/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) and sarcopenia (low skeletal muscle mass and function) share a bidirectional relationship. The prevalence of these diseases increases with age and they share common risk factors. Skeletal muscle fat infiltration, commonly referred to as myosteatosis, may be a major contributor to both T2DM and sarcopenia in older adults via independent effects on insulin resistance and muscle health. Many strategies to manage T2DM result in energy restriction and subsequent weight loss, and this can lead to significant declines in muscle mass in the absence of resistance exercise, which is also a first-line treatment for sarcopenia. In this review, we highlight recent evidence on established treatments and emerging therapies targeting weight loss and muscle mass and function improvements in older adults with, or at risk of, T2DM and/or sarcopenia. This includes dietary, physical activity and exercise interventions, new generation incretin-based agonists and myostatin-based antagonists, and endoscopic bariatric therapies. We also highlight how digital health technologies and health literacy interventions can increase uptake of, and adherence to, established and emerging treatments and therapies in older adults with T2DM and/or sarcopenia.
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Affiliation(s)
- Jakub Mesinovic
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Jackson J. Fyfe
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jason Talevski
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Australia
- School of Rural Health, Monash University, Warragul, Australia
| | - Michael J. Wheeler
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Gloria K.W. Leung
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| | - Elena S. George
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Melkamu T. Hunegnaw
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Costas Glavas
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Paul Jansons
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Robin M. Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
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9
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Kang J, Fardman BM, Ratamess NA, Faigenbaum AD, Bush JA. Efficacy of Postprandial Exercise in Mitigating Glycemic Responses in Overweight Individuals and Individuals with Obesity and Type 2 Diabetes-A Systematic Review and Meta-Analysis. Nutrients 2023; 15:4489. [PMID: 37892564 PMCID: PMC10610082 DOI: 10.3390/nu15204489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
Studies investigating the acute effect of postprandial exercise (PPE) on glucose responses exhibit significant heterogeneity in terms of participant demographic, exercise protocol, and exercise timing post-meal. As such, this study aimed to further analyze the existing literature on the impact of PPE on glycemic control in overweight individuals and individuals with obesity and type 2 diabetes (T2DM). A literature search was conducted through databases such as PubMed, CINAHL, and Google Scholar. Thirty-one original research studies that met the inclusion criteria were selected. A random-effect meta-analysis was performed to compare postprandial glucose area under the curve (AUC) and 24 h mean glucose levels between PPE and the time-matched no-exercise control (CON). Subgroup analyses were conducted to explore whether the glucose-lowering effect of PPE could be influenced by exercise duration, exercise timing post-meal, and the disease status of participants. This study revealed a significantly reduced glucose AUC (Hedges' g = -0.317; SE = 0.057; p < 0.05) and 24 h mean glucose levels (Hedges' g = -0.328; SE = 0.062; p < 0.05) following PPE compared to CON. The reduction in glucose AUC was greater (p < 0.05) following PPE lasting >30 min compared to ≤30 min. The reduction in 24 h mean glucose levels was also greater (p < 0.05) following PPE for ≥60 min compared to <60 min post-meal and in those with T2DM compared to those without T2DM. PPE offers a viable approach for glucose management and can be performed in various forms so long as exercise duration is sufficient. The glucose-lowering effect of PPE may be further enhanced by initiating it after the first hour post-meal. PPE is a promising strategy, particularly for patients with T2DM. This manuscript is registered with Research Registry (UIN: reviewregistry1693).
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Affiliation(s)
- Jie Kang
- Department of Kinesiology and Health Sciences, The College of New Jersey, Ewing, NJ 08618, USA; (N.A.R.); (A.D.F.); (J.A.B.)
| | - Brian M. Fardman
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ 08084, USA;
| | - Nicholas A. Ratamess
- Department of Kinesiology and Health Sciences, The College of New Jersey, Ewing, NJ 08618, USA; (N.A.R.); (A.D.F.); (J.A.B.)
| | - Avery D. Faigenbaum
- Department of Kinesiology and Health Sciences, The College of New Jersey, Ewing, NJ 08618, USA; (N.A.R.); (A.D.F.); (J.A.B.)
| | - Jill A. Bush
- Department of Kinesiology and Health Sciences, The College of New Jersey, Ewing, NJ 08618, USA; (N.A.R.); (A.D.F.); (J.A.B.)
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10
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Syeda UA, Battillo D, Visaria A, Malin SK. The importance of exercise for glycemic control in type 2 diabetes. AMERICAN JOURNAL OF MEDICINE OPEN 2023; 9:100031. [PMID: 39035065 PMCID: PMC11256236 DOI: 10.1016/j.ajmo.2023.100031] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 12/01/2022] [Accepted: 01/10/2023] [Indexed: 07/23/2024]
Abstract
Exercise is a first-line therapy recommended for patients with type 2 diabetes (T2D). Although moderate to vigorous exercise (e.g. 150 min/wk) is often advised alongside diet and/or behavior modification, exercise is an independent treatment that can prevent, delay or reverse T2D. Habitual exercise, consisting of aerobic, resistance or their combination, fosters improved short- and long-term glycemic control. Recent work also shows high-intensity interval training is successful at lowering blood glucose, as is breaking up sedentary behavior with short-bouts of light to vigorous movement (e.g. up to 3min). Interestingly, performing afternoon compared with morning as well as post-meal versus pre-meal exercise may yield slightly better glycemic benefit. Despite these efficacious benefits of exercise for T2D care, optimal exercise recommendations remain unclear when considering, dietary, medication, and/or other behaviors.
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Affiliation(s)
- U.S. Afsheen Syeda
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, United States
| | - Daniel Battillo
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, United States
| | - Aayush Visaria
- Center for Pharmacoepidemiology and Treatment Sciences, Rutgers Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ, United States
| | - Steven K. Malin
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, United States
- Center for Pharmacoepidemiology and Treatment Sciences, Rutgers Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ, United States
- New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ, United States
- Institute of Translational Medicine and Science, Rutgers University, New Brunswick, NJ, United States
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11
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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.
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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
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12
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Feng H, Yang L, Liang YY, Ai S, Liu Y, Liu Y, Jin X, Lei B, Wang J, Zheng N, Chen X, Chan JWY, Sum RKW, Chan NY, Tan X, Benedict C, Wing YK, Zhang J. Associations of timing of physical activity with all-cause and cause-specific mortality in a prospective cohort study. Nat Commun 2023; 14:930. [PMID: 36805455 PMCID: PMC9938683 DOI: 10.1038/s41467-023-36546-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/06/2023] [Indexed: 02/20/2023] Open
Abstract
There is a growing interest in the role of timing of daily behaviors in improving health. However, little is known about the optimal timing of physical activity to maximize health benefits. We perform a cohort study of 92,139 UK Biobank participants with valid accelerometer data and all-cause and cause-specific mortality outcomes, comprising over 7 years of median follow-up (638,825 person-years). Moderate-to-vigorous intensity physical activity (MVPA) at any time of day is associated with lower risks for all-cause, cardiovascular disease, and cancer mortality. In addition, compared with morning group (>50% of daily MVPA during 05:00-11:00), midday-afternoon (11:00-17:00) and mixed MVPA timing groups, but not evening group (17:00-24:00), have lower risks of all-cause and cardiovascular disease mortality. These protective associations are more pronounced among the elderly, males, less physically active participants, or those with preexisting cardiovascular diseases. Here, we show that MVPA timing may have the potential to improve public health.
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Affiliation(s)
- Hongliang Feng
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.,Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Lulu Yang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yannis Yan Liang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
| | - Sizhi Ai
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Cardiology, Heart Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan, China.,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yaping Liu
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yue Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Xinyi Jin
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Binbin Lei
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Jing Wang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Nana Zheng
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xinru Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.,Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Joey W Y Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Raymond Kim Wai Sum
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiao Tan
- Department of Big Data in Health Science, Zhejiang University School of Public Health and Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Christian Benedict
- Molecular Neuropharmacology, Department of Pharmaceutical Biosciences, Uppsala University, 751 24, Uppsala, Sweden
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China. .,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China. .,Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China. .,Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
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13
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Magkos F, Reeds DN, Mittendorfer B. Evolution of the diagnostic value of "the sugar of the blood": hitting the sweet spot to identify alterations in glucose dynamics. Physiol Rev 2023; 103:7-30. [PMID: 35635320 PMCID: PMC9576168 DOI: 10.1152/physrev.00015.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/22/2022] Open
Abstract
In this paper, we provide an overview of the evolution of the definition of hyperglycemia during the past century and the alterations in glucose dynamics that cause fasting and postprandial hyperglycemia. We discuss how extensive mechanistic, physiological research into the factors and pathways that regulate the appearance of glucose in the circulation and its uptake and metabolism by tissues and organs has contributed knowledge that has advanced our understanding of different types of hyperglycemia, namely prediabetes and diabetes and their subtypes (impaired fasting plasma glucose, impaired glucose tolerance, combined impaired fasting plasma glucose, impaired glucose tolerance, type 1 diabetes, type 2 diabetes, gestational diabetes mellitus), their relationships with medical complications, and how to prevent and treat hyperglycemia.
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Affiliation(s)
- Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Dominic N Reeds
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri
| | - Bettina Mittendorfer
- Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri
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14
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Wang Y, Cao P, Liu F, Chen Y, Xie J, Bai B, Liu Q, Ma H, Geng Q. Gender Differences in Unhealthy Lifestyle Behaviors among Adults with Diabetes in the United States between 1999 and 2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16412. [PMID: 36554290 PMCID: PMC9778889 DOI: 10.3390/ijerph192416412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/29/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Lifestyle management is important to patients with diabetes, but whether gender differences exist in lifestyle management is unclear. Data from the US National Health and Nutrition Examination Survey (NHANES 1999 to 2018) was used for this research. Gender differences were evaluated descriptively and using an odds ratio (OR) with a 95% confidence interval (CI). A total of 8412 participants (48% women) were finally included. Across these surveys, the incidences of poor diet (OR: 1.26 (95% CI, 1.12, 1.43)), smoking (1.58 (1.35, 1.84)), alcohol consumption (1.94 (1.68, 2.25)) and sedentary behavior (1.20 (1.04, 1.39)) were more common in men, while depression (0.47 (0.37, 0.59)), obesity (0.69 (0.61, 0.78)) and insufficient physical activity (0.56 (0.49, 0.65)) were more common in women. Reductions in poor diet were greater in men between 1999 and 2000 and 2017 and 2018 (p = 0.037), while the mean body mass index (BMI) levels (p = 0.019) increased more among women. Furthermore, several gender differences were found to be related to age, race/ethnicity and marital/insurance/employment statuses. Our research found gender differences in diabetes-related unhealthy lifestyle behaviors and provides reference data for implementing measures to reduce the gender differences. Further work to reduce gender-specific barriers to a healthy lifestyle is warranted in order to further improve diabetes management.
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Affiliation(s)
- Yu Wang
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Peihua Cao
- Clinical Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Fengyao Liu
- School of Medicine, South China University of Technology, Guangzhou 510006, China
| | - Yilin Chen
- School of Medicine, South China University of Technology, Guangzhou 510006, China
| | - Jingyu Xie
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Bingqing Bai
- School of Medicine, South China University of Technology, Guangzhou 510006, China
| | - Quanjun Liu
- School of Medicine, South China University of Technology, Guangzhou 510006, China
| | - Huan Ma
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - Qingshan Geng
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
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15
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Davis CL, Bugbee AC, Ward C. The effect of postprandial exercise on mean blood glucose concentrations following high and maintenance carbohydrate content meals in healthy dogs. Res Vet Sci 2022; 150:144-148. [PMID: 35839707 DOI: 10.1016/j.rvsc.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 04/18/2022] [Accepted: 05/23/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To compare the effect of 15 min of exercise 30 min post-meal on mean blood glucose concentrations in 5 well-conditioned versus 5 over-conditioned dogs. To compare the effect of exercise on glycemic control in dogs eating their maintenance diet as compared to a high carbohydrate meal. ANIMALS Ten healthy staff or student owned dogs, five well- and five over-conditioned. PROCEDURES This was a crossover study over 5 days. Continuous glucose monitors (CGM) were placed on day 1. On days 2 and 3, dogs received their maintenance diet and a high carbohydrate meal, respectively and were walked on the treadmill for 15 min following each meal. On day 4, dogs were given their maintenance diet in hospital without treadmill activity. On day 5, the CGM were removed. The mean blood glucose 30 min post-meal, during exercise, 15 min after completing exercise, and the 1-3 h period after completing the exercise were compared to detect any effect of exercise, diet composition, or body condition. RESULTS Dogs consuming a high carbohydrate meal had a significantly higher mean blood glucose 15 min post-exercise. Mean glucose values at all time points following a high carbohydrate meal were significantly higher than mean glucose values on the non-exercise day. CONCLUSIONS AND CLINICAL RELEVANCE No impact of post-prandial exercise on glucose concentrations were identified in this study, however, the carbohydrate content of the meal impacted post-prandial glycemic responses in healthy dogs regardless of body condition. Evaluating the impact of post-prandial exercise in insulin-dependent or glucose-intolerant dogs is warranted to determine if these findings persist.
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Affiliation(s)
- Chelsea L Davis
- University of Georgia College of Veterinary Medicine, 2200 College Station Road, Athens, GA 30602, United States of America
| | - Andrew C Bugbee
- University of Georgia College of Veterinary Medicine, 2200 College Station Road, Athens, GA 30602, United States of America.
| | - Cynthia Ward
- University of Georgia College of Veterinary Medicine, 2200 College Station Road, Athens, GA 30602, United States of America
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16
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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 2022; 41:311-321. [PMID: 37092166 PMCID: PMC10115764 DOI: 10.2337/cd22-0076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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17
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Liao Y, Schembre SM, Brannon GE, Pan Z, Wang J, Ali S, Beg MS, Basen-Engquist KM. Using wearable biological sensors to provide personalized feedback to motivate behavioral changes: Study protocol for a randomized controlled physical activity intervention in cancer survivors (Project KNOWN). PLoS One 2022; 17:e0274492. [PMID: 36099282 PMCID: PMC9469963 DOI: 10.1371/journal.pone.0274492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 11/19/2022] Open
Abstract
Regular physical activity reduces the progression of several cancers and offers physical and mental health benefits for cancer survivors. However, many cancer survivors are not sufficiently active to achieve these health benefits. Possible biological mechanisms through which physical activity could affect cancer progression include reduced systemic inflammation and positive changes in metabolic markers. Chronic and acute hyperglycemia could have downstream effects on cell proliferation and tumorigenesis. One novel strategy to motivate cancer survivors to be more active is to provide personalized biological-based feedback that demonstrates the immediate positive impact of physical activity. Continuous glucose monitors (CGMs) have been used to demonstrate the acute beneficial effects of physical activity on insulin sensitivity and glucose metabolisms in controlled lab settings. Using personal data from CGMs to illustrate the immediate impact of physical activity on glucose patterns could be particularly relevant for cancer survivors because they are at a higher risk for developing type 2 diabetes (T2D). As a pilot project, this study aims to (1) test the preliminary effect of a remotely delivered physical activity intervention that incorporates personalized biological-based feedback on daily physical activity levels, and (2) explore the association between daily glucose patterns and cancer-related insulin pathway and inflammatory biomarkers in cancer survivors who are at high risk for T2D. We will recruit 50 insufficiently active, post-treatment cancer survivors who are at elevated risk for T2D. Participants will be randomly assigned into (1) a group that receives personalized biological feedback related to physical activity behaviors; and (2) a control group that receives standard educational material. The feasibility and preliminary efficacy of this wearable sensor-based, biofeedback-enhanced 12-week physical activity intervention will be evaluated. Data from this study will support the further refinement and enhancement of a more comprehensive remotely delivered physical activity intervention that targets cancer survivors. Trial registration: ClinicalTrials.gov Identifier: NCT05490641.
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Affiliation(s)
- Yue Liao
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, Texas, United States of America
- * E-mail:
| | - Susan M. Schembre
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States of America
| | - Grace E. Brannon
- Department of Communication, College of Liberal Arts, The University of Texas at Arlington, Arlington, Texas, United States of America
| | - Zui Pan
- Department of Graduate Nursing, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, Texas, United States of America
| | - Jing Wang
- Department of Graduate Nursing, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, Texas, United States of America
| | - Sadia Ali
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, United States of America
| | - M. Shaalan Beg
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, United States of America
| | - Karen M. Basen-Engquist
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
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18
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Skurk T, Bosy-Westphal A, Grünerbel A, Kabisch S, Keuthage W, Kronsbein P, Müssig K, Pfeiffer AFH, Simon MC, Tombek A, Weber KS, Rubin D. Dietary recommendations for persons with type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes 2022; 130:S151-S184. [PMID: 35359013 DOI: 10.1055/a-1624-5095] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Thomas Skurk
- ZIEL Institute for Food & Health, Technical University of Munich, Freising, Germany.,Else Kröner-Fresenius-Center for Nutritional Medicine, Technical University of Munich, Freising, Germany
| | - Anja Bosy-Westphal
- Institute for Human Nutrition, Faculty of Agricultural and Nutritional Sciences, Christian-Albrechts-University of Kiel, Kiel, Germany
| | | | - Stefan Kabisch
- German Institute of Human Nutrition Potsdam-Rehbrücke, Potsdam, Germany.,Department of Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.,German Center for Diabetes Research (DZD), Munich, Germany
| | - Winfried Keuthage
- Focus Practice for Diabetes and Nutritional Medicine, Münster, Germany
| | - Peter Kronsbein
- Department of Ecotrophology, Niederrhein University of Applied Sciences, Mönchengladbach Campus, Germany
| | - Karsten Müssig
- Department of Internal Medicine, Gastroenterology and Diabetology, Niels Stensen Hospitals, Franziskus Hospital Harderberg, Georgsmarienhütte, Germany
| | - Andreas F H Pfeiffer
- Department of Endocrinology, Diabetes and Nutritional Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Marie-Christine Simon
- Institute of Nutrition and Food Sciences, Rheinische Friedrich-Wilhelms University, Bonn, Germany
| | | | - Katharina S Weber
- Institute of Epidemiology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Diana Rubin
- Vivantes Hospital Spandau, Berlin, Germany.,Vivantes Humboldt Hospital, Berlin, Germany
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19
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Zhang X, Zheng C, Ho RST, Miyashita M, Wong SHS. The Effects of Accumulated Versus Continuous Exercise on Postprandial Glycemia, Insulin, and Triglycerides in Adults with or Without Diabetes: A Systematic Review and Meta-Analysis. SPORTS MEDICINE - OPEN 2022; 8:14. [PMID: 35072806 PMCID: PMC8786998 DOI: 10.1186/s40798-021-00401-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 12/21/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Postprandial dysmetabolism, an important cardiovascular disease risk factor, can be improved by exercise. Further systematic review and meta-analysis is needed to compare the effects of accumulated exercise with a single session of energy-matched continuous exercise on postprandial glucose (PPG), insulin, and triglycerides in adults with or without diabetes. METHODS Eight electronic databases were searched on August 28, 2020, and updated on April 27, 2021. Eligible studies were randomized, quasi-randomized, or non-randomized controlled or crossover trials that evaluated the acute or longitudinal effects of accumulated exercise compared with a single session of energy-matched continuous exercise on PPG, postprandial insulin, and triglycerides in diabetic and non-diabetic adults. Same-day and second-morning effects were assessed separately for acute intervention studies. Subgroup analyses were conducted based on the number of exercise bouts (2-3 bouts or frequent brief bouts (e.g., 1-6 min) throughout the day at 20-60-min intervals (known as physical activity [PA] breaks, ≥ 5 bouts)), exercise intensity, and populations. Risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials. Pooled effects were reported as standardized mean differences (SMD) and 95% CI using a random effects model. RESULTS Twenty-seven studies (635 participants) were included. A significant difference was found for same-day PPG control, which favored accumulated exercise over one bout of energy-matched continuous exercise (SMD - 0.36 [95%CI: (- 0.56, - 0.17)], P = 0.0002, I2 = 1%), specifically in accumulated exercise with PA breaks (SMD - 0.36 [95%CI: (- 0.64, - 0.08)], P = 0.01, I2 = 30%), low-moderate intensity exercise (SMD - 0.38 [(95%CI: (- 0.59, - 0.17)], P = 0.0005, I2 = 0%), and in non-diabetic populations (SMD - 0.36 [95%CI: (- 0.62, - 0.10)], P = 0.007, I2 = 16%). No differences were found for same-day postprandial insulin and triglycerides, and second-morning effects (postprandial or fasting glucose, insulin, and triglycerides) between different exercise patterns. CONCLUSION Compared with one session of continuous exercise, accumulated exercise-specifically in subgroups of PA breaks, low-moderate intensity exercises-produced greater acute effects on same-day PPG control for non-diabetic adults. There were no differences between continuous and accumulated patterns of exercise in terms of same-day postprandial insulin and triglycerides, and second-morning effects on all previously mentioned markers. The findings provide additional PA options for PPG control for individuals with limited time or exercise capacity to engage in PA in one session. Registration: PROSPERO (identification code: CRD42021251325).
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Affiliation(s)
- Xiaoyuan Zhang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
- Department of Physical Education, Peking University, Bejing, China
| | - Chen Zheng
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Robin S T Ho
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Stephen Heung Sang Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China.
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20
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Firdous P, Nissar K, Bashir H, Hussain QA, Masoodi SR, Ganai BA. Environmental Factors as Diabetic Mediators: A Mechanistic Approach. Curr Diabetes Rev 2022; 18:e301221199656. [PMID: 34967298 DOI: 10.2174/1573399818666211230104327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/13/2021] [Accepted: 09/29/2021] [Indexed: 11/22/2022]
Abstract
Despite substantial investment in research and treatment options, diabetes mellitus remains a pressing public health concern with potential epidemic proportions globally. There are reports that by the end of 2040, 642 million people will be suffering from diabetes. Also, according to an estimation, 1.6 million deaths were caused directly by diabetes in 2016. Diabetes is a metabolic disorder characterized by impaired glucose regulation in the body due to the destruction of pancreatic β-cells or insulin resistance. Genetic propensity, unhealthy and imbalanced diet, obesity and increasing urbanization are the common risk factors for diabetes. Besides this, it has been reported that environmental pollutants like organic pesticides, heavy metals, and air pollutants act as strong predisposing factors for diabetes owing to their highly bio-accumulative nature. These pollutants disturb glucose homeostasis either by up-regulating or down-regulating the expression of diabetic marker genes like insulin (INS) and glucokinase (GCK). Unfortunately, the molecular mechanism of the role of pollutants in causing diabetes is not very clear. This mechanistic review provides evidence of different environmental determinants, including persistent organic pollutants (POPs), air pollutants, toxic metals, etc., in inducing diabetes and proposes a framework for the possible mechanisms involved. It also illuminates the current status and future challenges, which will not only broaden our understanding but can also be a reasonable platform for further investigation.
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Affiliation(s)
- Parveena Firdous
- Centre of Research for Development (CORD), University of Kashmir, Srinagar, Jammu and Kashmir 190006, India
| | - Kamran Nissar
- Centre of Research for Development (CORD), University of Kashmir, Srinagar, Jammu and Kashmir 190006, India
- Department of Biochemistry, University of Kashmir, Srinagar, Jammu and Kashmir 190006, India
- Department of Clinical Biochemistry, University of Kashmir, Srinagar, Jammu and Kashmir 190006, India
| | - Humayra Bashir
- Centre of Research for Development (CORD), University of Kashmir, Srinagar, Jammu and Kashmir 190006, India
| | - Qazi A Hussain
- P.G. Department of Environmental Science, Sri Pratap College Campus, Cluster University Srinagar, Jammu and Kashmir 190001, India
| | | | - Bashir Ahmad Ganai
- Centre of Research for Development (CORD), University of Kashmir, Srinagar, Jammu and Kashmir 190006, India
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21
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Cui X, Xu J, Yang X, Li L, Jia X, Yu J, Li N, Zhang Y. Acute high intensity interval exercise is similarly effective as moderate intensity continuous exercise on plasma glucose control in type 2 diabetic men aged 30 to 50 years: a randomized controlled trial. J Sports Med Phys Fitness 2021; 62:1246-1254. [PMID: 34931782 DOI: 10.23736/s0022-4707.21.12717-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study aimed to compare the acute effects of high-intensity interval exercise (HIIE) versus moderate-intensity continuous exercise (MICE) on postprandial plasma glucose and insulin concentrations in men aged 30-50 years with type 2 diabetes (T2D), hoping to provide empirical evidence for the effects of different exercise types on glucose management in T2D patients. METHODS 14 men with type 2 diabetes (T2D) underwent a randomized three crossover intervention: HIIE with cycling; energy expenditure matched MICE with cycling; and a sedentary control (CON)) in postprandial state. Plasma glucose and insulin levels were measured at pre-exercise, post-exercise, 1 h post-exercise, pre-lunch and 1 h post-lunch, respectively. Responses of areas under the curve (AUC) during 4 h from pre-exercise to 1 h post-lunch were also calculated. RESULTS Both HIIE and MICE decreased plasma glucose and insulin levels during 4 h experimental period compared to CON, with significant intervention × time interaction effects for glucose (P = 0.001) and insulin (P = 0.006) values evolution. Area under curve (AUCs) for glucose and insulin were reduced in HIIE and MICE compared to CON (P < 0.05), whereas no differences were found between HIIE and MICE. CONCLUSIONS Acute HIIE and the matched MICE improve plasma glucose control in the same magnitude in type 2 diabetic men aged 30-50 years.
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Affiliation(s)
- Xinwen Cui
- China Institute of Sport Science, Dongcheng District, Beijing, China.,Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Haidian District, Beijing, China
| | - Jianfang Xu
- China Institute of Sport Science, Dongcheng District, Beijing, China
| | - Xingya Yang
- China Institute of Sport Science, Dongcheng District, Beijing, China
| | - Lifeng Li
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Haidian District, Beijing, China
| | - Xiao Jia
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Haidian District, Beijing, China
| | - Jingjing Yu
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Haidian District, Beijing, China
| | - Naishi Li
- Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China -
| | - Yimin Zhang
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Haidian District, Beijing, China
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22
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Timing of Meals and Exercise Affects Hormonal Control of Glucoregulation, Insulin Resistance, Substrate Metabolism, and Gastrointestinal Hormones, but Has Little Effect on Appetite in Postmenopausal Women. Nutrients 2021; 13:nu13124342. [PMID: 34959894 PMCID: PMC8707655 DOI: 10.3390/nu13124342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 12/22/2022] Open
Abstract
The current prevalence of obesity in the US is strongly associated with excessive food intake and insufficient physical activity. This study examined whether changing the timing of exercise before or after two daily meals could alter human appetite for food. Fifty-four healthy postmenopausal women were matched by body weight and assigned to two groups: (1) two bouts of 2-h moderate-intensity exercise ending one hour before each weight-maintenance meal (XM, n = 23), (2) two-hour moderate-intensity exercise starting 1 h after each weight-maintenance meal (MX, n = 23), and one sedentary control (SED) arm (n = 8). Measurements included appetite ratings, circulating glucose, free fatty acids (FFAs), a ketone body D-ß-hydroxybutyrate (BHB), glucoregulatory hormones insulin and glucagon, and gastrointestinal hormones associated with food digestion and absorption and implicated in appetite sensations. XM group increased concentrations of FFAs and BHB during exercise and increased insulin and homeostatic assessment of insulin resistance (HOMA-IR) during postprandial periods. MX group reduced postprandial insulin and HOMA-IR by about 50% without a major change in plasma glucose. There was brief suppression of hunger and an increase in satiation in both exercise groups near the end of the first postprandial period. The time course of hunger was unrelated to the perturbations in fuel metabolism, depletion of liver glycogen, and not correlated with concentration changes in hunger-stimulating hormone ghrelin during XM exercise before meals. Similarly, there was no correlation between the time course of fullness during exercise after meals with the postprandial secretion of gastrointestinal hormones including cholecystokinin (CCK) that has been linked to satiation. Hunger and satiation appear to depend on oral intake and gastrointestinal processing of nutrients and are not affected by metabolic and hormonal consequences of the timing of exercise with respect to meals. Moderate-intensity exercise performed shortly after meals induces a rapid and highly effective lowering of insulin resistance.
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23
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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.
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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
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24
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Zhang X, Sun F, Wongpipit W, Huang WYJ, Wong SHS. Accuracy of Flash Glucose Monitoring During Postprandial Rest and Different Walking Conditions in Overweight or Obese Young Adults. Front Physiol 2021; 12:732751. [PMID: 34721064 PMCID: PMC8555657 DOI: 10.3389/fphys.2021.732751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/21/2021] [Indexed: 12/17/2022] Open
Abstract
Aims: To investigate the accuracy of FreeStyle LibreTM flash glucose monitoring (FGM) relevant to plasma glucose (PG) measurements during postprandial rest and different walking conditions in overweight/obese young adults. Methods: Data of 40 overweight/obese participants from two randomized crossover studies were pooled into four trials: (1) sitting (SIT, n = 40); (2) walking continuously for 30 min initiated 20 min before individual postprandial glucose peak (PPGP) (20iP + CONT, n = 40); (3) walking continuously for 30 min initiated at PPGP (iP + CONT, n = 20); and (4) accumulated walking for 30 min initiated 20 min before PPGP (20iP + ACCU, n = 20). Paired FGM and PG were measured 4 h following breakfast. Results: The overall mean absolute relative difference (MARD) between PG and FGM readings was 16.4 ± 8.6% for SIT, 16.2 ± 4.7% for 20iP + CONT, 16.7 ± 12.2% for iP + CONT, and 19.1 ± 6.8% for 20iP + ACCU. The Bland-Altman analysis showed a bias of -1.03 mmol⋅L-1 in SIT, -0.89 mmol⋅L-1 in 20iP + CONT, -0.82 mmol⋅L-1 in iP + CONT, and -1.23 mmol⋅L-1 in 20iP + ACCU. The Clarke error grid analysis showed that 99.6-100% of the values in all trials fell within zones A and B. Conclusion: Although FGM readings underestimated PG, the FGM accuracy was overall clinically acceptable during postprandial rest and walking in overweight/obese young adults.
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Affiliation(s)
- Xiaoyuan Zhang
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR China.,School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Fenghua Sun
- Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, Hong Kong, SAR China
| | - Waris Wongpipit
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR China.,Division of Health and Physical Education, Faculty of Education, Chulalongkorn University, Bangkok, Thailand
| | - Wendy Y J Huang
- Department of Sport, Physical Education, and Health, Hong Kong Baptist University, Kowloon, Hong Kong, SAR China
| | - Stephen H S Wong
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR China
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25
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Skurk T, Bosy-Westphal A, Grünerbel A, Kabisch S, Keuthage W, Kronsbein P, Müssig K, Pfeiffer AFH, Simon MC, Tombek A, Weber KS, Rubin D. Empfehlungen zur Ernährung von Personen mit Typ-2-Diabetes mellitus. DIABETOL STOFFWECHS 2021. [DOI: 10.1055/a-1543-1293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Thomas Skurk
- ZIEL- Institute for Food & Health, Technische Universität München, Freising
- Else Kröner-Fresenius-Zentrum für Ernährungsmedizin, Technische Universität München, Freising
| | - Anja Bosy-Westphal
- Institut für Humanernährung, Agrar- und Ernährungswissenschaftliche Fakultät, Christian-Albrechts-Universität zu Kiel, Kiel
| | | | - Stefan Kabisch
- Abt. Endokrinologie, Diabetes und Ernährungsmedizin, Charité Universitätsmedizin Berlin, Berlin
- Deutsche Zentrum für Diabetesforschung (DZD), München
| | | | - Peter Kronsbein
- Fachbereich Oecotrophologie, Hochschule Niederrhein, Campus Mönchengladbach
| | - Karsten Müssig
- Klinik für Innere Medizin und Gastroenterologie, Niels-Stensen-Kliniken, Franziskus-Hospital Harderberg, Georgsmarienhütte
| | - Andreas F. H. Pfeiffer
- Abt. Endokrinologie, Diabetes und Ernährungsmedizin, Charité Universitätsmedizin Berlin, Berlin
| | - Marie-Christine Simon
- Institut für Ernährungs- und Lebensmittelwissenschaften, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn
| | | | - Katharina S. Weber
- Institut für Epidemiologie, Christian-Albrechts-Universität zu Kiel, Kiel
| | - Diana Rubin
- Vivantes Klinikum Spandau, Berlin
- Vivantes Humboldt Klinikum, Berlin
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26
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Andersen MB, Fuglsang J, Ostenfeld EB, Poulsen CW, Daugaard M, Ovesen PG. Postprandial interval walking-effect on blood glucose in pregnant women with gestational diabetes. Am J Obstet Gynecol MFM 2021; 3:100440. [PMID: 34216833 DOI: 10.1016/j.ajogmf.2021.100440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND During pregnancy, postprandial hyperglycemia may increase the risk of complications such as fetal macrosomia. However, evidence on beneficial effects of physical activity on postprandial hyperglycemia is sparse. OBJECTIVE This study aimed to investigate the effect of 20 minutes of postprandial interval walking on glycemic control and glycemic variability in pregnant women diagnosed as having gestational diabetes mellitus. STUDY DESIGN A crossover controlled trial including 14 pregnant women (gestational age 31.8±1.3 weeks) diagnosed as having gestational diabetes mellitus (75 g oral glucose load with 2-hour venous plasma glucose of ≥9.0 mmol/L) was conducted. Participants completed a 4-day intervention period and a 4-day control period with 3 days in between. In each study period, participants received a fixed and identical diet. In the intervention period, participants engaged in 20 minutes of postprandial interval walking after breakfast, lunch, and dinner. Interval walking comprised alternating 3 minutes of slow and fast intervals. Interstitial glucose concentrations were determined during both study periods with a continuous glucose monitor. The mixed effects model was used to compare differences between exercise and no exercise. RESULTS Of note, 20 minutes of postprandial interval walking significantly reduced glycemic control during daytime hours relative to the control period (4-day mean glucose, 5.31 [5.04-5.59] vs 5.53 [5.25-5.81] mmol/L [95.6 (90.7-100.6) vs 99.5 (94.5-104.6) mg/dL]; P<.05). On each individual trial day, interval walking significantly reduced glycemic control during daytime hours on day 1 (mean glucose, 5.19 [4.92-5.47] vs 5.55 [5.27-5.83] mmol/L [93.4 (88.6-98.5) vs 99.9 (94.9-104.9) mg/dL]; P=.00), day 2 (mean glucose, 5.32 [5.05-5.60] vs 5.57 [5.29-5.84] mmol/L [95.8 (90.9-100.8) vs 100.3 (95.2-105.1) mg/dL]; P=.00), and day 3 (mean glucose, 5.27 [5.00-5.54] vs 5.46 [5.19-5.74] mmol/L [94.9 (90.0-99.7) vs 98.3 (93.4-103.3) mg/dL]; P=.00), but not on day 4. CONCLUSION A total of 20 minutes of postprandial interval walking seems to be an effective way to control postprandial glucose excursions in women with gestational diabetes mellitus.
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Affiliation(s)
- Mette B Andersen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.
| | - Jens Fuglsang
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Eva B Ostenfeld
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Charlotte W Poulsen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Merete Daugaard
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Per G Ovesen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
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27
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Gillen JB, Estafanos S, Govette A. Exercise-nutrient interactions for improved postprandial glycemic control and insulin sensitivity. Appl Physiol Nutr Metab 2021; 46:856-865. [PMID: 34081875 DOI: 10.1139/apnm-2021-0168] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Type 2 diabetes (T2D) is a rapidly growing yet largely preventable chronic disease. Exaggerated increases in blood glucose concentration following meals is a primary contributor to many long-term complications of the disease that decrease quality of life and reduce lifespan. Adverse health consequences also manifest years prior to the development of T2D due to underlying insulin resistance and exaggerated postprandial concentrations of the glucose-lowering hormone insulin. Postprandial hyperglycemic and hyperinsulinemic excursions can be improved by exercise, which contributes to the well-established benefits of physical activity for the prevention and treatment of T2D. The aim of this review is to describe the postprandial dysmetabolism that occurs in individuals at risk for and with T2D, and highlight how acute and chronic exercise can lower postprandial glucose and insulin excursions. In addition to describing the effects of traditional moderate-intensity continuous exercise on glycemic control, we highlight other forms of activity including low-intensity walking, high-intensity interval exercise, and resistance training. In an effort to improve knowledge translation and implementation of exercise for maximal glycemic benefits, we also describe how timing of exercise around meals and post-exercise nutrition can modify acute and chronic effects of exercise on glycemic control and insulin sensitivity. Novelty: Exaggerated postprandial blood glucose and insulin excursions are associated with disease risk. Both a single session and repeated sessions of exercise improve postprandial glycemic control in individuals with and without T2D. The glycemic benefits of exercise can be enhanced by considering the timing and macronutrient composition of meals around exercise.
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Affiliation(s)
- Jenna B Gillen
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada
| | - Stephanie Estafanos
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada
| | - Alexa Govette
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2C9, Canada
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28
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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.
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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
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29
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Chang CR, Russell BM, Dempsey PC, Christie HE, Campbell MD, Francois ME. Accumulating Physical Activity in Short or Brief Bouts for Glycemic Control in Adults With Prediabetes and Diabetes. Can J Diabetes 2020; 44:759-767. [PMID: 33279098 DOI: 10.1016/j.jcjd.2020.10.013] [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: 07/14/2020] [Revised: 10/20/2020] [Accepted: 10/23/2020] [Indexed: 01/04/2023]
Abstract
Clinical practice guidelines on physical activity and diabetes currently stipulate physical activity can be accumulated in bouts of ≥10 minutes to meet recommendations for health benefits. Individuals are also encouraged to interrupt prolonged sitting with brief activity breaks of ∼1 to 5 minutes in duration. Growing research highlights accumulating activity in shorter bouts across the day as a potential strategy to improve glycemic control and to help those who are largely sedentary meet physical activity guidelines. Research has shown favourable glycemic benefits for postprandial glucose and glycated hemoglobin with either 3 short (10 to 15 minutes) or frequent brief (1 to 5 minutes) bouts of activity spread around meals or throughout the day. To date, most studies examining accumulated activity were done with people with type 2 diabetes compared with sedentary conditions, were short term and measured various indices of glycemic control using continuous glucose monitoring. The 7 trials comparing accumulating 3 short bouts to a single bout showed comparable benefits for glycemic control (i.e. fasting glucose, 24 h mean glucose and postprandial hyperglycemia). Furthermore, timing short bouts around meals may improve postprandial glucose and hyperglycemia more than a single bout. It is unknown whether a threshold for the duration of accumulated bouts exists---that is, "how much is enough?" In this narrative review, we focus on the glycemic effects of physical activity accumulated in short or brief bouts for people with prediabetes and diabetes as compared with a single continuous bout. Given that poor adherence to physical activity recommendations and that fewer opportunities exist in modern societies for incidental (nonexercise) physical activity, accumulating activity may be a choice strategy for improving glycemic control in those with and at risk of diabetes.
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Affiliation(s)
- Courtney R Chang
- Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Brooke M Russell
- Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Paddy C Dempsey
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; Institute of Metabolic Science, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Hannah E Christie
- Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Matthew D Campbell
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom; Institute of Health Sciences and Wellbeing, University of Sunderland, Sunderland, United Kingdom
| | - Monique E Francois
- Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia.
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30
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Iida Y, Takeishi S, Fushimi N, Tanaka K, Mori A, Sato Y. Effect of postprandial moderate-intensity walking for 15-min on glucose homeostasis in type 2 diabetes mellitus patients. Diabetol Int 2020; 11:383-387. [PMID: 33088646 DOI: 10.1007/s13340-020-00433-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 03/19/2020] [Indexed: 11/29/2022]
Abstract
Aim Diabetes patients usually have a low activity level and complain about lack of time. Therefore, we investigated the effect of short time, postprandial moderate-intensity exercise on glucose homeostasis in type 2 diabetes patients. Methods Eleven patients with type 2 diabetes were recruited. Patients spent the first day of the study without exercise (non-exercise day; NE day). In the second day, they walked at moderate-intensity (40% of the maximum heart rate reserve) for 15 min, 30 min after each meal (exercise day; E day). Glucose homeostasis was estimated by a continuous glucose monitor (CGM). All meals during the study were of standard composition. We compared NE day and E day concerning 24-h glucose homeostasis and 3 h postprandial glucose levels by the incremental area under the curve (iAUC) method. Medications were not changed during the study. Results The number of patients under basal supported oral therapy, intensive insulin therapy and oral hypoglycemic agents (OHA) were 5, 4 and 2, respectively. The blood glucose standard deviation over 24 h and the iAUC for the 24-h glycemic variability (NE day vs. E day; 34,765 [21,424-56,014] vs. 23,205 [15,323-39,779]) were smaller in E day than in NE day. Conclusion These results suggest that postprandial moderate-intensity walking, easily performable in daily life activities, was effective for improving glucose homeostasis. Further study should be performed to clarify the relationship between postprandial walk and drug therapy (insulin and OHA), including insulin secretory ability.
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Affiliation(s)
- Yuji Iida
- Department of Rehabilitation, Ichinomiyanishi Hospital, Hira 1, Kaimei, Ichinomiya, Aichi 494-0001 Japan.,Department of Sports Medicine, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550 Japan
| | - Soichi Takeishi
- Department of Endocrinology and Diabetes, Ichinomiyanishi Hospital, Hira 1, Kaimei, Ichinomiya, Aichi 494-0001 Japan
| | - Nobutoshi Fushimi
- Department of Endocrinology and Diabetes, Ichinomiyanishi Hospital, Hira 1, Kaimei, Ichinomiya, Aichi 494-0001 Japan
| | - Kazuhiko Tanaka
- Department of Rehabilitation, Ichinomiyanishi Hospital, Hira 1, Kaimei, Ichinomiya, Aichi 494-0001 Japan
| | - Akihiro Mori
- Department of Endocrinology and Diabetes, Ichinomiyanishi Hospital, Hira 1, Kaimei, Ichinomiya, Aichi 494-0001 Japan
| | - Yuzo Sato
- The Graduate Center of Human Sciences, Aichi Mizuho College, 2-13, Shunko-cho, Mizuho-ku, Nagoya, Aichi 467-0867 Japan
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31
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Gouldrup H, Ma T. Why are physical activity breaks more effective than a single session of isoenergetic exercise in reducing postprandial glucose? A systemic review and meta-analysis. J Sports Sci 2020; 39:212-218. [PMID: 32835621 DOI: 10.1080/02640414.2020.1812196] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Previous studies revealed that interrupting sitting time with short, frequent physical activity (PA) breaks were more effective than a single session of isoenergetic exercise in reducing postprandial glucose. However, in those studies, the expected glucose-lowering effects of single-session exercises were diminished or even eliminated by exercise-induced glucose counterregulation as evidenced by the higher glucose levels during or after exercise compared to uninterrupted sitting. This study was aimed to investigate whether glucose counterregulation is a potential explanation of PA breaks being more effective than a single session of isoenergetic exercise in reducing postprandial glucose. We meta-analysed the standardized mean differences (SMD) of glucose incremental area under the curve (iAUC). PA breaks were more effective than single-session exercise in reducing glucose iAUC (5 studies, SMD = -0.581; 95% confidence interval [CI], -0.777 to -0.385; P < 0.0001) when exercise-induced glucose counterregulation occurred. There was no significant difference in glucose iAUC between PA breaks and single-session exercises (2 studies, SMD = 0.302; 95% CI, -0.107 to 0.711; P = 0.451) when glucose counterregulation did not occur. We concluded that the exercise-induced glucose counterregulation was a potential explanation of PA breaks being more effective than a single session of isoenergetic exercise in reducing postprandial glucose responses. (PROSPERO ID: CRD42020175737).
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Affiliation(s)
- Hannah Gouldrup
- Health Sciences Department, Franklin Pierce University , Rindge, NH, USA
| | - Tongyu Ma
- Health Sciences Department, Franklin Pierce University , Rindge, NH, USA
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32
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An NP's guide to current physical activity recommendations. Nurse Pract 2020; 45:24-31. [PMID: 32826536 DOI: 10.1097/01.npr.0000694708.74213.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Physical inactivity is a public health crisis that contributes to many of the chronic diseases that affect Americans. This review emphasizes the beneficial health implications of physical activity along with the dangers of sedentary lifestyles. It also provides advice tailored to NPs to help their patients become more physically active.
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33
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Shambrook P, Kingsley MI, Taylor NF, Wundersitz DW, Wundersitz CE, Gordon BA. Multiple short bouts of exercise are better than a single continuous bout for cardiometabolic health: a randomised crossover trial. Eur J Appl Physiol 2020; 120:2361-2369. [PMID: 32776220 DOI: 10.1007/s00421-020-04461-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/04/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To compare cardiometabolic responses to five consecutive days of daily postprandial exercise accumulated in three 10-min bouts or a single 30-min bout to a no-exercise control. METHODS Ten insufficiently active adults completed three trials in a randomised order. Each trial comprised five consecutive days of 30 min of exercise either accumulated in three separate 10-min bouts (ACC) after main meals; a single 30-min bout after dinner (CONT); or a no-exercise control (NOEX). Glucose regulation was assessed from an oral glucose tolerance test. Applanation tonometry was used to assess pulse wave velocity approximately 12 h following completion of the final trial. RESULTS Area under the 2-h glucose curve was similar for CONT (mean; 95% CI 917 mmol L-1 2 h-1; 815 to 1019) and ACC (931 mmol L-1 2 h-1; 794 to 1068, p = 0.671). Area under the 2-h insulin curve was greater following NOEX (70,328 pmol L-1 2 h-1; 30,962 to 109,693) than ACC (51,313 pmol L-1 2 h-1: 21,822 to 80,806, p = 0.007). Pulse wave velocity was lower for ACC (5.96 m s-1: 5.38 to 6.53) compared to CONT (6.93 m s-1: 5.92 to 7.94, p = 0.031) but not significantly lower for ACC compared to NOEX (6.52 m s-1: 5.70 to 7.34, p = 0.151). CONCLUSION Accumulating 30 min of moderate-intensity walking in three bouts throughout the day is more effective at reducing markers of cardiometabolic health risk in insufficiently active, apparently healthy adults than a single daily bout. Both accumulated and single-bout walking were equally as effective at reducing postprandial glucose concentrations compared to a no-exercise control. Therefore, accumulating exercise in short bouts after each main meal might be more advantageous for overall cardiometabolic health.
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Affiliation(s)
- Philip Shambrook
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, P.O. Box 199, Bendigo, VIC, 3552, Australia
| | - Michael I Kingsley
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, P.O. Box 199, Bendigo, VIC, 3552, Australia.,Department of Exercise Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand
| | - Nicholas F Taylor
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Daniel W Wundersitz
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, P.O. Box 199, Bendigo, VIC, 3552, Australia
| | - Claire E Wundersitz
- Angliss Hospital Community Rehabilitation Programme, Eastern Health, Melbourne, Australia
| | - Brett A Gordon
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, P.O. Box 199, Bendigo, VIC, 3552, Australia.
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Loh R, Stamatakis E, Folkerts D, Allgrove JE, Moir HJ. Effects of Interrupting Prolonged Sitting with Physical Activity Breaks on Blood Glucose, Insulin and Triacylglycerol Measures: A Systematic Review and Meta-analysis. Sports Med 2020; 50:295-330. [PMID: 31552570 PMCID: PMC6985064 DOI: 10.1007/s40279-019-01183-w] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Physical activity (PA) breaks in sitting time might attenuate metabolic markers relevant to the prevention of type 2 diabetes. OBJECTIVES The primary aim of this paper was to systematically review and meta-analyse trials that compared the effects of breaking up prolonged sitting with bouts of PA throughout the day (INT) versus continuous sitting (SIT) on glucose, insulin and triacylglycerol (TAG) measures. A second aim was to compare the effects of INT versus continuous exercise (EX) on glucose, insulin and TAG measures. METHODS The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) recommendations. Eligibility criteria consisted of trials comparing INT vs. SIT or INT vs. one bout of EX before or after sitting, in participants aged 18 or above, who were classified as either metabolically healthy or impaired, but not with other major health conditions such as chronic obstructive pulmonary disease or peripheral arterial disease. RESULTS A total of 42 studies were included in the overall review, whereas a total of 37 studies were included in the meta-analysis. There was a standardised mean difference (SMD) of - 0.54 (95% CI - 0.70, - 0.37, p = 0.00001) in favour of INT compared to SIT for glucose. With respect to insulin, there was an SMD of - 0.56 (95% CI - 0.74, - 0.38, p = 0.00001) in favour of INT. For TAG, there was an SMD of - 0.26 (95% CI - 0.44, - 0.09, p = 0.002) in favour of INT. Body mass index (BMI) was associated with glucose responses (β = - 0.05, 95% CI - 0.09, - 0.01, p = 0.01), and insulin (β = - 0.05, 95% CI - 0.10, - 0.006, p = 0.03), but not TAG (β = 0.02, 95% CI - 0.02, 0.06, p = 0.37). When energy expenditure was matched, there was an SMD of - 0.26 (95% CI - 0.50, - 0.02, p = 0.03) in favour of INT for glucose, but no statistically significant SMDs for insulin, i.e. 0.35 (95% CI - 0.37, 1.07, p = 0.35), or TAG i.e. 0.08 (95% CI - 0.22, 0.37, p = 0.62). It is worth noting that there was possible publication bias for TAG outcomes when PA breaks were compared with sitting. CONCLUSION The use of PA breaks during sitting moderately attenuated post-prandial glucose, insulin, and TAG, with greater glycaemic attenuation in people with higher BMI. There was a statistically significant small advantage for PA breaks over continuous exercise for attenuating glucose measures when exercise protocols were energy matched, but no statistically significant differences for insulin and TAG. PROSPERO Registration: CRD42017080982. PROSPERO REGISTRATION CRD42017080982.
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Affiliation(s)
- Roland Loh
- School of Life Sciences, Pharmacy and Chemistry, Faculty of Science, Engineering and Computing, Kingston University, Penrhyn Road, Kingston upon Thames, Surrey, London, KT1 2EE, UK.
| | - Emmanuel Stamatakis
- Charles Perkins Centre, Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Dirk Folkerts
- School of Life Sciences, Pharmacy and Chemistry, Faculty of Science, Engineering and Computing, Kingston University, Penrhyn Road, Kingston upon Thames, Surrey, London, KT1 2EE, UK.,Faculty of Sport and Exercise Sciences, University of Muenster, Münster, Germany
| | - Judith E Allgrove
- School of Life Sciences, Pharmacy and Chemistry, Faculty of Science, Engineering and Computing, Kingston University, Penrhyn Road, Kingston upon Thames, Surrey, London, KT1 2EE, UK
| | - Hannah J Moir
- School of Life Sciences, Pharmacy and Chemistry, Faculty of Science, Engineering and Computing, Kingston University, Penrhyn Road, Kingston upon Thames, Surrey, London, KT1 2EE, UK.
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Abstract
Several evidence-based lifestyle habits focusing on the composition, timing, and sequence of meals and on pre- and postmeal exercise can improve diabetes management. Consuming low-carbohydrate, balanced meals and eating most carbohydrates early in the day are helpful habits. Eating the protein and vegetable components of a meal first and consuming the carbohydrates 30 minutes later can moderate glucose levels. Postmeal glucose surges can be blunted without precipitating hypoglycemia with moderate exercise 30-60 minutes before the anticipated peak. Short-duration, high-intensity exercise could also be effective. Premeal exercise can improve insulin sensitivity but can also cause post-exertion glucose elevations. Moreover, high-intensity premeal exercise may precipitate delayed hypoglycemia in some people. Glycemia benefits can be enhanced by eating a light, balanced breakfast after premeal exercise.
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Affiliation(s)
- Elsamma Chacko
- Department of Internal Medicine, Connecticut Valley Hospital, Middletown, CT
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Anitha Rani M, Shriraam V. Are Patients With Type 2 Diabetes Not Aware or Are They Unable to Practice Self-Care? A Qualitative Study in Rural South India. J Prim Care Community Health 2020; 10:2150132719865820. [PMID: 31375045 PMCID: PMC6681247 DOI: 10.1177/2150132719865820] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Lack of awareness and poor adherence to dietary,
lifestyle modifications, and medications among patients with diabetes result in
poor health outcomes. Aim: This study aimed to understand patients’
perceptions about barriers to self-management of diabetes. Materials and
Methods: This was a descriptive qualitative study among patients with
diabetes attending a rural health center. Five focus group discussions were
conducted with 8 to 11 participants using a topic guide. Results:
Many were unaware of target levels and complications of diabetes. Some aspects
of the dietary information were found to be quite confusing. Physical
constraints prevented many from going for outdoor walking. They have not
received any information on foot care. Conclusions: Understanding
the barriers for self-care will help health care workers manage diabetes
better.
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Affiliation(s)
- M Anitha Rani
- 1 Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
| | - Vanishree Shriraam
- 1 Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
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37
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REducing SEDENTary Behavior Among Mild to Moderate Cognitively Impaired Assisted Living Residents: A Pilot Randomized Controlled Trial (RESEDENT Study). J Aging Phys Act 2020; 29:27-35. [PMID: 32580164 DOI: 10.1123/japa.2019-0440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 04/03/2020] [Accepted: 04/23/2020] [Indexed: 11/18/2022]
Abstract
Older adults in assisted living spend most of their day in sedentary behaviors, which may be detrimental to cognitive function. The primary purpose of this pilot study was to assess the feasibility of using a prompting device to reduce sitting time with light walking among older adults with mild to moderate cognitive impairment residing in an assisted living setting. A secondary purpose was to examine the effectiveness of the intervention on the residents' cognitive function, physical function, and quality of life. The participants (n = 25, mean age = 86.7 [5.3] years) were assigned in clusters into a two-arm 10-week single-site pilot randomized controlled trial. The intervention group was prompted with a watch to interrupt sedentary behaviors and partake in 10 min of light physical activity (i.e., walking) three times a day after a meal. The assessments included hip-worn accelerometers (Actical) and diaries, the Alzheimer's disease assessment scale-cognitive, Timed Up and Go, and the short-form 36 health survey. Adherence was high, as there were no dropouts, and over 70% of the participants completed over 80% of the prescribed physical activity bouts. Significant effects favoring the intervention were shown for all outcomes.
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Davis DW, Navalta JW, McGinnis GR, Serafica R, Izuora K, Basu A. Effects of Acute Dietary Polyphenols and Post-Meal Physical Activity on Postprandial Metabolism in Adults with Features of the Metabolic Syndrome. Nutrients 2020; 12:E1120. [PMID: 32316418 PMCID: PMC7230938 DOI: 10.3390/nu12041120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/07/2020] [Accepted: 04/15/2020] [Indexed: 01/10/2023] Open
Abstract
Approximately 22% of U.S. adults and 25% of adults globally have metabolic syndrome (MetS). Key features, such as dysglycemia and dyslipidemia, predict type 2 diabetes, cardiovascular disease, premature disability, and death. Acute supplementation of dietary polyphenols and post-meal physical activity hold promise in improving postprandial dysmetabolism. To our knowledge, no published review has described the effects of either intervention on postprandial glucose, insulin, lipids, and markers of oxidative damage and inflammation in adults with features of MetS. Thus, we conducted this review of controlled clinical trials that provided dietary polyphenols from oils, fruits, teas, and legumes during a dietary challenge, or implemented walking, cycling, and stair climbing and descending after a dietary challenge. Clinical trials were identified using ClinicalTrials.gov, PubMed, and Google Scholar and were published between 2000 and 2019. Dietary polyphenols from extra virgin olive oil, grapes, blackcurrants, strawberries, black tea, and black beans improved postprandial glucose, insulin, and markers of oxidative damage and inflammation, but results were not consistent among clinical trials. Freeze-dried strawberry powder distinctly improved postprandial insulin and markers of oxidative damage and inflammation. Post-meal physical activity attenuated postprandial glucose, but effects on postprandial lipids and markers of oxidative damage and inflammation were inconclusive. Consuming dietary polyphenols with a meal and completing physical activity after a meal may mitigate postprandial dysmetabolism in adults with features of MetS.
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Affiliation(s)
- Dustin W Davis
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (D.W.D.); (J.W.N.); (G.R.M.)
| | - James W Navalta
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (D.W.D.); (J.W.N.); (G.R.M.)
| | - Graham R McGinnis
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (D.W.D.); (J.W.N.); (G.R.M.)
| | - Reimund Serafica
- School of Nursing, University of Nevada, Las Vegas, NV 89154, USA;
| | - Kenneth Izuora
- Department of Internal Medicine, School of Medicine, University of Nevada, Las Vegas, NV 89154, USA;
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV 89154, USA; (D.W.D.); (J.W.N.); (G.R.M.)
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Suntornlohanakul O, Areevut C, Saetung S, Ingsathit A, Rattarasarn C. Glycemic effect of post-meal walking compared to one prandial insulin injection in type 2 diabetic patients treated with basal insulin: A randomized controlled cross-over study. PLoS One 2020; 15:e0230554. [PMID: 32236116 PMCID: PMC7112182 DOI: 10.1371/journal.pone.0230554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 02/25/2020] [Indexed: 11/21/2022] Open
Abstract
Studies demonstrate that post-meal walking decreases postprandial hyperglycemia in type 2 diabetic patients but it has never been tested with the active treatment comparator. The objective of this study was to determine the effect of post-meal walking on glycemic control compared with one prandial insulin in type 2 diabetic patients who failed basal insulin. A randomized controlled cross-over study of post-meal walking or one prandial insulin was done in type 2 diabetic patients who were being treated with basal insulin between May 2017 and March 2018. In post-meal walking group, patients walked after meal for 15–20 minutes one meal a day every day for 6 weeks. In prandial insulin (basal plus) group, one prandial insulin was injected before breakfast or main meal with rapid-acting insulin. The primary outcome was a difference in HbA1c reduction in post-meal walking compared with basal plus groups. Fourteen patients completed the study. By intention-to-treat analysis, HbA1c was reduced by -0.05(range:-1.08 to 0.74) and -0.19(range:-0.8 to 0.56) % in post-meal walking and basal plus groups respectively. By per-protocol analysis, post-meal walking and basal plus groups decreased HbA1c by 0.13(range:-0.74 to 1.08) and 0.2(range:-0.56 to 0.8) %, respectively. There was were no significant differences in HbA1c reduction from baseline in each group and between groups in both intention-to-treat and per-protocol analysis. Fructosamine levels were decreased by 17.5(-59 to 43) and 10(-15 to 40) μmol/L, respectively at 3 and 6 weeks in post-meal walking group whereas the respective changes in basal plus group were 12.5(-17 to 64) and 17.5(-28 to 38) μmol/L and there were no significant differences in fructosamine reduction from baseline in each group and between groups. In conclusion, although post-meal walking might be as effective as one prandial insulin to improve glycemic control in type 2 diabetic patients who failed basal insulin but the magnitude of reduction was small. A longer-term study with a larger sample size or with a different walking protocol is required.
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Affiliation(s)
- Onnicha Suntornlohanakul
- Division of Endocrinology and Metabolism, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chatvara Areevut
- Division of Endocrinology and Metabolism, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sunee Saetung
- Division of Endocrinology and Metabolism, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Atiporn Ingsathit
- Division of Nephrology, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Department of Clinical Epidemiology and Biostatistics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chatchalit Rattarasarn
- Division of Endocrinology and Metabolism, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- * E-mail:
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40
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Abstract
Real-time continuous glucose monitoring (CGM) use may lead to behavioral modifications in food selection and physical activity, but there are limited data on the utility of CGM in facilitating lifestyle changes. This article describes an 18-item survey developed to explore whether patients currently using CGM believe the technology has caused them to change their behavior.
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41
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Liao Y, Basen-Engquist KM, Urbauer DL, Bevers TB, Hawk E, Schembre SM. Using Continuous Glucose Monitoring to Motivate Physical Activity in Overweight and Obese Adults: A Pilot Study. Cancer Epidemiol Biomarkers Prev 2020; 29:761-768. [PMID: 32066620 DOI: 10.1158/1055-9965.epi-19-0906] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/22/2019] [Accepted: 02/12/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Regular physical activity (PA) is associated with a lower risk of several types of cancers. However, two-thirds of overweight/obese adults are not sufficiently active; this, in combination with the unfavorable effect of excess body weight, puts them at a greater risk for cancer. One reason that these individuals do not engage in enough PA may be their lack of motivation to change their current behavior due to the perception of putting in effort for possible future gain without obvious short-term benefits. There is a need for innovative ways to help individuals recognize the immediate health benefits of PA and thus increase their motivation. METHODS This pilot intervention tested a PA education module that included a one-on-one counseling session highlighting the acute effects of PA on glucose patterns, followed by a 10-day self-monitoring period with a continuous glucose monitor (CGM) and a Fitbit tracker. Participants rated the acceptability of the education module on a 5-point Likert scale and completed surveys assessing stages of change for motivational readiness. RESULTS Nineteen overweight/obese adults (84% female) completed the study. Participants gave high ratings to the counseling session for improving their PA-related knowledge (mean = 4.22), increasing motivation (mean = 4.29), and providing personally relevant information (mean = 4.35). The summary acceptability scores for the self-monitoring period were 4.46 for CGM and 4.51 for Fitbit. Participants reported a significant decrease in the precontemplation stage and an increase in the action stage (P < 0.05). CONCLUSIONS CGM is a feasible tool for PA interventions. IMPACT Information from CGM could be used as biological-based feedback to motivate PA.See all articles in this CEBP Focus section, "Modernizing Population Science."
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Affiliation(s)
- Yue Liao
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Karen M Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Diana L Urbauer
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Therese B Bevers
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ernest Hawk
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Susan M Schembre
- Department of Family & Community Medicine, University of Arizona, Tucson, Arizona
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Paing AC, McMillan KA, Kirk AF, Collier A, Hewitt A, Chastin SFM. Impact of free-living pattern of sedentary behaviour on intra-day glucose regulation in type 2 diabetes. Eur J Appl Physiol 2019; 120:171-179. [PMID: 31705275 PMCID: PMC6969863 DOI: 10.1007/s00421-019-04261-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 11/05/2019] [Indexed: 12/14/2022]
Abstract
Purpose To investigate how the pattern of sedentary behaviour affects intra-day glucose regulation in type 2 diabetes. Methods This intensive longitudinal study was conducted in 37 participants with type 2 diabetes (age, 62.8 ± 10.5 years). Glucose and sedentary behaviour/physical activity were assessed with a continuous glucose monitoring (Abbott FreeStyle Libre) and an activity monitor (activPAL3) for 14 days. Multiple regression models with generalised estimating equations (GEEs) approach were used to assess the associations of sedentary time and breaks in sedentary time with pre-breakfast glucose, pre-lunch glucose, pre-dinner glucose, post-breakfast glucose, post-lunch glucose, post-dinner glucose, bedtime glucose, the dawn phenomenon, time in target glucose range (TIR, glucose 3.9–10 mmol/L) and time above target glucose range (TAR, glucose > 10 mmol/L). Results Sedentary time was associated with higher pre-breakfast glucose (p = 0.001), pre-dinner glucose (p < 0.001), post-lunch glucose (p = 0.005), post-dinner glucose (p = 0.013) and the dawn phenomenon (p < 0.001). Breaks in sedentary time were associated with lower pre-breakfast glucose (p = 0.023), pre-dinner glucose (p = 0.023), post-breakfast glucose (p < 0.001) and the dawn phenomenon (p = 0.004). The association between sedentary time and less TIR (p = 0.022) and the association between breaks in sedentary time and more TIR (p = 0.001) were also observed. Conclusions Reducing sedentary time and promoting breaks in sedentary time could be clinically relevant to improve intra-day glucose regulation in type 2 diabetes. Electronic supplementary material The online version of this article (10.1007/s00421-019-04261-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aye C Paing
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
| | - Kathryn A McMillan
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Alison F Kirk
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Andrew Collier
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Allan Hewitt
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Sebastien F M Chastin
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.,Department of Movement and Sports Science, Ghent University, Ghent, Belgium
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43
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Büsing F, Hägele FA, Nas A, Hasler M, Müller MJ, Bosy-Westphal A. Impact of energy turnover on the regulation of glucose homeostasis in healthy subjects. Nutr Diabetes 2019; 9:22. [PMID: 31395858 PMCID: PMC6687696 DOI: 10.1038/s41387-019-0089-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/09/2019] [Accepted: 07/15/2019] [Indexed: 12/27/2022] Open
Abstract
Objective Sedentary lifestyle increases the risk of type 2 diabetes. The aim of this study was to investigate the impact of different levels of energy turnover (ET; low, medium, and high level of physical activity and the corresponding energy intake) on glucose metabolism at zero energy balance, caloric restriction, and overfeeding. Methods Sixteen healthy individuals (13 men, 3 women, 25.1 ± 3.9 years, BMI 24.0 ± 3.2 kg/m2) participated in a randomized crossover intervention under metabolic ward conditions. Subjects passed 3 × 3 intervention days. Three levels of physical activity (PAL: low 1.3, medium 1.6, and high 1.8 achieved by walking at 4 km/h for 0, 3 × 55, or 3 × 110 min) were compared under three levels of energy balance (zero energy balance (EB): 100% of energy requirement (Ereq); caloric restriction (CR): 75% Ereq, and overfeeding (OF): 125% Ereq). Continuous interstitial glucose monitoring, C-peptide excretion, and HOMA–IR, as well as postprandial glucose and insulin were measured. Results Daylong glycemia and insulin secretion did not increase with higher ET at all conditions of energy balance (EB, CR, and OF), despite a correspondingly higher CHO intake (Δ low vs. high ET: +86 to 135 g of CHO/d). At CR, daylong glycemia (p = 0.02) and insulin secretion (p = 0.04) were even reduced with high compared with low ET. HOMA–IR was impaired with OF and improved with CR, whereas ET had no effect on fasting insulin sensitivity. A higher ET led to lower postprandial glucose and insulin levels under conditions of CR and OF. Conclusion Low-intensity physical activity can significantly improve postprandial glycemic response of healthy individuals, independent of energy balance.
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Affiliation(s)
- Franziska Büsing
- Institute of Human Nutrition and Food Science, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Franziska Anna Hägele
- Institute of Human Nutrition and Food Science, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Alessa Nas
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Mario Hasler
- Applied Statistics, Faculty of Agricultural and Nutritional Sciences, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Manfred James Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts University of Kiel, Kiel, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts University of Kiel, Kiel, Germany.
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Rees JL, Chang CR, François ME, Marcotte-Chénard A, Fontvieille A, Klaprat ND, Dyck RA, Funk DR, Snydmiller G, Bastell K, Godkin FE, Dubé MC, Riesco E, McGavock JM, Yardley JE, Sigal RJ, Gibala MJ, Weisnagel SJ, Prado CM, Jung M, Manders R, Lee T, Singer J, Boulé NG, Little JP. Minimal effect of walking before dinner on glycemic responses in type 2 diabetes: outcomes from the multi-site E-PAraDiGM study. Acta Diabetol 2019; 56:755-765. [PMID: 31093764 DOI: 10.1007/s00592-019-01358-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 05/02/2019] [Indexed: 12/16/2022]
Abstract
AIM To examine the effect of walking before dinner on 24-h glycemic control in individuals with type 2 diabetes using the standardized multi-site Exercise-Physical Activity and Diabetes Glucose Monitoring (E-PAraDiGM) Protocol. METHODS Eighty participants were studied under two conditions (exercise vs. non-exercise control) separated by 72 h in a randomized crossover design. Each condition lasted 2 days during which standardized meals were provided. Exercise consisted of 50 min of treadmill walking at 5.0 km/h before the evening meal, while control involved 50 min of sitting. The primary outcome measure was mean glucose during the 24-h period following exercise (or sitting) measured by continuous glucose monitoring. RESULTS Of the 80 participants who were initially randomized, 73 completed both exercise and control. Sixty-three participants [29 males, 34 females; age = 64 ± 8 years, body mass index = 30.5 ± 6.5 kg/m2 and HbA1c = 51 ± 8 mmol/mol (6.8 ± 0.7%), mean ± SD] complied with the standardized diets and had complete continuous glucose monitoring data. Exercise did not affect mean 24-h glucose compared to control (0.03 mmol/L; 95% CI - 0.17, 0.22, P = 0.778) but individual differences between conditions ranged from - 2.8 to +1.8 mmol/L. Exercise did not affect fasting glucose, postprandial glucose or glucose variability. Glucose concentrations measured by continuous glucose monitoring were reduced during the 50 min of walking in exercise compared to sitting in control (- 1.56 mmol/L; 95% CI - 2.18, - 0.95, p < 0.001). CONCLUSION Contrary to previous acute exercise studies, 50 min of walking before dinner in the E-PAraDiGM protocol did not affect 24-h glucose profiles. However, highly heterogeneous responses to exercise were observed. TRIAL REGISTRATION NCT02834689.
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Affiliation(s)
- Jordan L Rees
- Faculty of Kinesiology, Sport, and Recreation, and Alberta Diabetes Institute, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Courtney R Chang
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia - Okanagan, Kelowna, BC, V1V 1V7, Canada
| | - Monique E François
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia - Okanagan, Kelowna, BC, V1V 1V7, Canada
| | - Alexis Marcotte-Chénard
- Faculty of Physical Activity Sciences, Université de Sherbrooke, Sherbrooke, QC, J1K 2R1, Canada
- Research Center on Aging, CIUSSSE - CHUS, Sherbrooke, QC, J1H 4C4, Canada
| | - Adeline Fontvieille
- Faculty of Physical Activity Sciences, Université de Sherbrooke, Sherbrooke, QC, J1K 2R1, Canada
- Research Center on Aging, CIUSSSE - CHUS, Sherbrooke, QC, J1H 4C4, Canada
| | - Nika D Klaprat
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Rebecca A Dyck
- Augustana Faculty, University of Alberta, Camrose, AB, T4V 2R3, Canada
| | - Deanna R Funk
- Augustana Faculty, University of Alberta, Camrose, AB, T4V 2R3, Canada
| | - Gary Snydmiller
- Augustana Faculty, University of Alberta, Camrose, AB, T4V 2R3, Canada
| | - Kent Bastell
- Faculty of Kinesiology, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Florence E Godkin
- Department of Kinesiology, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Marie-Christine Dubé
- Department of Medicine, Université Laval, Quebec City, QC, G1V 0A6, Canada
- Department of Agriculture and Food Science, Université Laval, Quebec City, QC, G1V 0A6, Canada
| | - Eléonor Riesco
- Faculty of Physical Activity Sciences, Université de Sherbrooke, Sherbrooke, QC, J1K 2R1, Canada
- Research Center on Aging, CIUSSSE - CHUS, Sherbrooke, QC, J1H 4C4, Canada
| | - Jon M McGavock
- DREAM Research Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, MB, R3E 3P4, Canada
| | - Jane E Yardley
- Faculty of Kinesiology, Sport, and Recreation, and Alberta Diabetes Institute, University of Alberta, Edmonton, AB, T6G 2H9, Canada
- Augustana Faculty, University of Alberta, Camrose, AB, T4V 2R3, Canada
| | - Ronald J Sigal
- Departments of Medicine, Cardiac Sciences and Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Martin J Gibala
- Department of Kinesiology, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - S John Weisnagel
- Department of Medicine, Université Laval, Quebec City, QC, G1V 0A6, Canada
- Department of Agriculture and Food Science, Université Laval, Quebec City, QC, G1V 0A6, Canada
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, T6G 2E1, Canada
| | - Mary Jung
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia - Okanagan, Kelowna, BC, V1V 1V7, Canada
| | - Ralph Manders
- Faculty of Health and Medical Sciences, University of Surrey, Guilford, GU2 7WG, UK
| | - Terry Lee
- Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, BC, V6Z 1Y6, Canada
| | - Joel Singer
- Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, BC, V6Z 1Y6, Canada
| | - Normand G Boulé
- Faculty of Kinesiology, Sport, and Recreation, and Alberta Diabetes Institute, University of Alberta, Edmonton, AB, T6G 2H9, Canada.
| | - Jonathan P Little
- School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia - Okanagan, Kelowna, BC, V1V 1V7, Canada.
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Jing L, Chengji W. GC/MS-based metabolomics strategy to analyze the effect of exercise intervention in diabetic rats. Endocr Connect 2019; 8:654-660. [PMID: 31042671 PMCID: PMC6528492 DOI: 10.1530/ec-19-0012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 04/30/2019] [Indexed: 12/15/2022]
Abstract
Metabolomics was used to explore the effect of exercise intervention on type 2 diabetes. The rat model of type 2 diabetes was induced by an injection of streptozocin (30 mg/kg), after fed with 8-week high-fat diet. The rats were divided into three groups: the control group, the diabetic model group (DM) and the diabetes + exercise group (DME). After exercise for 10 weeks, blood samples were collected to test biomedical indexes, and 24-h urine samples were collected for the metabolomics experiment. In the DME group, fasting blood glucose (FBG), both total cholesterol (TC) and total plasma triglycerides (TG), were decreased significantly, compared with those in the DM group. Based on gas chromatography-mass spectrometry (GC/MS), a urinary metabolomics method was used to study the mechanism of exercise intervention on diabetes mellitus. Based on the principal component analysis (PCA), it was found that the DM group and control group were separated into two different clusters. The DME group was located between the DM group and the control group, closer to the control group. Twelve significantly changed metabolites of diabetes mellitus were detected and identified, including glycolate, 4-methyl phenol, benzoic acid, 1H-indole, arabinitol, threitol, ribonic acid, malic acid, 2,3-dihydroxy-butanoic, aminomalonic acid, l-ascorbic acid and 3-hydroxy hexanedioic acid. After exercise, seven metabolites were significantly changed, compared with the control group, the relative contents of benzoic acid, aminomalonic acid, tetrabutyl alcohol and ribonucleic acid in the diabetic exercise group decreased significantly. The relative contents of 2,3-dihydroxybutyric acid, l-ascorbic acid and 3-hydroxy adipic acid increased significantly. l-ascorbic acid and aminomalonic acid which related with the oxidative stress were significantly regulated to normal. The results showed that exercise could display anti-hyperglycemic and anti-hyperlipidemic effects. The exercise had antioxidation function in preventing the occurrence of complications with diabetes mellitus to some extent. The work illustrates that the metabolomics method is a useful tool to study the mechanism of exercise treatment.
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Affiliation(s)
- Li Jing
- College of Physical Education, Chaohu University, Anhui Province, China
- Correspondence should be addressed to L Jing:
| | - Wang Chengji
- College of Physical Education, Chaohu University, Anhui Province, China
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Blankenship JM, Chipkin SR, Freedson PS, Staudenmayer J, Lyden K, Braun B. Managing free-living hyperglycemia with exercise or interrupted sitting in type 2 diabetes. J Appl Physiol (1985) 2019; 126:616-625. [DOI: 10.1152/japplphysiol.00389.2018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Breaking up sitting with light physical activity (PA) is effective in reducing hyperglycemia in the laboratory. Whether the same effects are observed in the free-living environment remains unknown. We evaluated how daily and postprandial glycemia is impacted by 20, 40, or 60 min of activity performed as either breaks from sitting after each meal (BR) or as one continuous walk after breakfast (WALK). Thirty individuals with type 2 diabetes completed three experimental conditions [BR, WALK, and control (CON)] in a randomized crossover design. Conditions were performed in a free-living environment with strict dietary control over 7 days. Participants increased PA in BR and WALK by 20, 40, or 60 min ( n = 10 in each group) and maintained habitual levels of PA during CON. A continuous glucose monitor (iPro2) and activPAL activity monitor were worn to quantify glycemic control and PA. Using linear mixed models with repeated measures, we 1) compared postprandial glucose (PPG) across conditions and 2) assessed the relationship between activity volume and glucose responses. Whereas WALK tended to shorten the daily duration of hyperglycemia compared with CON ( P = 0.0875), BR was not different from CON. BR and WALK significantly attenuated the breakfast PPG versus CON ( P ≤ 0.05), but lunch and dinner PPG were unaffected by BR and WALK. In conclusion, continuous walking was more effective than breaks from sitting in lowering daily hyperglycemia for the group, but both conditions lowered breakfast PPG. In contrast to tightly controlled laboratory studies, breaks from sitting did not lower hyperglycemia in the free-living environment. NEW & NOTEWORTHY Our “ecolabical” approach is new and noteworthy. This approach combines the external validity of the free-living environment (ecological) with the control of key confounding variables in the laboratory and allows for highly translatable findings by minimizing confounding variables. We found that both postmeal continuous walking and short breaks from sitting similarly attenuated the postprandial glucose (PPG) response to breakfast. Unlike previous laboratory studies, neither condition (walk after breakfast or postmeal breaks) significantly impacted PPG at lunch or dinner.
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Affiliation(s)
| | - Stuart R. Chipkin
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Patty S. Freedson
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts
| | - John Staudenmayer
- Department of Mathematics and Statistics, University of Massachusetts Amherst, Amherst, Massachusetts
| | | | - Barry Braun
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado
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Myette-Côté É, Durrer C, Neudorf H, Bammert TD, Botezelli JD, Johnson JD, DeSouza CA, Little JP. The effect of a short-term low-carbohydrate, high-fat diet with or without postmeal walks on glycemic control and inflammation in type 2 diabetes: a randomized trial. Am J Physiol Regul Integr Comp Physiol 2018; 315:R1210-R1219. [PMID: 30303707 PMCID: PMC6734060 DOI: 10.1152/ajpregu.00240.2018] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/03/2018] [Accepted: 10/05/2018] [Indexed: 12/17/2022]
Abstract
Lowering carbohydrate consumption effectively lowers glucose, but impacts on inflammation are unclear. The objectives of this study were to: 1) determine whether reducing hyperglycemia by following a low-carbohydrate, high-fat (LC) diet could lower markers of innate immune cell activation in type 2 diabetes (T2D) and 2) examine if the combination of an LC diet with strategically timed postmeal walking was superior to an LC diet alone. Participants with T2D ( n = 11) completed a randomized crossover study involving three 4-day diet interventions: 1) low-fat low-glycemic index (GL), 2) and 3) LC with 15-min postmeal walks (LC+Ex). Four-day mean glucose was significantly lower in the LC+Ex group as compared with LC (-5%, P < 0.05), whereas both LC+Ex (-16%, P < 0.001) and LC (-12%, P < 0.001) conditions were lower than GL. A significant main effect of time was observed for peripheral blood mononuclear cells phosphorylated c-Jun N-terminal kinase ( P < 0.001), with decreases in all three conditions (GL: -32%, LC: -45%, and LC+Ex: -44%). A significant condition by time interaction was observed for monocyte microparticles ( P = 0.040) with a significant decrease in GL (-76%, P = 0.035) and a tendency for a reduction in LC (-70%, P = 0.064), whereas there was no significant change in LC+Ex (0.5%, P = 0.990). Both LC (-27%, P = 0.001) and LC+Ex (-35%, P = 0.005) also led to significant reductions in circulating proinsulin. An LC diet improved 4-day glycemic control and fasting proinsulin levels when compared with GL, with added glucose-lowering benefits when LC was combined with postmeal walking.
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Affiliation(s)
- Étienne Myette-Côté
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Cody Durrer
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Helena Neudorf
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Tyler D Bammert
- Integrative Vascular Biology Laboratory, Department of Integrative Physiology, University of Colorado , Boulder, Colorado
| | - José Diego Botezelli
- Department of Cellular and Physiological Sciences, University of British Columbia , Vancouver, BC , Canada
| | - James D Johnson
- Department of Cellular and Physiological Sciences, University of British Columbia , Vancouver, BC , Canada
| | - Christopher A DeSouza
- Integrative Vascular Biology Laboratory, Department of Integrative Physiology, University of Colorado , Boulder, Colorado
| | - Jonathan P Little
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC, Canada
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Reynolds AN, Venn BJ. The Timing of Activity after Eating Affects the Glycaemic Response of Healthy Adults: A Randomised Controlled Trial. Nutrients 2018; 10:nu10111743. [PMID: 30428521 PMCID: PMC6267507 DOI: 10.3390/nu10111743] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/02/2018] [Accepted: 11/12/2018] [Indexed: 11/16/2022] Open
Abstract
There is scant information on how a time lag between the cessation of eating and commencement of physical activity affects postprandial glycaemia. Starting at baseline (t = 0), participants ingested white bread containing 50 g of available carbohydrates within 10 min. Using two crossover conditions, we tested the effect over 2 h on postprandial glycaemia of participants undertaking light activity at 15 or 45 min following baseline and compared it with a sedentary control condition. The activity involved cycling on a stationary ergometer for 10 min at 40 revolutions per min with zero resistance. Seventy-eight healthy adults were randomized to the 15 or 45 min activity arm and then randomised to the order in which they undertook the active and sedentary conditions. Cycling 45 min after baseline changed the course of the blood glucose response (likelihood ratio chi square = 31.47, p < 0.01) and reduced mean blood glucose by 0.44 mmol/L (95% confidence interval 0.14 to 0.74) at 60 min when compared with the sedentary control. No differences in postprandial blood glucose response were observed when cycling started 15 min after baseline compared with the sedentary control. Undertaking activity after waiting for 30 min following eating might be optimal in modifying the glycaemic response.
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Affiliation(s)
- Andrew N Reynolds
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
- Edgar National Centre for Diabetes and Obesity Research, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Bernard J Venn
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
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Liao Y, Schembre S. Acceptability of Continuous Glucose Monitoring in Free-Living Healthy Individuals: Implications for the Use of Wearable Biosensors in Diet and Physical Activity Research. JMIR Mhealth Uhealth 2018; 6:e11181. [PMID: 30355561 PMCID: PMC6231900 DOI: 10.2196/11181] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/10/2018] [Accepted: 09/27/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Wearable sensors have been increasingly used in behavioral research for real-time assessment and intervention purposes. The rapid advancement of biomedical technology typically used in clinical settings has made wearable sensors more accessible to a wider population. Yet the acceptability of this technology for nonclinical purposes has not been examined. OBJECTIVE The aim was to assess the acceptability of wearing a continuous glucose monitor (CGM) device among a sample of nondiabetic individuals, and to compare the acceptability of a CGM between a mobile diet tracking app (MyFitnessPal) and an accelerometer. METHODS A total of 30 nondiabetic adults went through a 7-day observational study. They wore a CGM sensor, tracked their diet and physical activity using the CGM receiver and MyFitnessPal, and wore an accelerometer on their waist. After the monitoring period, they completed a 10-item survey regarding acceptability of each of the study tools. Two-tailed paired-sample t tests were conducted to examine whether the summary acceptability scores were comparable between the CGM sensor/receiver and MyFitnessPal/accelerometer. RESULTS More than 90% of the study participants agreed that the CGM sensor and receiver were easy to use (28/30 and 27/30, respectively), useful (28/30 and 29/30, respectively), and provided relevant information that was of interest to them (27/30 and 28/30, respectively). The summary acceptability scores (out of a 5-point Likert scale) were mean 4.06 (SD 0.55) for the CGM sensor, mean 4.05 (SD 0.58) for the CGM receiver, mean 4.10 (SD 0.68) for MyFitnessPal, and mean 3.73 (SD 0.76) for the accelerometer. CONCLUSIONS The high acceptability of using a CGM from this study suggests a great potential for using CGMs in nondiabetic adults in research settings. Although potential selection bias might contribute to the high acceptability in this study, the continued advancements in wearable sensor technology will make the barriers to tracking and collecting personal physiological data more and more minimal.
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Affiliation(s)
- Yue Liao
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Susan Schembre
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Department of Family and Community Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ, United States
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