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Delevatti RS, Leonel LDS, Rodrigues JGDS, Kanitz AC, Alberton CL, Lovatel GA, Siqueira IR, Kruel LFM. Aerobic Exercise in the Aquatic Environment Suppresses the Plasma Renin Activity in Individuals with Type 2 Diabetes: A Secondary Analysis of a Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:938. [PMID: 39063514 PMCID: PMC11277236 DOI: 10.3390/ijerph21070938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024]
Abstract
To compare the acute effects of aquatic walking/running versus dry-land walking/running on blood glucose and plasma renin activity (PRA) in individuals with type 2 diabetes, participants with type 2 diabetes performed deep-water or dry-land walking and/or running sessions in a swimming pool or on an athletics track, respectively. Both sessions comprised seven blocks of 3 min at 85-90% of the heart rate deflection point (HRDP), interspersed with 2 min at <85% HRDP, totaling 35 min, with a 48 h interval between sessions. PRA and blood glucose were assessed before and immediately after the sessions. Generalized estimation equations were used to verify the session effects, with the Bonferroni post hoc test, considering the significance level as 0.05. Twelve individuals (53.2 ± 8.9 years) diagnosed with type 2 diabetes for 6.3 ± 6.34 years participated in the study. A reduction in PRA was found only after the aquatic session (-7.75 ng/mL/h; -69%; p: 0.034), while both aquatic and dry-land sessions similarly reduced the blood glucose levels (aquatic: -38 mg/dL, -21%; dry-land: -26 mg/dL, -14%; time effect, p = 0.007). Despite yielding similar glycemic reductions as dry-land walking/running, aquatic walking/running led to an expressive decrease in PRA among individuals with type 2 diabetes.
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Affiliation(s)
- Rodrigo Sudatti Delevatti
- Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus Trindade, Florianópolis 88040-900, SC, Brazil; (L.d.S.L.); (G.A.L.)
| | - Larissa dos Santos Leonel
- Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus Trindade, Florianópolis 88040-900, SC, Brazil; (L.d.S.L.); (G.A.L.)
| | - João Gabriel da Silveira Rodrigues
- Department of Physical Education, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, University Campus, Pampulha, Belo Horizonte 31310-25, MG, Brazil;
| | - Ana Carolina Kanitz
- Department of Physical Education, Federal University of Rio Grande do Sul, Porto Alegre 90040-060, RS, Brazil; (A.C.K.); (L.F.M.K.)
| | - Cristine Lima Alberton
- Department of Physical Education, Federal University of Pelotas, Pelotas 96020-220, RS, Brazil;
| | - Gisele Agustini Lovatel
- Department of Physical Education, Sports Center, Federal University of Santa Catarina, University Campus Trindade, Florianópolis 88040-900, SC, Brazil; (L.d.S.L.); (G.A.L.)
| | - Ionara Rodrigues Siqueira
- Department of Pharmacology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre 90040-060, RS, Brazil;
| | - Luiz Fernando Martins Kruel
- Department of Physical Education, Federal University of Rio Grande do Sul, Porto Alegre 90040-060, RS, Brazil; (A.C.K.); (L.F.M.K.)
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Niyazi A, Yasrebi SMA, Yazdanian M, Mohammad Rahimi GR. High-Intensity Interval Versus Moderate-Intensity Continuous Exercise Training on Glycemic Control, Beta Cell Function, and Aerobic Fitness in Women with Type 2 Diabetes. Biol Res Nurs 2024; 26:449-459. [PMID: 38477318 DOI: 10.1177/10998004241239330] [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] [Indexed: 03/14/2024]
Abstract
Objective: This study aimed to compare the effects of High-Intensity Interval Training (HIIT) and Moderate-Intensity Continuous Training (MICT) on glycemic control, beta-cell function, and aerobic fitness in women with Type 2 Diabetes Mellitus (T2DM). Methods: Thirty-six women with T2DM were assigned equally to HIIT, MICT, and control (CON) groups. Participants in the exercise cohorts underwent a 12-week training regimen (three sessions per week), while the CON group maintained an inactive lifestyle. Glycaemia variables, beta-cell function, maximal oxygen uptake (VO2max), lipid profiles, and body composition were assessed at baseline and post-intervention. Results: Both HIIT and MICT interventions led to significant improvements in glucose, insulin, HbA1c, and insulin resistance index. Moreover, visceral adiposity index (VAI), lipid accumulation product (LAP), total cholesterol (TC), and low-density lipoprotein (LDL) levels significantly decreased in the HIIT and MICT groups after 12 weeks. Triglyceride (TG) levels decreased only after MICT, while high-density lipoprotein (HDL) levels increased after both interventions. Maximal oxygen uptake (VO2max), body mass, body mass index (BMI), and waist circumference (WC) significantly improved in all exercise groups. Notably, the HIIT group showed greater reductions in body mass compared to MICT. Nevertheless, beta-cell function remained unaltered after these two exercise regimens. Conclusion: Both HIIT and MICT interventions effectively managed T2DM in women, regardless of exercise intensity. The HIIT regimen can be considered for time-efficient lifestyle interventions in people with T2DM.
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Affiliation(s)
- Arghavan Niyazi
- Department of Exercise Physiology, Ayandegan-e-Sharq Healthcare Center, Mashhad, Iran
| | | | - Mohtaram Yazdanian
- Department of Exercise Physiology, Sanabad Golbahar Institute of Higher Education, Mashhad, Iran
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Carrard J, Hofer M, Prechtl L, Fleischlin E, Huber M, Gallart-Ayala H, Teav T, Infanger D, Höchsmann C, Koehler K, Hinrichs T, Hanssen H, Ivanisevic J, Schmidt-Trucksäss A. Effect of an eight-week high-intensity interval training programme on circulating sphingolipid levels in middle-aged adults at elevated cardiometabolic risk (SphingoFIT)-Protocol for a randomised controlled exercise trial. PLoS One 2024; 19:e0302477. [PMID: 38717997 PMCID: PMC11078397 DOI: 10.1371/journal.pone.0302477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Evidence indicates that sphingolipid accumulation drives complex molecular alterations promoting cardiometabolic diseases. Clinically, it was shown that sphingolipids predict cardiometabolic risk independently of and beyond traditional biomarkers such as low-density lipoprotein cholesterol. To date, little is known about therapeutic modalities to lower sphingolipid levels. Exercise, a powerful means to prevent and treat cardiometabolic diseases, is a promising modality to mitigate sphingolipid levels in a cost-effective, safe, and patient-empowering manner. METHODS This randomised controlled trial will explore whether and to what extent an 8-week fitness-enhancing training programme can lower serum sphingolipid levels of middle-aged adults at elevated cardiometabolic risk (n = 98, 50% females). The exercise intervention will consist of supervised high-intensity interval training (three sessions weekly), while the control group will receive physical activity counselling based on current guidelines. Blood will be sampled early in the morning in a fasted state before and after the 8-week programme. Participants will be provided with individualised, pre-packaged meals for the two days preceding blood sampling to minimise potential confounding. An 'omic-scale sphingolipid profiling, using high-coverage reversed-phase liquid chromatography coupled to tandem mass spectrometry, will be applied to capture the circulating sphingolipidome. Maximal cardiopulmonary exercise tests will be performed before and after the 8-week programme to assess patient fitness changes. Cholesterol, triglycerides, glycated haemoglobin, the homeostatic model assessment for insulin resistance, static retinal vessel analysis, flow-mediated dilatation, and strain analysis of the heart cavities will also be assessed pre- and post-intervention. This study shall inform whether and to what extent exercise can be used as an evidence-based treatment to lower circulating sphingolipid levels. TRIAL REGISTRATION The trial was registered on www.clinicaltrials.gov (NCT06024291) on August 28, 2023.
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Affiliation(s)
- Justin Carrard
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- SportAdo Centre, Children and Adolescent Surgery, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Manuel Hofer
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Luisa Prechtl
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Eva Fleischlin
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Manuel Huber
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Hector Gallart-Ayala
- Metabolomics Platform, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Tony Teav
- Metabolomics Platform, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Denis Infanger
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Christoph Höchsmann
- Department of Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Karsten Koehler
- Department of Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Timo Hinrichs
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Henner Hanssen
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Julijana Ivanisevic
- Metabolomics Platform, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Arno Schmidt-Trucksäss
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Abonie US, Addo RA, Kumah L, Ofori – Ampomah AK, Makinyi V. Effect of treadmill ambulatory training on glucose control and blood pressure in persons with type 2 diabetes: A pilot study. PLoS One 2024; 19:e0298179. [PMID: 38574086 PMCID: PMC10994293 DOI: 10.1371/journal.pone.0298179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/14/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Lack of time is often cited by persons with type 2 diabetes for non-participation in regular exercise. This highlights the need to explores ways to help persons with type 2 diabetes to engage in an active lifestyle. This study evaluated the effect of a short duration norm intensity exercise on blood glucose and blood pressure in persons with type 2 diabetes. METHODS Twenty persons with type 2 diabetes were randomly assigned to either training group (n = 10) or control group (n = 10). The training group received 4-weeks ambulatory training on a motor-driven treadmill (2 x 20 min per week at 60% target heart rate). The control group received no training. Blood glucose, and systolic and diastolic blood pressures were assessed before and after the 4-weeks training. Repeated measures ANOVA were used to examine training effect. RESULTS Training significantly improved blood glucose (mean difference = -2.73; p = 0.03). No effects were found for systolic blood pressure (mean difference = -0.30; p = 0.96) and diastolic blood pressure (mean difference = -0.90; p = 0.82). CONCLUSION Training improved blood glucose but not blood pressure. A short-duration ambulatory training is an appropriate exercise mode to elicit beneficial effect, and exercise adoption in persons with type 2 diabetes. TRIAL REGISTRATION This pilot trial is registered with the Pan African Clinical Trial Registry at pactr.samrc.ac.za (PACTR202306601940612).
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Affiliation(s)
- Ulric Sena Abonie
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Coach Lane Campus, Benton, Newcastle upon Tyne, United Kingdom
- Department of Physiotherapy and Rehabilitation Sciences, University of Health and Allied Sciences, Ho, Volta Region-Ghana
| | - Raphael Aseye Addo
- Department of Physiotherapy and Rehabilitation Sciences, University of Health and Allied Sciences, Ho, Volta Region-Ghana
| | - Laureen Kumah
- Department of Physiotherapy and Rehabilitation Sciences, University of Health and Allied Sciences, Ho, Volta Region-Ghana
| | - Ama Kissiwaa Ofori – Ampomah
- Department of Physiotherapy and Rehabilitation Sciences, University of Health and Allied Sciences, Ho, Volta Region-Ghana
| | - Vincent Makinyi
- Department of Physiotherapy and Rehabilitation Sciences, University of Health and Allied Sciences, Ho, Volta Region-Ghana
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Danielsen JH, Nielsen SG, Varming AR, Vilsbøll T, Molsted S. Long-term follow-up on patient-reported outcomes after supervised exercise training in individuals at risk of complications to type 2 diabetes. Diabetes Metab Syndr 2024; 18:102953. [PMID: 38412696 DOI: 10.1016/j.dsx.2024.102953] [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: 02/26/2023] [Revised: 12/18/2023] [Accepted: 01/24/2024] [Indexed: 02/29/2024]
Abstract
AIMS We investigated long-term changes of patient-reported outcomes after a supervised exercise intervention in individuals with type 2 diabetes (T2D). METHODS In an intervention study without a control group, follow-up assessments were performed 12 months after initiating 12 weeks of physical exercise in individuals with T2D at intermediate or high risk of complications. Primary outcomes were health-related quality of life assessed with EQ-5D-5L, empowerment with Diabetes Empowerment Scale-Short Form, and self-reported physical activity with the Physical Activity Scale. Secondary outcomes were physical function (30-s chair-stand test) and working capacity (Aastrand or Graded Cycling Test). RESULTS 153 participants completed follow-up (35% women, age (mean ± SD) 67 ± 11 years, body mass index 33.1 ± 5.9 kg/m2, glycated haemoglobin A1c 7.8 ± 3.7%). No changes were reported in health-related quality of life (index score p = 0.444, visual analogue scale p = 0.270), empowerment (p = 0.232), and moderate intensity physical activity (p = 0.917). Vigorous intensity physical activity decreased (mean (95% CI) -25.5 (-37.14; -13.94) min/day, p < 0.001). Physical function increased (p < 0.001) and working capacity decreased (Aastrand p = 0.002, Graded Cycling Test p = 0.039). CONCLUSIONS Health-related quality of life, empowerment, and self-reported moderate intensity physical activity time remained elevated at the long-term follow-up after a supervised exercise intervention.
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Affiliation(s)
- Julie H Danielsen
- Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark.
| | - Susanne G Nielsen
- Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark.
| | - Annemarie R Varming
- Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark.
| | - Tina Vilsbøll
- Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Stig Molsted
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Research, Nordsjællands Hospital, Hillerød, Denmark.
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Parada Flores B, Luna-Villouta P, Martínez Salazar C, Flández Valderrama J, Valenzuela Contreras L, Flores-Rivera C, Vargas-Vitoria R. Physical Exercise Methods and Their Effects on Glycemic Control and Body Composition in Adults with Type 2 Diabetes Mellitus (T2DM): A Systematic Review. Eur J Investig Health Psychol Educ 2023; 13:2529-2545. [PMID: 37998066 PMCID: PMC10670304 DOI: 10.3390/ejihpe13110176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/25/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
The prevalence of T2DM represents a challenge for health agencies due to its high risk of morbidity and mortality. Physical Activity (PA) is one of the fundamental pillars for the treatment of T2DM, so Physical Exercise (PE) programs have been applied to research their effectiveness. The objective of the study was to analyze the effects of PE methods on glycemic control and body composition of adults with T2DM. A systematic review without meta-analysis was performed, using the PubMed database. Quasi-experimental and pure experimental clinical trials were included, which were available free of charge and were published during 2010-2020. In the results, 589 articles were found and 25 passed the inclusion criteria. These were classified and analyzed according to the methods identified (AE, IE, RE, COM, and others), duration and variable(s) studied. It is concluded that PE is effective for glycemic control and body composition in adults with T2DM using different methods (AE, IE, RE, COM, and others), both in the short and long term. Adequate organization of PE components such as frequency, duration, volume, and intensity, is essential.
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Affiliation(s)
- Bastián Parada Flores
- Facultad de Educación, Magíster en Ciencias de la Actividad Física, Universidad Católica del Maule, Talca 3460000, Chile;
| | - Pablo Luna-Villouta
- Facultad de Educación, Departamento de Educación Física, Universidad de Concepción, Concepción 4030000, Chile;
| | - Cristian Martínez Salazar
- Departamento de Educación Física, Deportes y Recreación, Universidad de La Frontera, Temuco 4780000, Chile;
| | - Jorge Flández Valderrama
- Facultad Filosofía y Humanidades, Instituto de Ciencias de la Educación, Escuela de Educación Física, Universidad Austral de Chile, Valdivia 5090000, Chile;
| | - Luis Valenzuela Contreras
- Facultad de Educación, Pedagogía en Educación Física, Universidad Católica Silva Henríquez, Santiago 8330226, Chile;
| | - Carol Flores-Rivera
- Facultad de Educación y Ciencias Sociales, Universidad Andres Bello, Concepción 4030000, Chile;
| | - Rodrigo Vargas-Vitoria
- Facultad de Educación, Pedagogía en Educación Física, Universidad Católica del Maule, Talca 3460000, Chile
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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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Yu P, Zhu Z, He J, Gao B, Chen Q, Wu Y, Zhou J, Cheng Y, Ling J, Zhang J, Shi A, Huang H, Sun R, Gao Y, Li W, Liu X, Yan Z. Effects of high-intensity interval training, moderate-intensity continuous training, and guideline-based physical activity on cardiovascular metabolic markers, cognitive and motor function in elderly sedentary patients with type 2 diabetes (HIIT-DM): a protocol for a randomized controlled trial. Front Aging Neurosci 2023; 15:1211990. [PMID: 37649720 PMCID: PMC10465302 DOI: 10.3389/fnagi.2023.1211990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/26/2023] [Indexed: 09/01/2023] Open
Abstract
Background and objective Sedentary behavior is of increasing concern in older patients with type 2 diabetes mellitus (T2DM) due to its potential adverse effects on cardiovascular health, cognitive function, and motor function. While regular exercise has been shown to improve the health of individuals with T2DM, the most effective exercise program for elderly sedentary patients with T2DM remains unclear. Therefore, the objective of this study was to assess the impact of high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), and guideline-based physical activity programs on the cardiovascular health, cognitive function, and motor function of this specific population. Methods This study will be a randomized, assessor-blind, three-arm controlled trial. A total of 330 (1:1:1) elderly sedentary patients diagnosed with T2DM will be randomly assigned the HIIT group (10 × 1-min at 85-95% peak HR, intersperse with 1-min active recovery at 60-70% peak HR), MICT (35 min at 65-75% peak HR), and guideline-based group (guideline group) for 12 weeks training. Participants in the guideline group will receive 1-time advice and weekly remote supervision through smartphones. The primary outcomes will be the change in glycosylated hemoglobin (HbA1c) and brain-derived neurotrophic factor (BDNF) after 12-weeks. Secondary outcomes will includes physical activity levels, anthropometric parameters (weight, waist circumference, hip circumference, and body mass index), physical measurements (fat percentage, muscle percentage, and fitness rate), cardiorespiratory fitness indicators (blood pressure, heart rate, vital capacity, and maximum oxygen), biochemical markers (high-density lipoprotein, low-density lipoprotein, triglycerides, total cholesterol, and HbA1c), inflammation level (C-reactive protein), cognitive function (reaction time and dual-task gait test performance), and motor function (static balance, dynamic balance, single-task gait test performance, and grip strength) after 12 weeks. Discussion The objective of this study is to evaluate the effect of 12 weeks of HIIT, MICT, and a guideline-based physical activity program on elderly sedentary patients diagnosed with T2DM. Our hypothesis is that both HIIT and MICT will yield improvements in glucose control, cognitive function, cardiopulmonary function, metabolite levels, motor function, and physical fitness compared to the guideline group. Additionally, we anticipate that HIIT will lead to greater benefits in these areas. The findings from this study will provide valuable insights into the selection of appropriate exercise regimens for elderly sedentary individuals with T2DM. Ethics and dissemination This study has been approved by the Ethics Review Committee of the Reproductive Hospital Affiliated with China Medical University (approval number: 202203). Informed consent will be obtained from all participants or their guardians. Upon completion, the authors will submit their findings to a peer-reviewed journal or academic conference for publication. Clinical trial registration Chinese Clinical Trial Registry, identifier ChiCTR2200061573.
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Affiliation(s)
- Peng Yu
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, Jiangxi, China
| | - Zicheng Zhu
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jiahui He
- The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Bohua Gao
- School of Basic Medicine, Fujian Medical University, Fuzhou, China
| | - Qi Chen
- Laboratory of Exercise Physiology, Liaoning Province Sports Development Center, Shenyang, Liaoning, China
| | - Yifan Wu
- The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Jing Zhou
- The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Yixuan Cheng
- The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Jitao Ling
- The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Jing Zhang
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Ao Shi
- St. George’s University of London, London, United Kingdom
- School of Medicine, University of Nicosia, Nicosia, Cyprus
| | - Huijing Huang
- The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Runlu Sun
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, Guangdong, China
| | - Yan Gao
- College of Kinesiology, Shenyang Sport University, Shenyang, Liaoning, China
| | - Weiguang Li
- Cardiology Department, Liaoning Province Jinqiu Hospital, Shenyang, Liaoning, China
| | - Xiao Liu
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, Guangdong, China
| | - Zhiwei Yan
- College of Kinesiology, Shenyang Sport University, Shenyang, Liaoning, China
- Provincial University Key Laboratory of Sport and Health Science, School of Physical Education and Sport Sciences, Fujian Normal University, Fuzhou, Fujian, China
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Bajdek N, Merchant N, Camhi SM, Yan H. Racial Differences in Blood Pressure and Autonomic Recovery Following Acute Supramaximal Exercise in Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095615. [PMID: 37174135 PMCID: PMC10178025 DOI: 10.3390/ijerph20095615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/01/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023]
Abstract
Despite the growing popularity of high-intensity anaerobic exercise, little is known about the acute effects of this form of exercise on cardiovascular hemodynamics or autonomic modulation, which might provide insight into the individual assessment of responses to training load. The purpose of this study was to compare blood pressure and autonomic recovery following repeated bouts of acute supramaximal exercise in Black and White women. A convenience sample of twelve White and eight Black young, healthy women were recruited for this study and completed two consecutive bouts of supramaximal exercise on the cycle ergometer with 30 min of recovery in between. Brachial and central aortic blood pressures were assessed by tonometry (SphygmoCor Xcel) at rest and 15-min and 30-min following each exercise bout. Central aortic blood pressure was estimated using brachial pressure waveforms and customized software. Autonomic modulation was measured in a subset of ten participants by heart-rate variability and baroreflex sensitivity. Brachial mean arterial pressure and diastolic blood pressure were significantly higher in Blacks compared to Whites across time (race effect, p = 0.043 and p = 0.049, respectively). Very-low-frequency and low-frequency bands of heart rate variability, which are associated with sympathovagal balance and vasomotor tone, were 22.5% and 24.9% lower, respectively, in Blacks compared to Whites (race effect, p = 0.045 and p = 0.006, respectively). In conclusion, the preliminary findings of racial differences in blood pressure and autonomic recovery following supramaximal exercise warrant further investigations of tailored exercise prescriptions for Blacks and Whites.
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Affiliation(s)
- Nicole Bajdek
- Exercise and Health Sciences Department, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02184, USA
| | - Noelle Merchant
- Exercise and Health Sciences Department, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02184, USA
| | - Sarah M Camhi
- Kinesiology Department, University of San Francisco, San Francisco, CA 94117, USA
| | - Huimin Yan
- Exercise and Health Sciences Department, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA 02184, USA
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10
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Portela PFDM, Neto VGC, Monteiro ER, Santos da Silva R, da Silva VF, Nogueira CJ, Schutz S, Scudese E, Salvino AKS, Valentim-Silva JR. HIIT is most effective than mict on glycemic control of older people with glucose metabolism impairments: A systematic review and metanalysis. Prim Care Diabetes 2023; 17:129-136. [PMID: 36740492 DOI: 10.1016/j.pcd.2023.01.009] [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: 08/20/2022] [Revised: 01/06/2023] [Accepted: 01/24/2023] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Physical exercise can improve glucose metabolism; however, the best type, volume, intensity, and frequency aren't knowledge. High-Intensity Interval Training (HIIT), an emergent exercise type implicated as a short time-efficient exercise to improve metabolic health, needs more investigation regarding the traditional Moderate-Intensity Continuous Training (MICT). OBJECTIVE To identify the effects of MICT and HIIT on glycemic control of older people with glucose metabolism impairments. METHODS Our research question was based on the PICO model and the systematic review of the literature according to the guidelines of the preferred report items for systematic reviews and PRISMA meta-analyses. An extensive search was conducted in the Web of Science, PubMed, and Scielo databases. Only English language papers were included. The keywords used were "HIIT and metabolism of the elderly", "HIIT and glucose metabolism of the elderly", and "MICT and metabolism of the elderly", which were crossed with the Boolean operators "AND" and "OR" or both according to the guidelines of the PRISMA. RESULTS Seventy papers were retrieved in the initial search. After applying all inclusions and exclusion parameters, 63 articles were excluded. In the end, six papers were classified as eligible for this study. All data categorically demonstrates that both HIIT and MICT can improve glucose metabolism with a larger effect size towards the HIIT model after the meta-analysis, pointing to HIIT as the most effective strategy. CONCLUSION Both modalities can improve glucose metabolism in the elderly with a clear advantage for HIIT over MICT.
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Affiliation(s)
| | - Victor Gonçalves Corrêa Neto
- University Center Gama e Souza (Unigama), Estácio de Sá University, and Laboratory of Integrative Research in exercise, biomedicine, and Colective Health, Rio de Janeiro, Brazil
| | - Estêvão Rios Monteiro
- University Center of Brazilian Institute of Medical Rehabilitation (IBMR), University Center Augusto Motta, and Post Gradution Program in Phisical Education EEFD/UFRJ, Brazil
| | - Rudson Santos da Silva
- National Institute of Infectiology of Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Vernon Furtado da Silva
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Federal University of Rondônia, Porto Velho, Rondônia, Brazil
| | | | - Silvia Schutz
- Teacher of State of Amazônia, and Municipal Secretariat of Education of Humaitá, Amazônia, Brazil
| | - Estevão Scudese
- Laboratory of Biosciences of Human Motricity (LABIMH) of the Federal University of State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil; Sport Sciences and Exercise Laboratory (LaCEE), Catholic University of Petrópolis (UCP), Brazil
| | | | - João Rafael Valentim-Silva
- Laboratory of Biosciences of Human Motricity of the Federal University of State of Rio de Janeiro, Rio de Janeiro, Brazil; Federal University of Rondônia, Porto Velho, Rondônia, Brazil; Nanobiotechnology Laboratory of Federal University of Acre, Rio Branco, Acre, Brazil; Laboratory of Cineantropometry and Human Performance of Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
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11
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Kettinen J, Tikkanen H, Venojärvi M. Comparative effectiveness of playing golf to Nordic walking and walking on acute physiological effects on cardiometabolic markers in healthy older adults: a randomised cross-over study. BMJ Open Sport Exerc Med 2023; 9:e001474. [PMID: 36816424 PMCID: PMC9930551 DOI: 10.1136/bmjsem-2022-001474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 02/08/2023] Open
Abstract
Objectives The acute effects of aerobic exercise on cardiometabolic markers are well documented in younger healthy individuals, but the same effects in older adults have not been elucidated. As such, this study compares the acute effects of three different types of age-appropriate aerobic exercises on cardiometabolic markers. Methods Healthy older golfers (n=25, 16 male and 9 female, 68±4 years) were enrolled in a randomised cross-over experiment. We compared the effects of three different acute aerobic exercises (18-hole golf, 6 km Nordic walk, 6 km walk) on blood pressure, blood glucose and blood lipid profile in a real-life environment. Results In the between-group comparison, playing golf resulted in a difference in blood glucose (golf: 0.01±1.0 mmol/L, walk: 1.3±0.9 mmol/L, p<0.001) compared with walking and triglycerides (golf: 0.13±0.2 mmol/L, Nordic walk: 0.31±0.2 mmol/L, walk: 0.23±0.2 mmol, p=0.012) and high-density lipoprotein cholesterol (golf: 0.04±0.06 mmol/L, Nordic walk: -0.02±0.06 mmol/L, walk: -0.02±0.07 mmol/L, p=0.002) compared with Nordic walking and walking. In addition, all groups had significant decreases (p<0.001) in systolic blood pressure, and Nordic walking and walking also demonstrated a decrease in diastolic blood pressure (p<0.05). Conclusion Acute bouts of aerobic exercise improved cardiovascular profile in healthy older adults. Despite the lower exercise intensity of golf, the longer duration and higher energy expenditure appeared to have a more positive effect on lipid profile and glucose metabolism compared with Nordic walking and walking. Trial registration number ISRCTN10007294.
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Affiliation(s)
- Julia Kettinen
- Institute of Biomedicine, Sports and Exercise Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Heikki Tikkanen
- Institute of Biomedicine, Sports and Exercise Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Mika Venojärvi
- Institute of Biomedicine, Sports and Exercise Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
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12
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Mudjanarko SW, Irawati A, Tinduh D, Susanto TN. EFFECT OF MODERATE-INTENSITY TREADMILL EXERCISE ON INCREASED ADIPONECTIN LEVELS IN TYPE 2 DIABETES MELLITUS PATIENTS. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329022022_0144i] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
ABSTRACT Introduction: Adiponectin plays a significant role in the metabolic system in proinflammatory cytokine inhibition and glucose uptake utilization. The treadmill is an aerobic walking device that stimulates natural walking features. Exercises increase adiponectin levels leading to improvement in insulin sensitivity. Objectives: To analyze the effect of aerobic exercise using a moderate-intensity treadmill with a gradual increase in speed and inclination on adiponectin levels in men with type 2 diabetes mellitus (T2DM). Methods: Twenty-two participants with T2DM were randomized into treadmill exercise and control groups. The experimental group underwent 30-minute sessions of moderate-intensity treadmill exercise with increasing speed and gradual inclination three times a week for four weeks. The control group underwent individual exercise for 150 minutes per week. Participants were assessed for clinical and laboratory parameters before and after the four-week program. Results: There was a significant increase in the adiponectin level from 456.3 ± 42 pg/ml to 586.3 ± 87.8 pg/ml (p=0.04, p<0.05) in the treadmill exercise group. In the control group, adiponectin only increased from 466.7 ± 85 pg/ml to 471.8 ± 59 pg/ml (p=0.646). Conclusions: Moderate-intensity treadmill with increasing speed and gradual inclination was found to lead to a significantly better outcome in improving adiponectin levels than standard individual physical exercise in managing T2DM. Level of evidence II; Therapeutic studies – Investigation of the treatment results.
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13
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Mudjanarko SW, Irawati A, Tinduh D, Susanto TN. EFEITO DO EXERCÍCIO EM ESTEIRA DE INTENSIDADE MODERADA NO AUMENTO DOS NÍVEIS DE ADIPONECTINA EM PACIENTES COM DIABETES MELLITUS TIPO 2. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329022022_0144p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
RESUMO Introdução: A adiponectina desempenha um papel significativo no sistema metabólico na inibição da citocina pró-inflamatória e na utilização da captação de glicose. A esteira é um aparelho de caminhada aeróbica que estimula as características da caminhada natural. Os exercícios aumentam o nível de adiponectina, resultando na melhora da sensibilidade à insulina. Objetivos: Analisar o efeito de exercícios aeróbicos em uma esteira de intensidade moderada com um aumento gradual de velocidade e inclinação sobre os níveis de adiponectina em homens com diabetes mellitus tipo 2 (DMT2). Método: Vinte e dois participantes com DMT2 foram randomizados para grupos de exercício em esteira e controle. O grupo experimental realizou sessões de 30 minutos de exercício em esteira de intensidade moderada com velocidade crescente e inclinação gradual três vezes por semana durante quatro semanas. O grupo de controle se submeteu a exercício individual durante 150 minutos por semana. Os participantes foram avaliados em relação aos parâmetros clínicos e laboratoriais antes e após o programa de quatro semanas. Resultados: Houve um aumento significativo no nível de adiponectina de 456,3 ± 42 pg/ml para 586,3 ± 87,8 pg/ml (p=0,04, p<0,05) no grupo de exercício em esteira. No grupo de controle, a adiponectina apresentou um pequeno aumento de 466,7 ± 85 pg/ml para 471,8 ± 59 pg/ml (p=0,646). Conclusão: Descobriu-se que exercícios na esteira de intensidade moderada com velocidade crescente e inclinação gradual conduzem a um resultado significativamente superior na melhora dos níveis de adiponectina em relação a exercícios físicos individuais padrão ao tratar o DMT2. Nível de evidência II; Estudos terapêuticos – Investigação de resultados do tratamento.
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14
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Delfan M, Vahed A, Bishop DJ, Amadeh Juybari R, Laher I, Saeidi A, Granacher U, Zouhal H. Effects of two workload-matched high intensity interval training protocols on regulatory factors associated with mitochondrial biogenesis in the soleus muscle of diabetic rats. Front Physiol 2022; 13:927969. [PMID: 36213227 PMCID: PMC9541894 DOI: 10.3389/fphys.2022.927969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/29/2022] [Indexed: 11/15/2022] Open
Abstract
Aims: High intensity interval training (HIIT) improves mitochondrial characteristics. This study compared the impact of two workload-matched high intensity interval training (HIIT) protocols with different work:recovery ratios on regulatory factors related to mitochondrial biogenesis in the soleus muscle of diabetic rats. Materials and methods: Twenty-four Wistar rats were randomly divided into four equal-sized groups: non-diabetic control, diabetic control (DC), diabetic with long recovery exercise [4-5 × 2-min running at 80%-90% of the maximum speed reached with 2-min of recovery at 40% of the maximum speed reached (DHIIT1:1)], and diabetic with short recovery exercise (5-6 × 2-min running at 80%-90% of the maximum speed reached with 1-min of recovery at 30% of the maximum speed reached [DHIIT2:1]). Both HIIT protocols were completed five times/week for 4 weeks while maintaining equal running distances in each session. Results: Gene and protein expressions of PGC-1α, p53, and citrate synthase of the muscles increased significantly following DHIIT1:1 and DHIIT2:1 compared to DC (p ˂ 0.05). Most parameters, except for PGC-1α protein (p = 0.597), were significantly higher in DHIIT2:1 than in DHIIT1:1 (p ˂ 0.05). Both DHIIT groups showed significant increases in maximum speed with larger increases in DHIIT2:1 compared with DHIIT1:1. Conclusion: Our findings indicate that both HIIT protocols can potently up-regulate gene and protein expression of PGC-1α, p53, and CS. However, DHIIT2:1 has superior effects compared with DHIIT1:1 in improving mitochondrial adaptive responses in diabetic rats.
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Affiliation(s)
- Maryam Delfan
- Department of Exercise Physiology, Faculty of Sport Sciences, Alzahra University, Tehran, Iran
| | - Alieh Vahed
- Department of Exercise Physiology, Faculty of Sport Sciences, Alzahra University, Tehran, Iran
| | - David J. Bishop
- Institute for Sport and Health (iHeS), Victoria University, Melbourne, VIC, Australia
| | - Raheleh Amadeh Juybari
- Department of Exercise Physiology, Faculty of Sport Sciences, Alzahra University, Tehran, Iran
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Ayoub Saeidi
- Department of Physical Education and Sport Sciences, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, Kurdistan, Iran
| | - Urs Granacher
- Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany
| | - Hassane Zouhal
- Movement, Sport, Health and Sciences Laboratory (M2S), UFR-STAPS, University of Rennes 2-ENS Cachan, Rennes Cedex, France
- Institut International des Sciences du Sport (2I2S), Irodouer, France
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15
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Zhao K, Hu Z, Wang T, Tian L, Wang M, Liu R, Zuo C, Jihua W. Acute effects of two different work-to-rest ratio of high-intensity interval training on brain-derived neurotrophic factor in untrained young men. Front Physiol 2022; 13:988773. [PMID: 36160866 PMCID: PMC9490303 DOI: 10.3389/fphys.2022.988773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Aerobic exercise could produce a positive effect on the brain by releasing brain-derived neurotrophic factor (BDNF). In untrained healthy humans there seems to be a linear correlation between exercise duration and the positive effect of acute aerobic exercise on brain-derived neurotrophic factor levels. Therefore, we performed two different duration of high-intensity interval training protocols (HIIT), both known to improve cardiovascular fitness, to determine whether then have a similar efficacy in affecting brain-derived neurotrophic factor levels.Methods: 12 untrained young males (aged 23.7 ± 1.8 years), participated in a randomized controlled cross-over trial. They underwent two different work-to-rest ratio high-intensity interval training protocols: high-intensity interval training 1 (30 min, 15 intervals of 1 min efforts at 85%–90% VO2max with 1 min of active recovery at 50%–60% VO2max) and HIIT2 (30 min, 10 intervals of 2 min efforts at 85%–90% VO2max with 1 min of active recovery at 50%–60% VO2max). Serum cortisol, brain-derived neurotrophic factor were collected at baseline, immediately following intervention, and 30 min into recovery for measurements using a Sandwich ELISA method, blood lactate was measured by using a portable lactate analyzer.Results: Our results showed that the similar serum brain-derived neurotrophic factor change in both high-intensity interval training protocols, with maximal serum brain-derived neurotrophic factor levels being reached toward the end of intervention. There was no significant change in serum brain-derived neurotrophic factor from baseline after 30 min recovery. We then showed that both high-intensity interval training protocols significantly increase blood lactate and serum cortisol compared with baseline value (high-intensity interval training p < 0.01; high-intensity interval training 2 p < 0.01), with high-intensity interval training 2 reaching higher blood lactate levels than high-intensity interval training 1 (p = 0.027), but no difference was observed in serum cortisol between both protocols. Moreover, changes in serum brain-derived neurotrophic factor did corelate with change in blood lactate (high-intensity interval training 1 r = 0.577, p < 0.05; high-intensity interval training 2 r = 0.635, p < 0.05), but did not correlate with the change in serum cortisol.Conclusions: brain-derived neurotrophic factor levels in untrained young men are significantly increased in response to different work-to-rest ratio of high-intensity interval training protocols, and the magnitude of increase is exercise duration independent. Moreover, the higher blood lactate did not raise circulating brain-derived neurotrophic factor. Therefore, given that prolonged exercise causes higher levels of cortisol. We suggest that the 1:1work-to-rest ratio of high-intensity interval training protocol might represent a preferred intervention for promoting brain health.
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Affiliation(s)
- Kegang Zhao
- School of Physical Education of Shandong Normal University, Jinan, China
- *Correspondence: Kegang Zhao,
| | | | - Tao Wang
- School of Physical Education of Liaocheng University, Jinan, China
| | - Lei Tian
- School of Physical Education of Shandong Normal University, Jinan, China
| | - Maoye Wang
- School of Physical Education of Shandong Normal University, Jinan, China
| | - Ruijiang Liu
- School of Physical Education of Shandong Normal University, Jinan, China
| | - Chongwen Zuo
- Capital Institute of Physical Education and Sports, Beijing, China
| | - Wang Jihua
- Department of Information Science and Engineering of Shandong Normal University, Jinan, China
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16
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Palermi S, Iacono O, Sirico F, Modestino M, Ruosi C, Spera R, De Luca M. The complex relationship between physical activity and diabetes: an overview. J Basic Clin Physiol Pharmacol 2022; 33:535-547. [PMID: 34592073 DOI: 10.1515/jbcpp-2021-0279] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/19/2021] [Indexed: 06/13/2023]
Abstract
Diabetes mellitus (DM) is a widespread condition, representing a challenging disease to manage. Exercise is being increasingly recommended as part of the therapeutic regimen for DM but the management of different forms of physical activity is difficult for individuals with diabetes, trainers, and physicians. Regular exercise can improve health and well-being, helping individuals to achieve their target lipid profile, body composition, cardio-respiratory fitness, and glycemic goals. People with diabetes tend to be as inactive as the general population, with a large percentage of individuals not achieving the minimum amount of recommended physical activity levels. Indeed, several barriers to exercise exist for persons with diabetes, including sports eligibility, multi-modality management of diabetic athletes, and inadequate knowledge about adequate type and intensity of exercise. The aim of the present review is to provide the current understanding of mechanisms, recommendations, and beneficial effects of different modalities of exercise for the treatment of DM.
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Affiliation(s)
- Stefano Palermi
- Public Health Department, University Federico II, Naples, Italy
| | - Olimpia Iacono
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Felice Sirico
- Public Health Department, University Federico II, Naples, Italy
| | - Michele Modestino
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Carlo Ruosi
- Public Health Department, University Federico II, Naples, Italy
| | - Rocco Spera
- Public Health Department, University Federico II, Naples, Italy
| | - Mariarosaria De Luca
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
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17
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Systematic Review and Meta-Analysis on the Rehabilitation Effect of Different Intensity Exercise on the Patients with Cardiovascular Diseases. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:1364985. [PMID: 35941894 PMCID: PMC9356822 DOI: 10.1155/2022/1364985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/15/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022]
Abstract
Background. Cardiovascular disease is a common disease with high prevalence, disability, and mortality. Exercise therapy can improve cardiac functional reserve and life quality of patients, but the benefits of different exercise intensities for cardiovascular patients are still controversial. In this study, literature search and meta-analysis were used to explore the effect of 2 intensities of exercise on the rehabilitation effect of cardiovascular patients. Methods. We searched Embase, Wiley online library, PubMed, Science Direct, and Clinicaltrials to look for randomized controlled trial (RCT) studies of high-intensity interval training (HIIT) versus moderate continuous training (MCT). After screening the inclusion criteria for the literature and assessing the risk of bias, a software analysis was performed using the R language toolkit to obtain forest plots and funnel maps. Results. 10 articles were included in this study into the quantitative analysis, and 520 patients participated in the study; meta-analysis results showed that after HIIT intervention, the VO2 peak index of patients was higher than that of the MCT group (
, 95% CI (0.10, 2.68),
,
), the peak heart rate HR peak was higher than that of the MCT training (
, 95% CI (5.12, 10.30),
,
), the respiratory exchange rate (maximum RER) was higher than that of the MCT training (
, 95% CI (0.00, 0.04),
,
), and the quality of life was higher than that of the MCT training (
, 95% CI (0.07, 0.71),
,
). Discussion. Compared with moderate continuous training, high intensity interval training is more conducive to improve the cardiopulmonary function of cardiovascular patients and improve their physical life quality.
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18
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Delfan M, Amadeh Juybari R, Gorgani-Firuzjaee S, Høiriis Nielsen J, Delfan N, Laher I, Saeidi A, Granacher U, Zouhal H. High-Intensity Interval Training Improves Cardiac Function by miR-206 Dependent HSP60 Induction in Diabetic Rats. Front Cardiovasc Med 2022; 9:927956. [PMID: 35845054 PMCID: PMC9277013 DOI: 10.3389/fcvm.2022.927956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/13/2022] [Indexed: 12/12/2022] Open
Abstract
Objective A role for microRNAs is implicated in several biological and pathological processes. We investigated the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on molecular markers of diabetic cardiomyopathy in rats. Methods Eighteen male Wistar rats (260 ± 10 g; aged 8 weeks) with streptozotocin (STZ)-induced type 1 diabetes mellitus (55 mg/kg, IP) were randomly allocated to three groups: control, MICT, and HIIT. The two different training protocols were performed 5 days each week for 5 weeks. Cardiac performance (end-systolic and end-diastolic dimensions, ejection fraction), the expression of miR-206, HSP60, and markers of apoptosis (cleaved PARP and cytochrome C) were determined at the end of the exercise interventions. Results Both exercise interventions (HIIT and MICT) decreased blood glucose levels and improved cardiac performance, with greater changes in the HIIT group (p < 0.001, η2: 0.909). While the expressions of miR-206 and apoptotic markers decreased in both training protocols (p < 0.001, η2: 0.967), HIIT caused greater reductions in apoptotic markers and produced a 20% greater reduction in miR-206 compared with the MICT protocol (p < 0.001). Furthermore, both training protocols enhanced the expression of HSP60 (p < 0.001, η2: 0.976), with a nearly 50% greater increase in the HIIT group compared with MICT. Conclusions Our results indicate that both exercise protocols, HIIT and MICT, have the potential to reduce diabetic cardiomyopathy by modifying the expression of miR-206 and its downstream targets of apoptosis. It seems however that HIIT is even more effective than MICT to modulate these molecular markers.
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Affiliation(s)
- Maryam Delfan
- Department of Exercise Physiology, Faculty of Sport Sciences, Alzahra University, Tehran, Iran
| | - Raheleh Amadeh Juybari
- Department of Exercise Physiology, Faculty of Sport Sciences, Alzahra University, Tehran, Iran
| | - Sattar Gorgani-Firuzjaee
- Department of Medical Laboratory Sciences, School of Allied Health Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Jens Høiriis Nielsen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Neda Delfan
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Ayoub Saeidi
- Department of Physical Education and Sport Sciences, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, Iran
| | - Urs Granacher
- Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany
| | - Hassane Zouhal
- Movement, Sport, Health and Sciences Laboratory (M2S), UFR-STAPS, University of Rennes 2-ENS Cachan, Av. Charles Tillon, Rennes Cedex, France.,Institut International des Sciences du Sport (2IS), Irodouer, France
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19
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Zhao D, Shi W, Bi L, Qi Y, Hu S, Li C, Zhang Y, Zheng X. Effect of short-term acute moderate-intensity resistance exercise on blood glucose in older patients with type 2 diabetes mellitus and sarcopenia. Geriatr Gerontol Int 2022; 22:653-659. [PMID: 35841217 DOI: 10.1111/ggi.14437] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 06/02/2022] [Accepted: 06/14/2022] [Indexed: 11/28/2022]
Abstract
AIM To investigate the effects of short-term acute moderate-intensity resistance exercise on blood glucose in older patients with type 2 diabetes mellitus and sarcopenia using ambulatory glucose monitoring technology. METHODS This is a prospective intervention of an own-controlled before-and-after cohort study. A total of 24 older type 2 diabetes mellitus patients who met the enrollment criteria were selected, including 12 cases in the sarcopenia and 12 in the non-sarcopenia groups. First, they wore ambulatory glucose monitoring devices (Medtronic, Ipro2) and retained baseline data. Then they wore Ipro2 again and carried out two sessions of resistance exercise on alternate days. Blood glucose level, blood glucose fluctuation, and time in target range on the contrast and exercise days were compared and analyzed in both groups. RESULTS The area under the curve of glucose level across 24 h and the mean blood glucose post exercise decreased (P < 0.05) in the sarcopenia group. On the exercise day, the coefficient of variation of glucose, the largest amplitude of glycemic excursions, amplitude of postprandial glucose excursions and low blood glucose index decreased, whereas the time in target range increased (P < 0.05). CONCLUSIONS Short-term acute moderate-intensity resistance exercise is an effective and safe exercise modality, which can reduce blood glucose levels, blood glucose fluctuations and the risk of hypoglycemia, as well as improve the time in target range for older patients with type 2 diabetes mellitus and sarcopenia. Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Dan Zhao
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Wenli Shi
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Lina Bi
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Yanyan Qi
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Su Hu
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Chang Li
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Yan Zhang
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
| | - Xin Zheng
- Department of Endocrinology, Beijing Boai Hospital, China Rehabilitation Research Center, Beijing, China
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20
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Acute Effects of High-Intensity Interval Training on Diabetes Mellitus: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127049. [PMID: 35742298 PMCID: PMC9223048 DOI: 10.3390/ijerph19127049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 12/19/2022]
Abstract
This study evaluated the scientific evidence on the acute effects of high-intensity interval training (HIIT) on biochemical, cardiovascular, and metabolic parameters in patients with diabetes mellitus. The research took place using two databases (PubMed and Google Scholar) with eligible studies conducted between 2010 and 2020, using the following keywords: (1) high-intensity training/exercise; (2) interval training/exercise; (3) HIIT/exercise; AND “diabetes”. Data extraction was then performed on the eligible studies through content analysis using the categories: author and year of publication; sample characteristics; methods and data collected; intervention protocol; and results found. Methodological quality was assessed using the PEDro scale. Fourteen studies were included, evaluating 168 people with diabetes (122/46 type 2/1) and 42 normoglycemic individuals, which evaluated markers such as capillary and fasting blood glucose, 24-h blood glucose profile, postprandial blood glucose, incidence, and prevalence of hyperglycemia, vascular function and pressure response and control of inflammatory markers. Physical exercise was found to have several acute beneficial effects on the health of the diabetic population, such as reduced capillary and postprandial blood glucose, blood glucose profile, and blood pressure. Moreover, HIIT seems to be a safe and effective alternative in glycemic control and associated factors, superior to continuous moderate-intensity training.
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21
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Liu QQ, Xie WQ, Luo YX, Li YD, Huang WH, Wu YX, Li YS. High Intensity Interval Training: A Potential Method for Treating Sarcopenia. Clin Interv Aging 2022; 17:857-872. [PMID: 35656091 PMCID: PMC9152764 DOI: 10.2147/cia.s366245] [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: 03/17/2022] [Accepted: 05/14/2022] [Indexed: 11/23/2022] Open
Abstract
Sarcopenia, an age-related disease characterized by loss of muscle strength and muscle mass, has attracted the attention of medical experts due to its severe morbidity, low living quality, high expenditure of health care, and mortality. Traditionally, persistent aerobic exercise (PAE) is considered as a valid way to attenuate muscular atrophy. However, nowadays, high intensity interval training (HIIT) has emerged as a more effective and time-efficient method to replace traditional exercise modes. HIIT displays comprehensive effects on exercise capacity and skeletal muscle metabolism, and it provides a time-out for the recovery of cardiopulmonary and muscular functions without causing severe adverse effects. Studies demonstrated that compared with PAE, HIIT showed similar or even higher effects in improving muscle strength, enhancing physical performances and increasing muscle mass of elder people. Therefore, HIIT might become a promising way to cope with the age-related loss of muscle mass and muscle function. However, it is worth mentioning that no study of HIIT was conducted directly on sarcopenia patients, which is attributed to the suspicious of safety and validity. In this review, we will assess the effects of different training parameters on muscle and sarcopenia, summarize previous papers which compared the effects of HIIT and PAE in improving muscle quality and function, and evaluate the potential of HIIT to replace the status of PAE in treating old people with muscle atrophy and low modality; and point out drawbacks of temporary experiments. Our aim is to discuss the feasibility of HIIT to treat sarcopenia and provide a reference for clinical scientists who want to utilize HIIT as a new way to cope with sarcopenia.
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Affiliation(s)
- Qian-Qi Liu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, 410083, People’s Republic of China
| | - Wen-Qing Xie
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
| | - Yu-Xuan Luo
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, 410083, People’s Republic of China
| | - Yi-Dan Li
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- Xiangya School of Medicine, Central South University, Changsha, Hunan, 410083, People’s Republic of China
| | - Wei-Hong Huang
- Mobile Health Ministry of Education - China Mobile Joint Laboratory, Xiangya Hospital Central South University, Changsha, Hunan, 410008, People’s Republic of China
| | - Yu-Xiang Wu
- Department of Health and Kinesiology, School of Physical Education, Jianghan University, Wuhan, Hubei, 430056, People’s Republic of China
- Yu-Xiang Wu, Department of Health and Kinesiology, School of Physical Education, Jianghan University, No. 8, Sanjiaohu Road, Wuhan, Hubei, 430056, People’s Republic of China, Tel +86 27 8422 6921, Email
| | - Yu-Sheng Li
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
- Correspondence: Yu-Sheng Li, Department of Orthopedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, 410008, People’s Republic of China, Tel +86-13975889696, Email
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22
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Wang L, Ma J, Wu W, Fang Y, Liu F, Yang Q, Hu X, Gu X, He Z, Sun D, Jin L, Zhang X. Effect of aerobic exercise as a treatment on type 2 diabetes mellitus with depression-like behavior zebrafish. Life Sci 2022; 300:120578. [PMID: 35489565 DOI: 10.1016/j.lfs.2022.120578] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/11/2022] [Accepted: 04/20/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Depression is the most known complication of type 2 diabetes mellitus (T2DM). Aerobic exercise improves glycemic control in T2DM, although the underlying mechanisms of comorbid depression-like behaviors in T2DM have not yet been fully elucidated. METHODS 120 zebrafish were randomly assigned to four groups: Control, T2DM, T2DM + metformin, and T2DM + aerobic exercise. Then, all animals except the control group were fed with high glucose fairy shrimp (~40 g/kg/day) and exposed reserpine (40 μg/ml for 20 min) for 10 days. Here, behavioral tests were used for model verification. Following the verification, all groups were treated as before. Additionally, the T2DM + metformin group received metformin (~10.6 mg/kg/day) at the same time, while the T2DM + aerobic exercise group received aerobic exercise 30 min/day. Finally, blood glucose and behavioral tests, as well as protein and molecular levels were determined at Day 11 and 12. RESULTS Aerobic exercise alleviated depressive-like behavior and enhanced the levels of antidepressant biomarkers (NE, 5-HIAA) in zebrafish after 10 consecutive days of exercise. Additionally, 10 consecutive days of aerobic exercise decreased the levels of inflammatory biomarkers (IFN-γ, IL-1, IL-4) and depressive biomarkers (cortisol). Meanwhile, it also aided in the reduction of CD11b, IL-6, IL-6R, and caspase-3 expression to combat the neuroinflammation induced by T2DM, mediated the BDNF-TrkB pathway, and increased Bcl-2/Bax levels. CONCLUSION Given the remarkable similarity in neurochemistry between humans and zebrafish, this study supports the effectiveness of aerobic exercise as clinical guidance in preventing and treating T2DM complicated with depression.
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Affiliation(s)
- Lei Wang
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Jiahui Ma
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Wei Wu
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing 400044, China
| | - Yimeng Fang
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Fan Liu
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China
| | - Qinsi Yang
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325000, China
| | - Xiang Hu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xuejiang Gu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Zhiying He
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Da Sun
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China.
| | - Libo Jin
- Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou 325035, China.
| | - Xingxing Zhang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
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23
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Diesel M, Heberle I, Juchem G, de Barcelos GT, Cavestré Coneglian J, Gerage AM, Delevatti RS. Blood Pressure and Blood Glucose Responses to Combined Exercise Sessions of Different Intensities in Individuals with Cardiovascular Risk Factors. Clin Exp Hypertens 2022; 44:436-441. [PMID: 35420926 DOI: 10.1080/10641963.2022.2065289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The purpose of the present study was to verify the acute effects of blood pressure and blood glucose after two sessions of combined exercise sessions performed at two levels of intensity in trained individuals with cardiovascular risk factors. METHODS Eighteen individuals (66.22 ± 8.61 years) of both sexes (6 women/12 men) with cardiovascular risk factors performed two sessions of combined exercises at different levels of intensity: moderate (MOD) and high (HI). To control the intensity of the aerobic training, the Borg Rating of Perceived Exertion (RPE) Scale was used. For the strength training, the maximum number of repetitions was carried out within a predetermined duration of sets. Blood pressure and blood glucose measurements were collected before and 20 minutes after the sessions. The data were analyzed using Generalized Estimating Equations, α 5%. RESULTS Reductions were observed in systolic blood pressure (MOD - Δ = -4.95 mmHg; HI - Δ = -3.31 mmHg) and blood glucose (MOD - Δ = -16.06 mg/dL; HI - Δ = -29.45 mg/dL) after the two sessions, with no difference between sessions. Diastolic blood pressure did not change (p < .05). CONCLUSION Combined exercises sessions of moderate or high intensity can promote an acute reduction in systolic blood pressure and glycemia in individuals with cardiovascular risk factors.
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Affiliation(s)
- Mabel Diesel
- Grupo de Pesquisa em Exercício Clínico (GPEC), Centro de Desportos (CDS), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Isabel Heberle
- Grupo de Pesquisa em Exercício Clínico (GPEC), Centro de Desportos (CDS), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Gabriel Juchem
- Grupo de Pesquisa em Exercício Clínico (GPEC), Centro de Desportos (CDS), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Guilherme Tadeu de Barcelos
- Grupo de Pesquisa em Exercício Clínico (GPEC), Centro de Desportos (CDS), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Juliana Cavestré Coneglian
- Grupo de Pesquisa em Exercício Clínico (GPEC), Centro de Desportos (CDS), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Aline Mendes Gerage
- Grupo de Pesquisa em Exercício Clínico (GPEC), Centro de Desportos (CDS), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Rodrigo Sudatti Delevatti
- Grupo de Pesquisa em Exercício Clínico (GPEC), Centro de Desportos (CDS), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
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24
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Yuan Z, Xiao-Wei L, Juan W, Xiu-Juan L, Nian-Yun Z, Lei S. HIIT and MICT attenuate high-fat diet-induced hepatic lipid accumulation and ER stress via the PERK-ATF4-CHOP signaling pathway. J Physiol Biochem 2022; 78:641-652. [PMID: 35315506 PMCID: PMC9381492 DOI: 10.1007/s13105-022-00884-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 02/18/2022] [Indexed: 01/06/2023]
Abstract
Fatty liver can be induced by dietary habits and lifestyle and is directly related to obesity. Although the benefits of exercise interventions for reduction of liver fat have recently been acknowledged, the underlying mechanisms remain unclear. Thus, our present study investigated the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on high-fat diet-induced hepatic lipid accumulation, and explored the role of endoplasmic reticulum (ER) stress signaling pathways. To establish an obesity model, rats were fed with a normal standard diet or a high-fat diet (45% kcal as fat). Then, both lean and obese rats were divided into three subgroups: sedentary control (LC, OC) groups, high-intensity interval training (LHI, OHI) groups, and moderated-intensity continuous training (LMI, OMI) groups (n = 10). Rats in the exercise group underwent a swimming training protocol for 8 weeks. After the experimental period, serum and liver tissues from different groups were dissected for morphological and biochemical analyses. The results showed that with HIIT and MICT interventions, body weight and serum inflammatory markers (e.g., MCP-1, IL-1β, and TNF-α) were reduced in obese rats. Interestingly, HIIT was more effective in ameliorating liver triglyceride content and enhancing mitochondrial metabolic-enzymatic activity than was MICT in obese rats. Both HIIT and MICT conferred beneficial properties through upregulating Nrf2 expression, improving antioxidant enzyme activities and reduction of hepatic ER stress, which may have been regulated by the Bip-mediated PERK-ATF4-CHOP pathway. In conclusion, our findings confirmed the effectiveness of HIIT and MICT, particularly HIIT, in mitigating hepatic lipid accumulation.
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Affiliation(s)
- Zhang Yuan
- The Key Laboratory of Systems Biomedicine, Ministry of Education, and The Exercise Translational Medicine Centre, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, 200240, China.,School of Sports and Health, Nanjing Sport Institute, Nanjing, 210014, China.,Jiangsu Collaborative Innovation Center for Sport and Health Project, Nanjing, 210014, China
| | - Liu Xiao-Wei
- School of Sports and Health, Nanjing Sport Institute, Nanjing, 210014, China.,Huishan District Rehabilitation Hospital, Wuxi, 214100, China
| | - Wei Juan
- School of Sports and Health, Nanjing Sport Institute, Nanjing, 210014, China.,Jiangsu Collaborative Innovation Center for Sport and Health Project, Nanjing, 210014, China
| | - Liu Xiu-Juan
- School of Sports and Health, Nanjing Sport Institute, Nanjing, 210014, China.,Jiangsu Collaborative Innovation Center for Sport and Health Project, Nanjing, 210014, China
| | - Zhang Nian-Yun
- School of Sports and Health, Nanjing Sport Institute, Nanjing, 210014, China
| | - Sheng Lei
- School of Sports and Health, Nanjing Sport Institute, Nanjing, 210014, China. .,Jiangsu Collaborative Innovation Center for Sport and Health Project, Nanjing, 210014, China.
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25
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Teles GDO, Gentil P, Silva LRBE, Sousa WDM, Seguro CS, Rebelo ACS. HIIE Protocols Promote Better Acute Effects on Blood Glucose and Pressure Control in People with Type 2 Diabetes than Continuous Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052601. [PMID: 35270295 PMCID: PMC8909767 DOI: 10.3390/ijerph19052601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/09/2022] [Accepted: 02/15/2022] [Indexed: 02/05/2023]
Abstract
This study compared the acute effects of a session of different high-intensity interval exercise (HIIE) protocols and a session of moderate-intensity continuous exercise (MICE) on blood glucose, blood pressure (BP), and heart rate (HR) in people with Type 2 Diabetes Mellitus (DM2). The trial included 44 participants (age: 55.91 ± 1.25 years; BMI: 28.95 ± 0.67 kg/m2; Hb1Ac: 9.1 ± 2.3%; 76 mmol/mol) randomized into three exercise protocols based on the velocity at which maximum oxygen consumption was obtained (vVO2 max): long HIIE (2 min at 100% vV̇o2peak + 2 min of passive rest); short HIIE (30 s at 100% vV̇o2peak + 30 s of passive rest); or MICE (14 min at 70% vV̇o2peak) on a treadmill. Capillary blood glucose, BP, and HR measurements were taken at rest, during peak exercise, immediately after the end of exercise, and 10 min after exercise. Long and short HIIE protocols reduced capillary blood glucose by 32.14 mg/dL and 31.40 mg/dL, respectively, and reduced systolic BP by 12.43 mmHg and 8.73 mmHg, respectively. No significant changes were observed for MICE. HIIE was found to promote more acute effects than MICE on glycemia and BP in people with DM2.
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Affiliation(s)
- Gabriela de Oliveira Teles
- College of Physical Education and Dance, Federal University of Goias, Campus Samambaia, Goiânia 74690-900, Brazil
- Correspondence: (G.d.O.T.); (P.G.)
| | - Paulo Gentil
- College of Physical Education and Dance, Federal University of Goias, Campus Samambaia, Goiânia 74690-900, Brazil
- Correspondence: (G.d.O.T.); (P.G.)
| | | | | | | | - Ana Cristina Silva Rebelo
- Department of Morphology, Institute of Biological Sciences, Federal University of Goias, Goiânia 74690-900, Brazil;
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26
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Pellinger TK, Emhoff CAW. Skeletal Muscle Hyperemia: A Potential Bridge Between Post-exercise Hypotension and Glucose Regulation. Front Physiol 2022; 12:821919. [PMID: 35173625 PMCID: PMC8841576 DOI: 10.3389/fphys.2021.821919] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 12/28/2021] [Indexed: 11/16/2022] Open
Abstract
For both healthy individuals and patients with type 2 diabetes (T2D), the hemodynamic response to regular physical activity is important for regulating blood glucose, protecting vascular function, and reducing the risk of cardiovascular disease. In addition to these benefits of regular physical activity, evidence suggests even a single bout of dynamic exercise promotes increased insulin-mediated glucose uptake and insulin sensitivity during the acute recovery period. Importantly, post-exercise hypotension (PEH), which is defined as a sustained reduction in arterial pressure following a single bout of exercise, appears to be blunted in those with T2D compared to their non-diabetic counterparts. In this short review, we describe research that suggests the sustained post-exercise vasodilation often observed in PEH may sub-serve glycemic regulation following exercise in both healthy individuals and those with T2D. Furthermore, we discuss the interplay of enhanced perfusion, both macrovascular and microvascular, and glucose flux following exercise. Finally, we propose future research directions to enhance our understanding of the relationship between post-exercise hemodynamics and glucose regulation in healthy individuals and in those with T2D.
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Affiliation(s)
- Thomas K. Pellinger
- Department of Physical Therapy, University of Maryland Eastern Shore, Princess Anne, MD, United States
- *Correspondence: Thomas K. Pellinger,
| | - Chi-An W. Emhoff
- Department of Kinesiology, Saint Mary’s College of California, Moraga, CA, United States
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27
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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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28
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Effect of High-Intensity Interval Training on Physical Health in Coronary Artery Disease Patients: A Meta-Analysis of Randomized Controlled Trials. J Cardiovasc Dev Dis 2021; 8:jcdd8110158. [PMID: 34821711 PMCID: PMC8622669 DOI: 10.3390/jcdd8110158] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/10/2021] [Accepted: 11/15/2021] [Indexed: 01/02/2023] Open
Abstract
The effects of exercise-based cardiac rehabilitation (CR) on physical health in coronary artery disease (CAD) patients has long been established, while the optimal exercise mode remains to be determined. This meta-analysis compared the efficacy of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) in CAD patients. Databases were searched up to December 2020. Twenty-five studies with 1272 participants were analyzed. The results showed that both HIIT and MICT induced significant VO2peak improvement with a 4.52 mL/kg/min (p < 0.01) and 2.36 mL/kg/min (p < 0.01), respectively. Additionally, a larger improvement of VO2peak (1.92 mL/kg/min, p < 0.01) was observed in HIIT over MICT. HIIT with medium and long intervals, higher work/rest ratio induced larger VO2peak improvement than the compared subgroup. Interestingly, non-isocaloric exercise protocols induced larger VO2peak improvement compared with isocaloric protocols. In addition, both HIIT and MICT significantly increased anaerobic threshold and peak power with HIIT superior to MICT. No significant different changes were observed in blood pressure after HIIT or MICT intervention, however when HIIT was compared with MICT, MICT seems superior to HIIT in reducing systolic blood pressure (−3.61 mmHg, p < 0.01) and diastolic blood pressure (−2.37 mmHg, p < 0.01). Although, HIIT and MICT induced significant improvement of most other parameters, like HRrest, HRpeak, left ventricular ejection fraction (LVEF), quality of life (QoL), no significant differences were noted between groups. This meta-analysis suggested that HIIT is superior to MICT in increasing VO2peak, anaerobic threshold, peak power in CAD patients. Additionally, the efficacy of HIIT over MICT in improving VO2peaks was influenced by HIIT intervals, work/rest ratio and total caloric consumption. Both HIIT and MICT did not significantly influence resting BP, however, MICT seemed to be more effective in reducing BP than HIIT. HIIT and MICT equally significantly influenced HRrest, HRpeak, HRR1min, OUES, LVEF%, QoL.
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Benefits of adding food education sessions to an exercise programme on cardiovascular risk factors in patients with type 2 diabetes. J Nutr Sci 2021; 10:e59. [PMID: 34422261 PMCID: PMC8358841 DOI: 10.1017/jns.2021.50] [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: 09/03/2020] [Revised: 07/03/2021] [Accepted: 07/16/2021] [Indexed: 11/22/2022] Open
Abstract
To evaluate the impact of adding food education sessions to an exercise programme on cardiovascular risk factors in middle-aged and older patients with type 2 diabetes (T2D), a randomised parallel-group study was performed. Glycated haemoglobin, body mass index (BMI), waist circumference, fat mass (FM) and blood pressure were assessed at baseline and after 9 months. The recruitment was made in three primary healthcare centres from Vila Real, Portugal. Thirty-three patients (65⋅4 ± 5⋅9 years old) were engaged in a 9-month community-based lifestyle intervention programme: a supervised exercise programme (EX; n = 15; combined aerobic, resistance, agility/balance and flexibility exercise; three sessions per week; 75 min per session); or the same exercise programme plus concomitant food education sessions (EXFE; n = 18; 15-min lectures and dual-task strategies during exercise (answer nutrition questions while walking); 16 weeks). Significant differences between groups were identified in the evolution of BMI (P < 0.001, ) and FM (P < 0.001, ), with best improvements observed in the EXFE group. The addition of a simple food education dietary intervention to an exercise programme improved body weight and composition, but not glycaemic control and blood pressure in middle-aged and older patients with T2D.
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Sousa RALD, Improta-Caria AC, Souza BSDF. Exercise-Linked Irisin: Consequences on Mental and Cardiovascular Health in Type 2 Diabetes. Int J Mol Sci 2021; 22:2199. [PMID: 33672171 PMCID: PMC7926886 DOI: 10.3390/ijms22042199] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 12/11/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a metabolic disorder associated with insulin resistance and hyperglycemia. Chronic exposure to a T2DM microenvironment with hyperglycemia, hyperinsulinemia, oxidative stress and increased levels of proinflammatory mediators, has negative consequences to the cardiovascular system and mental health. Therefore, atherosclerotic cardiovascular diseases (CVD) and mental health issues have been strongly associated with T2DM. Lifestyle modifications, including physical exercise training, are necessary to prevent T2DM development and its associated complications. It is widely known that the regular practice of exercise provides several physiological benefits to subjects with T2DM, such as managing glycemic and blood pressure levels. Different types of exercise, from aerobic to resistance training, are effective to improve mental health and cognitive function in T2DM. Irisin is a myokine produced in response to exercise, which has been pointed as a relevant mechanism of action to explain the benefits of exercise on cardiovascular and mental health in T2DM patients. Here, we review emerging clinical and experimental evidence about exercise-linked irisin consequences to cardiovascular and mental health in T2DM.
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Affiliation(s)
- Ricardo Augusto Leoni De Sousa
- Multicenter Post Graduation Program in Physiological Sciences, Brazilian Society of Physiology, Federal University of the Valleys of Jequitinhonha and Mucuri, Diamantina, Minas Gerais CEP 39.000-000, Brazil;
- Neuroscience and Exercise Study Group (Grupo de Estudos em Neurociências e Exercício–GENE), Federal University of the Valleys of Jequitinhonha and Mucuri, Diamantina, Minas Gerais CEP 39.000-000, Brazil
| | - Alex Cleber Improta-Caria
- Post-Graduate Program in Medicine and Health, Faculty of Medicine, Federal University of Bahia, Bahia CEP 40.110-100, Brazil;
- Department of Physical Education in Cardiology, Brazilian Society of Cardiology, Bahia CEP 41.170-130, Brazil
- Center for Biotechnology and Cell Therapy, São Rafael Hospital, Bahia CEP 41.253-190, Brazil
| | - Bruno Solano de Freitas Souza
- Center for Biotechnology and Cell Therapy, São Rafael Hospital, Bahia CEP 41.253-190, Brazil
- D’Or Institute for Research and Education (IDOR), Rio de Janeiro CEP 22.281-100, Brazil
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Bahia CEP 40.296-710, Brazil
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Jevtovic F. Combination of Metformin and Exercise in Management of Metabolic Abnormalities Observed in Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2021; 14:4043-4057. [PMID: 34557007 PMCID: PMC8453852 DOI: 10.2147/dmso.s328694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/07/2021] [Indexed: 12/19/2022] Open
Abstract
Excess nutrient intake and lack of exercise characterize the problem of obesity and are common factors in insulin resistance (IR). With an increasing number of prediabetic, and type 2 diabetic populations, metformin is still the most prescribed glucose-lowering drug and is often accompanied by recommendations for regular physical exercise. Metformin, by the inhibition of complex 1 of the electron transport chain, and exercise, by increasing energy expenditure, both elicit a low cellular energy state that leads to improvements in glucose control via activation of adenosine 5' monophosphate-activated protein kinase (AMPK). An augmented stimulation of the energy-sensing enzyme AMPK by either of the two modalities leads to an increase in glycogenolysis, glucose uptake, fat oxidation, a decrease in glycogen and protein synthesis, and gluconeogenesis in muscle and the liver, which are remarked as having positive effects on metabolic pathophysiology observed in IR and type 2 diabetes mellitus (T2DM). While both modalities exploit the energy-sensing enzyme AMPK to attain glucose homeostasis, the synergistic effect of these two treatments is not distinctly supported by the literature. Further, an antagonistic dynamic has been observed in cases where metformin and exercise were combined. Reduction of insulin-sensitizing effects of exercise and an overall hindrance of exercise performance and adaptations have been reported and could suggest the possible incongruity of these two modalities. The aim of this review is to elucidate the effect that metformin and exercise have on the management of the metabolic abnormalities observed in T2DM and to provide an insight into the interaction of these two modalities.
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Affiliation(s)
- Filip Jevtovic
- Department of Kinesiology, College of Health and Human Performance, East Carolina University, Greenville, NC, USA
- Correspondence: Filip Jevtovic East Carolina University; School of Dental Medicine, Ledyard E. Ross Hall; 1851 MacGregor Downs Road, Mail Stop 701, Greenville, NC, 27834, USATel +1 616 844 8323Fax +1 252 737 7024 Email
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Wake AD. Antidiabetic Effects of Physical Activity: How It Helps to Control Type 2 Diabetes. Diabetes Metab Syndr Obes 2020; 13:2909-2923. [PMID: 32884317 PMCID: PMC7443456 DOI: 10.2147/dmso.s262289] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/01/2020] [Indexed: 12/15/2022] Open
Abstract
Despite the improvements in clinical care of the patients, research updates, and public health interventions, there is still an increase in the prevalence, incidence, and mortality because of diabetes mellitus (DM). DM is a public health problem in both developed and developing countries. It has increased alarmingly, putting this disease in the dimension of an epidemic. Diabetes is associated with several complications which increase the risk of many serious health problems on the other side. Therefore, this review was aimed to discuss the antidiabetic effects of physical activity (PA) on type 2 DM (T2DM) by summarizing the significant studies on this topic. This review found that several studies have recommended the utilization of PA for the effective management of T2DM. PA is a non-pharmacologic therapy which is a significant strategy for the management of T2DM and is an appropriate lifestyle modification approach to be practiced by these patients. The studies showed that PA has antidiabetic effects which are evidenced by its substantial role in improving the blood glucose (BG) levels of the individuals with T2DM where it helps them to control their levels of glucose in the blood. It plays a significant role in glycemic control of this disease by lowering the BG levels through possible mechanisms such as decreasing insulin resistance, increasing production of glucose transporter type 4 (GLUT-4), lowering visceral adipose tissue (VAT), increasing pancreatic β-cell functions, using glucose for energy, and so on. In turn, the controlled glycemia helps to prevent the complications associated with uncontrolled T2DM and this would further improve the overall health of the patients and the burden on the health professionals as well. Finally, this review concludes that PA is the cornerstone in the management of T2DM. It also suggests that more attention is needed to its significance in the prevention, glycemic control, and its role in the management of the morbidity and mortality associated with T2DM. Practical PA recommendations and suggestions for the future direction of research in this area are also provided.
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Affiliation(s)
- Addisu Dabi Wake
- Nursing Department, College of Health Sciences, Arsi University, Assela, Oromia, Ethiopia
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Reis VM. Effects of Exercise on Biomarkers in Health and Disease: Some New Insights with Special Focus on Extreme Exercise and Healthy Ageing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061986. [PMID: 32197302 PMCID: PMC7142583 DOI: 10.3390/ijerph17061986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 03/16/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Victor Machado Reis
- Research Center in Sports Sciences, Health Sciences & Human Development, CIDESD, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
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