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Glycemic and cardiometabolic effects of exercise in South Asian Sri Lankans with type 2 diabetes mellitus: A randomized controlled trial Sri Lanka diabetes aerobic and resistance training study (SL-DARTS).
Ranasinghe, C, Devage, S, Constantine, GR, Katulanda, P, Hills, AP, King, NA
Diabetes & metabolic syndrome. 2021;(1):77-85
Abstract
BACKGROUND AND AIMS To examine the effects of aerobic training (AT) and resistance training (RT) compared to standard care on glycemic control in South Asian Sri Lankan adults with Type 2 Diabetes Mellitus (T2DM). METHODS Randomized controlled trial (RCT) with parallel-group design recruited 86 sedentary Sri Lankans (aged 35-65 years) with T2DM into aerobic training (AT, n = 28), resistance training (RT, n = 28) and control (CN, n = 30) groups. Supervised progressive exercise training consisting of 75 min per session, 2 days per week for 12 weeks was conducted. The primary outcome was pre- and post-intervention absolute change in hemoglobin A1c (HBA1c). Secondary outcomes were serum lipids, liver enzymes, chronic inflammatory status, anthropometry, body composition and blood pressure. RESULTS The absolute change in HbA1c of RT vs. CN was -0.08% (95% CI, 0.8% to -0.7%, p = 0.8) and AT vs. CN was -0.22% (95% CI, 0.95% to -0.5%). Subgroup analysis (n = 49) with a high baseline HbA1c (>7.5%), absolute reduction in HbA1c in exercise groups were statistically significant (RT vs. CN was -0.37%; 95% CI 1.3% to -0.6%, p = 0.04 and AT vs. CN was -0.57%; 95% CI 1.7% to -0.6%, p = 0.03). The effect sizes (total and subgroup HbA1c >7.5%) ranged from 0.7 to 1.0 in AT, 0.4 to 1.1 in RT compared to 0.35 to 0.6 for the CN. Secondary outcomes did not significantly differ among groups. CONCLUSIONS Exercise training 2 days/week improved glycemic control in Sri Lankan adults with T2DM and the effects were significant in high baseline HbA1c (>7.5%) groups (RT > AT).
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Psychological mediators of exercise adherence among older adults in a group-based randomized trial.
Beauchamp, MR, Liu, Y, Dunlop, WL, Ruissen, GR, Schmader, T, Harden, SM, Wolf, SA, Puterman, E, Sheel, AW, Rhodes, RE
Health psychology : official journal of the Division of Health Psychology, American Psychological Association. 2021;(3):166-177
Abstract
OBJECTIVE To examine the psychological mediators of exercise adherence among older adults in a group-based physical activity randomized controlled trial. METHOD Older adults (≥65 years) were randomized to one of three conditions as part of the "GrOup-based physical Activity for oLder adults" (GOAL) randomized controlled trial. These included similar age same gender (SASG) and similar age mixed gender (SAMG) exercise programs that were informed by the tenets of self-categorization theory, and a "standard" mixed age mixed gender (MAMG) exercise program. Participants represented a subgroup (n = 483, Mage = 71.41 years) from the larger trial (n = 627) who completed measures of the trial's putative psychological mediators (i.e., group cohesion and affective attitudes) over the course of the 24-week exercise programs. RESULTS Piecewise latent growth modeling revealed different trajectories between participants in the two intervention conditions (SASG, SAMG) when compared with the comparison MAMG condition with regard to perceptions of group cohesion and affective attitudes. Results of subsequent cross-lagged panel modeling revealed that better program adherence in the two intervention conditions, when compared with the referent MAMG condition, was mediated by perceptions of group cohesion. CONCLUSIONS The findings provide insight into how the two intervention programs differentially strengthened perceptions of group cohesion and affective attitudes over time. Consistent with self-categorization theory, the results also shed light on the role of group cohesion, in particular, as a psychological mechanism of action to promote older adults' exercise adherence behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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l-carnitine supplementation vs cycle ergometer exercise for physical activity and muscle status in hemodialysis patients: A randomized clinical trial.
Yano, J, Kaida, Y, Maeda, T, Hashida, R, Tonan, T, Nagata, S, Hazama, T, Nakayama, Y, Ito, S, Kurokawa, Y, et al
Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy. 2021;(3):304-313
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Abstract
Serum carnitine is decreased in hemodialysis patients, which induces muscle atrophy. Thus, we examined the different effects of l-carnitine and exercise on exercise activity and muscle status in hemodialysis patients. Twenty patients were divided into l-carnitine and cycle ergometer groups and were followed for 3 months. Muscle and fat mass, physical activities, and muscle status were evaluated by an impedance, physical function test, and magnetic resonance imaging, respectively. The l-carnitine significantly increased muscle mass (P = .023) and thigh circumference (P = .027), decreased fat mass (P = .007), and shortened chair stand-up time (P = .002) and 10-m walk test (P = .037). The fat fraction was improved by the l-carnitine (P = .047). Compared with the exercise group, l-carnitine improved the changes in 10-m walk test (P = .026), chair stand-up time (P = .014), and thigh circumference (P = .022). Baseline fibroblast growth factor-21 and myostatin levels predicted the l-carnitine-associated changes in exercise activities. l-carnitine, rather than exercise, improved physical activity and muscle status in hemodialysis patients.
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The Effects of Exercise on β-Hydroxybutyrate Concentrations over a 36-h Fast: A Randomized Crossover Study.
Deru, LS, Bikman, BT, Davidson, LE, Tucker, LA, Fellingham, G, Bartholomew, CL, Yuan, HL, Bailey, BW
Medicine and science in sports and exercise. 2021;(9):1987-1998
Abstract
PURPOSE This study assessed β-hydroxybutyrate (BHB) concentration during a short-term fast and the degree to which an initial bout of exercise influences the rate of ketogenesis. METHODS Twenty subjects (11 male, 9 female) completed two 36-h fasts, with one protocol requiring the subject to complete a treadmill exercise session at the beginning of the fast. BHB levels were assessed via portable meter every 2 h, along with mood and hunger ratings. Venipuncture was performed every 12 h. RESULTS The mean (SD) areas under the curve for BHB concentration were 19.19 (2.59) mmol·L-1 (nonexercised) and 27.49 (2.59) mmol·L-1 (exercised), yielding a difference of 8.30 mmol·L-1 between conditions (95% posterior probability interval (PPI), 1.94 to 14.82 mmol·L-1; posterior probability (PP) = 0.99). The mean (SD) times to BHB concentration of 0.5 mmol·L-1 were 21.07 (2.95) h (nonexercised) and 17.5 (1.69) h (exercised), a 3.57-h difference (95% PPI, -2.11 to 10.87 h; PP = 0.89). The differences in area under the curve between conditions were 5.07 μU·mL-1 (95% PPI, -21.64 to 36.18 μU·mL-1; PP = 0.67) for insulin, 97.13 pg·mL-1 (95% PPI, 34.08 to 354.21 pg·mL-1; PP = 0.98) for glucagon, and 20.83 (95% PPI, 4.70 to 24.22; PP = 0.99) for the insulin/glucagon ratio. CONCLUSIONS Completing aerobic exercise at the beginning of a fast accelerates the production of BHB throughout the fast without altering subjective feelings of hunger, thirst, stomach discomfort, or mood. Insulin and the insulin/glucagon ratio experience a marked reduction within the first 12 h of fasting and was not altered with exercise. Thus, exercising at the beginning of a fast may improve the metabolic outcomes of fasting.
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White matter plasticity in healthy older adults: The effects of aerobic exercise.
Mendez Colmenares, A, Voss, MW, Fanning, J, Salerno, EA, Gothe, NP, Thomas, ML, McAuley, E, Kramer, AF, Burzynska, AZ
NeuroImage. 2021;:118305
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Abstract
White matter deterioration is associated with cognitive impairment in healthy aging and Alzheimer's disease. It is critical to identify interventions that can slow down white matter deterioration. So far, clinical trials have failed to demonstrate the benefits of aerobic exercise on the adult white matter using diffusion Magnetic Resonance Imaging. Here, we report the effects of a 6-month aerobic walking and dance interventions (clinical trial NCT01472744) on white matter integrity in healthy older adults (n = 180, 60-79 years) measured by changes in the ratio of calibrated T1- to T2-weighted images (T1w/T2w). Specifically, the aerobic walking and social dance interventions resulted in positive changes in the T1w/T2w signal in late-myelinating regions, as compared to widespread decreases in the T1w/T2w signal in the active control. Notably, in the aerobic walking group, positive change in the T1w/T2w signal correlated with improved episodic memory performance. Lastly, intervention-induced increases in cardiorespiratory fitness did not correlate with change in the T1w/T2w signal. Together, our findings suggest that white matter regions that are vulnerable to aging retain some degree of plasticity that can be induced by aerobic exercise training. In addition, we provided evidence that the T1w/T2w signal may be a useful and broadly accessible measure for studying short-term within-person plasticity and deterioration in the adult human white matter.
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The effect of solution-focused interviews (SFI) conducted by nurses on middle school adolescents' healthy lifestyles: a quasi-experimental study.
Aslan, F
Scandinavian journal of caring sciences. 2020;(3):719-726
Abstract
AIM: This study aimed at assessing the effect of solution-focused interviews for the promotion of health locus of control and self-efficacy on adolescents' healthy lifestyles. METHOD The present study, which was designed as a quasi-experimental study, included pretest and post-test control groups and was conducted in the period between 5 February 2017 and 30 April 2017. The intervention group comprised 28 (n = 28) adolescents from a school, and the control group comprised 30 (n = 30) adolescents from another school. Solution-focused interviews, which included educational information regarding leading a healthy lifestyle as well as cognitive-behavioural interview, were conducted with the adolescents of the intervention group, 1 day per week (nine sessions in total). RESULTS In comparison to the control group, adolescents in the intervention group exhibited differences in all the sub-dimensions health promotion scale (p < 0.001). CONCLUSIONS These results established the applicability and effectiveness of the programme, such that the health promotion programme could be included in the literature. Moreover, it is anticipated that this programme would be applied in school settings in the future.
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Comparing the Efficacy of Supervised and Unsupervised Exercise Training on Glycaemic Control in Type 2 Diabetes: A Systematic Review.
Gajanand, T, Keating, SE, Brown, WJ, Hordern, MD, Fassett, RG, Coombes, JS
Current diabetes reviews. 2020;(6):570-579
Abstract
BACKGROUND Exercise training is vital for glycaemic control in patients with type 2 diabetes mellitus (T2D). While the positive effects of supervised exercise training are well established, unsupervised training may offer an alternative and more sustainable means of realising the benefits of exercise away from a resource-heavy supervised setting. OBJECTIVE To evaluate the available literature and compare the efficacy of supervised and unsupervised exercise training programs on glycemic control in patients with T2D. METHODS CINAHL, MEDLINE, PubMed, and EMBASE, searched from inception to 20 July 2018. Only studies that included both supervised and unsupervised training were included. RESULTS Four studies, involving 115 participants, were included. One compared supervised with unsupervised exercise training and three investigated the efficacy of unsupervised training following supervised training. While supervised training is effective for improving glycaemic control in patients with T2D, unsupervised training may not maintain these changes. Included studies lacked detail relating to the supervised and unsupervised training programs. CONCLUSIONS Given that exercise is a critical component for maintenance of glycaemic control in patients with T2D, and because unsupervised training has been shown to be effective in improving clinical outcomes in other disease populations, further research is warranted to compare supervised and unsupervised exercise training in patients with T2D. It is important that future studies report standardised and detailed descriptions of key elements that form the basis of supervised and unsupervised exercise training groups.
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Effect of Ingestion of Medium-Chain Triglycerides on Substrate Oxidation during Aerobic Exercise Could Depend on Sex Difference in Middle-Aged Sedentary Persons.
Nosaka, N, Tsujino, S, Honda, K, Suemitsu, H, Kato, K, Kondo, K
Nutrients. 2020;(1)
Abstract
Fat oxidation (FAO) during aerobic exercise and whole-body FAO via lipid intake are thought to be important for the maintenance of health, such as the prevention of type 2 diabetes and obesity in sedentary persons in their 40s and 50s. Medium-chain triglycerides (MCTs) ingestion has been attracting attention. However, the effects of difference of sex and the composition of medium-chain fatty acids (MCFAs) are unclear, so we examined the effects of these factors on FAO during aerobic exercise. We conducted a randomized, double-blind, placebo-controlled, 3-arm, within-participants crossover trial. FAO during low- to moderate-intensity exercise was compared when octanoate-rich MCTs (C8R), decanoate-rich MCTs (C10R), or carbohydrate (control) was ingested. Three 2-week interventions were separated by two 2-week washout periods. An increase of FAO during exercise after the C8R diet was found in males, but not in females. An increase of carbohydrate oxidation (CAO) and oxygen uptake during exercise after the C10R diet was found in females, but not in males. In a pooled estimate of the effect of MCTs (C8R and C10R) in women and men, FAO increased during exercise. In conclusion, short-term ingestion of MCTs by middle-aged sedentary persons could increase FAO during aerobic exercise compared to carbohydrate ingestion, but the enhancing effect of MCTs on substrate utilization and oxygen uptake might vary, depending on sex and the composition of MCFAs.
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Moderate-Intensity Exercise and High-Intensity Interval Training Affect Insulin Sensitivity Similarly in Obese Adults.
Ryan, BJ, Schleh, MW, Ahn, C, Ludzki, AC, Gillen, JB, Varshney, P, Van Pelt, DW, Pitchford, LM, Chenevert, TL, Gioscia-Ryan, RA, et al
The Journal of clinical endocrinology and metabolism. 2020;(8):e2941-59
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Abstract
OBJECTIVE We compared the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on insulin sensitivity and other important metabolic adaptations in adults with obesity. METHODS Thirty-one inactive adults with obesity (age: 31 ± 6 years; body mass index: 33 ± 3 kg/m2) completed 12 weeks (4 sessions/week) of either HIIT (10 × 1-minute at 90%HRmax, 1-minute active recovery; n = 16) or MICT (45 minutes at 70%HRmax; n = 15). To assess the direct effects of exercise independent of weight/fat loss, participants were required to maintain body mass. RESULTS Training increased peak oxygen uptake by ~10% in both HIIT and MICT (P < 0.0001), and body weight/fat mass were unchanged. Peripheral insulin sensitivity (hyperinsulinemic-euglycemic clamp) was ~20% greater the day after the final exercise session compared to pretraining (P < 0.01), with no difference between HIIT and MICT. When trained participants abstained from exercise for 4 days, insulin sensitivity returned to pretraining levels in both groups. HIIT and MICT also induced similar increases in abundance of many skeletal muscle proteins involved in mitochondrial respiration and lipid and carbohydrate metabolism. Training-induced alterations in muscle lipid profile were also similar between groups. CONCLUSION Despite large differences in training intensity and exercise time, 12 weeks of HIIT and MICT induce similar acute improvements in peripheral insulin sensitivity the day after exercise, and similar longer term metabolic adaptations in skeletal muscle in adults with obesity. These findings support the notion that the insulin-sensitizing effects of both HIIT and MICT are mediated by factors stemming from the most recent exercise session(s) rather than adaptations that accrue with training.
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Effects of 120 g/h of Carbohydrates Intake during a Mountain Marathon on Exercise-Induced Muscle Damage in Elite Runners.
Viribay, A, Arribalzaga, S, Mielgo-Ayuso, J, Castañeda-Babarro, A, Seco-Calvo, J, Urdampilleta, A
Nutrients. 2020;(5)
Abstract
Background-exercise-induced muscle damage (EIMD) and internal exercise load are increased after competing in ultraendurance events such as mountain marathons. Adequate carbohydrate (CHO) intake during exercise optimizes athletic performance and could limit EIMD, reduce internal exercise load and, thus, improve recovery. Therefore, the aim of this study was to research into and compare the effects of high CHO intake (120 g/h) in terms of CHO intake recommendation (90 g/h) and regular CHO intake performed by ultraendurance athletes (60 g/h) during a mountain marathon, on exercise load and EIMD markers (creatine kinase (CK), lactate dehydrogenase (LDH), glutamic oxaloacetic transaminase (GOT), urea and creatinine). Materials and Methods-a randomized trial was carried out on 20 male elite runners who had previously undertaken nutritional and gut training, and who consumed different CHO dosages according to experimental (EXP-120 g/h), control (CON-90 g/h) and low CHO intake (LOW-60 g/h) groups during a ~4000 m cumulative slope mountain marathon. EIMD markers were analyzed before the race and 24 h afterwards. Internal exercise load was calculated based on rate of perceived exertion (RPE) during and after the marathon event. Results-internal exercise load during the mountain marathon was significantly lower (p = 0.019; η2p = 0.471) in EXP (3805 ± 281 AU) compared to LOW (4688 ± 705 AU) and CON (4692 ± 716 AU). Moreover, results revealed that the EXP group evidenced significantly lower CK (p = 0.019; η2p = 0.373), LDH (p < 0.001; η2p = 0.615) and GOT (p = 0.003; η2p = 0.500) values 24 h after the mountain marathon race compared to LOW and CON. Along these lines, EIMD and exercise load evidenced a close correlation (R = 0.742; p < 0.001). Conclusion: High CHO intake (120 g/h) during a mountain marathon could limit the EIMD observed by CK, LDH and GOT and internal exercise load compared to CHO ingestion of 60 and 90 g/h.