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Zimmer RT, Birnbaumer P, Sternad C, Zunner BEM, Schierbauer J, Fritsch M, Fröhlich-Reiterer E, Hofmann P, Sourij H, Aberer F, Moser O. Impact of a 4-week intensive track and field training intervention on glycaemia in adolescents with type 1 diabetes: The ChilDFiT1 study. Diabetes Obes Metab 2024; 26:631-641. [PMID: 37985360 DOI: 10.1111/dom.15352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/10/2023] [Accepted: 10/17/2023] [Indexed: 11/22/2023]
Abstract
AIM To investigate the safety and efficacy of track and field training compared with intensification of insulin treatment only in adolescents with type 1 diabetes (T1D). MATERIALS AND METHODS Eighteen adolescents (seven females) with T1D were included (age 15.1 ± 1.1 years, HbA1c 7.3% ± 1.0% [56.3 ± 10.9 mmol/mol]). After a 4-week observational control phase, participants were randomized to either stand-alone intensive glycaemic management (IT; telemedicine or on-site visits, three times/week) or additionally performed track and field exercise (EX; three 60-minute sessions/week) for 4 weeks. Glycaemia was assessed via continuous glucose monitoring during observational control and intervention phases. RESULTS Time in range (70-180 mg/dL; 3.9-10.0 mmol/L) significantly improved from the observational control phase to the exercise intervention phase in EX (69% ± 13% vs. 72% ± 11%, P = .049), but not in IT (59% ± 22% vs. 62% ± 16%, P = .399). Time below range 1 (54-69 mg/dL; < 3.9 mmol/L) improved in IT (3.1% ± 1.9% vs. 2.0% ± 0.8%, P = .017) and remained stable in EX (2.0% ± 1.7 vs. 1.9% ± 1.1%, P = .999). The EX group's HbA1c ameliorated preintervention to postintervention (mean difference: ΔHbA1c -0.19% ± 0.17%, P = .042), which was not seen within the IT group (ΔHbA1c -0.16% ± 0.37%, P = .40). Glucose standard deviation was reduced significantly in EX (55 ± 11 vs. 51 ± 10 mg/dL [3.1 ± 0.6 vs. 2.8 ± 0.6 mmol/L], P = .011), but not in IT (70 ± 24 vs. 63 ± 18 mg/dL [3.9 ± 1.3 vs. 3.5 ± 1.0 mmol/L], P = .186). CONCLUSION Track and field training combined with intensive glycaemic management improved glycaemia in adolescents with T1D, which was not observed in the non-exercise group.
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Affiliation(s)
- Rebecca T Zimmer
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University Bayreuth, Bayreuth, Germany
| | - Philipp Birnbaumer
- Exercise Physiology, Training & Training Therapy Research Group, Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Christoph Sternad
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Beate E M Zunner
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University Bayreuth, Bayreuth, Germany
| | - Janis Schierbauer
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University Bayreuth, Bayreuth, Germany
| | - Maria Fritsch
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University Graz, Graz, Austria
| | - Elke Fröhlich-Reiterer
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University Graz, Graz, Austria
| | - Peter Hofmann
- Exercise Physiology, Training & Training Therapy Research Group, Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Harald Sourij
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Felix Aberer
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University Bayreuth, Bayreuth, Germany
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Othmar Moser
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University Bayreuth, Bayreuth, Germany
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
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Cabral MD, Patel DR, Greydanus DE, Deleon J, Hudson E, Darweesh S. Medical perspectives on pediatric sports medicine–Selective topics. Dis Mon 2022; 68:101327. [DOI: 10.1016/j.disamonth.2022.101327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Mohammed MHH, Al-Qahtani MHH, Takken T. Effects of 12 weeks of recreational football (soccer) with caloric control on glycemia and cardiovascular health of adolescent boys with type 1 diabetes. Pediatr Diabetes 2021; 22:625-637. [PMID: 33745203 DOI: 10.1111/pedi.13203] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 02/09/2021] [Accepted: 03/11/2021] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To determine the effects of recreational football combined with caloric control on glycemia and cardiovascular health of adolescent boys with type 1 diabetes. BACKGROUND Though 12 weeks of physical activity alone improves the health of people with type 1 diabetes, there is little evidence that physical activity alone can improve glycemia in 12 weeks. RESEARCH DESIGN AND METHODS The participants were divided into four groups as follows: football with diet, football-only, diet-only, and the control groups. Each group consisted of 10 participants. The football with diet and the football-only groups had 1.5 h of football twice a week for 12 weeks. The following outcomes were measured before and after 12 weeks: Glycated hemoglobin, fasting blood glucose, total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, and resting blood pressures. Changes were considered significant when p ≤ 0.050 and common language effect size ≤42% or common language effect size ≥58%. RESULTS Glycated hemoglobin decreased in the football with diet group (mean change (standard deviation) = -0.9 (1.0) %, p = 0.019, and common language effect size = 31.5%) and was different from the control group (p = 2.4 × 10-4 and common language effect size = 95.5%.). However, none of the intervention groups showed a clear change in blood lipids nor blood pressure. CONCLUSIONS 12 weeks of combined football with diet intervention provides the greatest improvement in glycemia in adolescent boys with type 1 diabetes.
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Affiliation(s)
| | | | - Tim Takken
- Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
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Flotyńska J, Gawrecki A, Araszkiewicz A, Parchimowicz M, Michalski M, Różańska O, Stopczyńska-Szymecka M, Kamiński M, Cieluch A, Biegański G, Michalak A, Domaszewska K, Zozulińska-Ziółkiewicz D. Assessment of changes in blood lactate levels in children and adolescents with type 1 diabetes during a football tournament (GoalDiab Study). Pediatr Endocrinol Diabetes Metab 2021; 27:237-244. [PMID: 35114764 PMCID: PMC10226361 DOI: 10.5114/pedm.2021.109272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/24/2021] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Monitoring physical activity is a very important issue, especially in type 1 diabetes. One of the parameters assessing the intensity of exercise is the concentration of lactate in the blood. Aim of the study We assessed the intensity of PE and changes in lactate levels in children and adolescents with type 1 diabetes (T1D) during a football tournament. MATERIAL AND METHODS We enrolled 141 participants, the results of 70 of whom were analyzed, playing in two age categories: 10-13 and 14-17 years. Lactate levels were measured in the capillary blood before and after matches. Blood lactate of 4 mmol/l (Onset Blood Lactate Accumulation OBLA) was used as parameter indicating the prevalence of anaerobic metabolic changes. RESULTS The median lactate level was 1.8 mmol/l before and 4.4 mmol/l after matches (p < 0.001). The increase in lactate levels was higher in the older age category (4.3 vs. 1.8, p = 0.001) and was independent on gender (3.2 vs. 2.1, p = 0.597), personal insulin pump vs insulin pen use (3.0 vs. 1.5, p = 0.145) or training in a sports club (1.4 vs. 3.0, p = 0.084). A positive correlation was noted between increased lactate levels and age (Rs = 0.253, p = 0.034). 61% of the participants exceeded lactate levels ≥ 4 mmol/l. In univariate logistic regression analysis age was a significantly associated with lactate level ≥ 4 mmol/l [OR = 1.45 (1.08-1.95)] independent of HbA1c, gender, treatment method and training in a sports club. CONCLUSIONS PE intensity levels during football matches were found to be mixed aerobic-anaerobic. Increases in lactate levels were greater in the older subjects independently on the assessed factors.
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Affiliation(s)
- Justyna Flotyńska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poland
| | - Andrzej Gawrecki
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poland
| | - Aleksandra Araszkiewicz
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poland
| | - Mikołaj Parchimowicz
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poland
| | - Marcin Michalski
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poland
| | - Olga Różańska
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poland
| | | | - Mikołaj Kamiński
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poland
| | - Aleksandra Cieluch
- Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poland
| | - Grzegorz Biegański
- Department of Infectious Diseases and Paediatric Neurology, Poznan University of Medical Sciences, Poland
| | - Arkadiusz Michalak
- Department of Paediatrics, Diabetology and Endocrinology, and Nephrology, Medical University of Lodz
- Department of Biostatistics and Translational Medicine, Medical University of Lodz
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Liu Q, Gao J, Deng J, Xiao J. Current Studies and Future Directions of Exercise Therapy for Muscle Atrophy Induced by Heart Failure. Front Cardiovasc Med 2020; 7:593429. [PMID: 33195482 PMCID: PMC7644508 DOI: 10.3389/fcvm.2020.593429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/01/2020] [Indexed: 12/12/2022] Open
Abstract
Muscle atrophy is a common complication of heart failure. At present, there is no specific treatment to reverse the course of muscle atrophy. Exercise training, due to the safety and easy operation, is a recommended therapy for muscle atrophy induced by heart failure. However, the patients with muscle atrophy are weak in mobility and may not be able to train for a long time. Therefore, it is necessary to explore novel targets of exercise protection for muscle atrophy, so as to improve the quality of life and survival rate of patients with muscular atrophy induced by heart failure. This article aims to review latest studies, summarize the evidence and limitations, and provide a glimpse into the future of exercise for the treatment of muscle atrophy induced by heart failure. We wish to highlight some important findings about the essential roles of exercise sensors in muscle atrophy induced by heart failure, which might be helpful for searching potential therapeutic targets for muscle wasting induced by heart failure.
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Affiliation(s)
- Qi Liu
- Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, School of Life Science, Shanghai University, Shanghai, China
| | - Juan Gao
- School of Medicine, Shanghai University, Shanghai, China
| | - Jiali Deng
- Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, School of Life Science, Shanghai University, Shanghai, China
| | - Junjie Xiao
- Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, School of Life Science, Shanghai University, Shanghai, China.,School of Medicine, Shanghai University, Shanghai, China
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Fokkert M, van Dijk PR, Edens MA, Díez Hernández A, Slingerland R, Gans R, Delgado Álvarez E, Bilo H. Performance of the Eversense versus the Free Style Libre Flash glucose monitor during exercise and normal daily activities in subjects with type 1 diabetes mellitus. BMJ Open Diabetes Res Care 2020; 8:8/1/e001193. [PMID: 32784247 PMCID: PMC7418676 DOI: 10.1136/bmjdrc-2020-001193] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/12/2020] [Accepted: 06/27/2020] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Accurate blood glucose measurements are important in persons with diabetes during normal daily activities (NDA), even more so during exercise. We aimed to investigate the performance of fluorescence sensor-based and glucose oxidase-based interstitial glucose measurement during (intensive) exercise and NDA. RESEARCH DESIGN AND METHODS Prospective, observational study in 23 persons with type 1 diabetes when mountain biking for 6 days, followed by 6 days of NDA. Readings of the Eversense (fluorescence-based continuous glucose monitoring (CGM); subcutaneously implanted) and of the Free Style Libre (FSL; glucose oxidase-based flash glucose monitoring (FGM); transcutaneously placed) were compared with capillary glucose levels (Free Style Libre Precision NeoPro strip (FSLCstrip)). RESULTS Mean average differences (MAD) and mean average relative differences (MARD) were significantly different when comparing exercise with NDA (reference FSLCstrip); Eversense MAD 25±19 vs 17±6 mg/dL (p<0.001); MARD 17±6 vs 13%±6% (p<0.01) and FSL MAD 32±17 vs 18±8 mg/dL (p<0.01); MARD 20±7 vs 12%±5% (p<0.001).When analyzing the data according to the Integrated Continuous Glucose Monitoring Approvals (class II-510(K) guidelines), the overall performance of interstitial glucose readings within 20% of the FSLCstrip during exercise compared with NDA was 69% vs 81% for the Eversense and 59% vs 83% for the FSL, respectively. Within 15% of the FSLCstrip was 59% vs 70% for the Eversense and 46% vs 71% for the FSL. CONCLUSIONS During exercise, both fluorescence and glucose oxidase-based interstitial glucose measurements (using Eversense and FSL sensors) were less accurate compared with measurements during NDA. Even when acknowledging the beneficial effects of CGM or FGM, users should be aware of the risk of diminished accuracy of interstitial glucose readings during (intensive) exercise.
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Affiliation(s)
- Marion Fokkert
- Department of Clinical Chemistry, Isala, Zwolle, NA, The Netherlands
| | - Peter R van Dijk
- Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Diabetes Research Center, Isala, Zwolle, NA, The Netherlands
| | - Mireille A Edens
- Department Innovation and Science, Isala, Zwolle, NA, The Netherlands
| | | | | | - Rijk Gans
- Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Elías Delgado Álvarez
- Sección de Diabetes, Universidad de Oviedo, Oviedo, Asturias, Spain
- Sección de Diabetes, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Henk Bilo
- Diabetes Research Center, Isala, Zwolle, NA, The Netherlands
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Abstract
BACKGROUND Regular physical activity and exercise is the third management for the child with diabetes mellitus after diet regime and insulin therapy. The aim of the study is to evaluate the effect of swimming on glycemic control for a male adolescent with type 1 diabetes mellitus. The study evaluates the effect of swimming on glycemic control for a male adolescent with type 1 diabetes mellitus. METHODS The quasi-experimental design was conducted on 40 male adolescents with typ1 diabetes, then divided into two groups; study and control groups. 20 adolescents participated in the swimming program (study group) and other 20 did not expose to exercise program (control group) for 10 weeks. a venous blood sample was received to evaluate glycemic control (HbA1c %), in pre and post 10 weeks to compare HbA1c % for both groups. RESULTS Mean age 13.45±1.46 years (study group), while for control group age 13.55±1.5 years, and mean and standard deviation for Hba1c % was 9.61±1.15%, 9.65±2.23% in the study and control group respectively. The study showed that there was a high significant difference between pre and post-test HbA1c in the study group (P value<0.00) also the same result was observed in the control group but negatively (P value<0.00) it means the Hb1c % was raised. CONCLUSIONS The study concluded that regular physical activity (swimming) had a positive effect on lowering Glycosylated hemoglobin (HbA1c).
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Affiliation(s)
- Kaify J Qadir
- Department of Pediatric Nursing Science, Hawler Medical University College of Nursing, Erbil, Iraq -
| | - Kawes O Zangana
- Departmeny of Pediatric Medicine, Hawler Medical University College of Medicine, Erbil, Iraq
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Andrade EF, de Oliveira Silva V, Orlando DR, Pereira LJ. Mechanisms Involved in Glycemic Control Promoted by Exercise in Diabetics. Curr Diabetes Rev 2019; 15:105-110. [PMID: 29446746 DOI: 10.2174/1573399814666180214144717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 01/22/2018] [Accepted: 01/31/2018] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Diabetes mellitus is a metabolic disease characterized by high glycemic levels for long periods. This disease has a high prevalence in the world population, being currently observed an increase in its incidence. This fact is mainly due to the sedentary lifestyle and hypercaloric diets. Non-pharmacological interventions for glycemic control include exercise, which promotes changes in skeletal muscle and adipocytes. Thus, increased glucose uptake by skeletal muscle and decreased insulin resistance through modulating adipocytes are the main factors that improve glycemic control against diabetes. CONCLUSION It was sought to elucidate mechanisms involved in the improvement of glycemic control in diabetics in front of the exercise.
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Affiliation(s)
| | | | - Débora Ribeiro Orlando
- Department of Agricultural Sciences, Federal University of Jequitinhonha and Mucuri Valleys, Unai, Brazil
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Wróbel M, Rokicka D, Czuba M, Gołaś A, Pyka Ł, Greif M, Szymborska-Kajanek A, Strojek K, Gąsior M. Aerobic as well as resistance exercises are good for patients with type 1 diabetes. Diabetes Res Clin Pract 2018; 144:93-101. [PMID: 30121304 DOI: 10.1016/j.diabres.2018.08.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/26/2018] [Accepted: 08/13/2018] [Indexed: 12/16/2022]
Abstract
AIMS To assess whether aerobic or resistance training has greater benefits in non-physically active men with a long lasting type 1 diabetes. The effects of exercise were evaluated in terms of diabetes control and risk factors for cardiovascular complications. METHODS 21 male participants (mean age: 37 yrs, diabetes duration: 23 yrs, mean HbA1c: 7.4%) randomly assigned to 2 groups: 1-aerobic training (n = 10) and 2-resistance training (n = 11). All subjects participated in 60-min training sessions, either aerobic or resistance, twice a week for three months. At baseline and after 3 months: echocardiography, ECG and incremental exercise test, ECG and blood pressure monitoring, lipid profile, lactate and diabetes control parameters were assessed in all patients. RESULTS Baseline HbA1c was 7.44% in aerobic group and 7.36% in resistance group (p = 0.84). After 3 months there was no significant change in HbA1c value in any exercise group but a non-statistically significant downward trend was seen particularly in aerobic exercise group (p = 0.07) vs the resistance group (p = 0.15). There was no significant difference in body mass, risk of hypoglycemia and cardiovascular risk factors. CONCLUSIONS Both forms of exercise are safe in terms of glycemic control and cardiovascular risk factors in patients with quite well-controlled type 1 diabetes without advanced late complications.
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Affiliation(s)
- Marta Wróbel
- Department of Internal Diseases, Diabetology and Cardiometabolic Diseases, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, ul. M. Curie-Skłodowskiej 9, 41-800 Zabrze, Poland.
| | - Dominika Rokicka
- Department of Internal Diseases, Diabetology and Cardiometabolic Diseases, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, ul. M. Curie-Skłodowskiej 9, 41-800 Zabrze, Poland
| | - Miłosz Czuba
- Department of Kinesiology, Institute of Sport, ul. Trylogii 2/16, 01-982 Warsaw, Poland
| | - Artur Gołaś
- Department of Sports Training, The Jerzy Kukuczka Academy of Physical Education, ul. Mikołowska 72 a, 40-065 Katowice, Poland
| | - Łukasz Pyka
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, ul. M. Curie-Skłodowskiej 9, 41-800 Zabrze, Poland
| | - Małgorzata Greif
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, ul. M. Curie-Skłodowskiej 9, 41-800 Zabrze, Poland
| | - Aleksandra Szymborska-Kajanek
- Department of Internal Diseases, Diabetology and Cardiometabolic Diseases, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, ul. M. Curie-Skłodowskiej 9, 41-800 Zabrze, Poland
| | - Krzysztof Strojek
- Department of Internal Diseases, Diabetology and Cardiometabolic Diseases, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, ul. M. Curie-Skłodowskiej 9, 41-800 Zabrze, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, ul. M. Curie-Skłodowskiej 9, 41-800 Zabrze, Poland
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Witard OC, McGlory C, Hamilton DL, Phillips SM. Growing older with health and vitality: a nexus of physical activity, exercise and nutrition. Biogerontology 2016; 17:529-46. [PMID: 26878863 DOI: 10.1007/s10522-016-9637-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 02/02/2016] [Indexed: 02/07/2023]
Abstract
The preservation of skeletal muscle mass and strength with advancing age are, we propose, critical aspects of ageing with health and vitality. Physical inactivity and poor nutrition are known to accelerate the gradual age-related decline in muscle mass and strength—sarcopenia—however, both are subject to modification. The main purpose of this review is to present the latest, evidence-based recommendations for physical activity and exercise, as well as diet for older adults that would help in preserving muscle mass and strength. We take the position that future physical activity/exercise guidelines need to make specific reference to resistance exercise and highlight the benefits of higher-intensity aerobic exercise training, alongside advocating older adults perform aerobic-based physical activity and household tasks (e.g., carrying groceries). In terms of dietary recommendations, greater emphasis should be placed on optimal rather than minimum protein intakes for older adults. Indeed, guidelines that endorse a daily protein intake of 1.2–1.5 g/kg BM/day, which are levels 50–90 % greater than the current protein Recommendation Dietary Allowance (0.8 g/kg BM/day), are likely to help preserve muscle mass and strength and are safe for healthy older adults. Being cognisant of factors (e.g., reduced appetite) that may preclude older adults from increasing their total daily protein intake, we echo the viewpoint of other active researchers in advocating that protein recommendations for older adults be based on a per meal approach in order to maximize muscle protein synthesis (MPS). On this basis, assuming three meals are consumed daily, a protein dose of 0.4–0.5 g/kg BM should be contained in each meal. We are beginning to understand ways in which to increase the utilization of ingested protein for the stimulation of MPS, namely by increasing the proportion of leucine contained in a given dose of protein, co-ingesting other nutrients (e.g., carbohydrate and fat or supplementation with n-3 polyunsaturated fatty acids) or being physically active prior to protein intake. Clearly, developing simple lifestyle interventions targeted at preserving muscle mass and strength with advancing age is crucial for facilitating longer, healthier lives into older age.
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Kraus M, Latsch J. Intensiver Ausdauersport bei Typ-1-Diabetes. Diabetologe 2015; 11:641-4. [DOI: 10.1007/s11428-015-0037-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Regular physical activity (PA) promotes numerous health benefits for people living with type 1 diabetes (T1D). However, PA also complicates blood glucose control. Factors affecting blood glucose fluctuations during PA include activity type, intensity and duration as well as the amount of insulin and food in the body at the time of the activity. To maintain equilibrium with blood glucose concentrations during PA, the rate of glucose appearance (Ra) to disappearance (Rd) in the bloodstream must be balanced. In nondiabetics, there is a rise in glucagon and a reduction in insulin release at the onset of mild to moderate aerobic PA. During intense aerobic -anaerobic work, insulin release first decreases and then rises rapidly in early recovery to offset a more dramatic increase in counterregulatory hormones and metabolites. An "exercise smart" artificial pancreas (AP) must be capable of sensing glucose and perhaps other physiological responses to various types and intensities of PA. The emergence of this new technology may benefit active persons with T1D who are prone to hypo and hyperglycemia.
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Affiliation(s)
- Michael C Riddell
- School of Kinesiology and Health Science, Faculty of Health, Physical Activity and Chronic Disease Unit, York University, Toronto, Ontario, Canada
| | - Dessi P Zaharieva
- School of Kinesiology and Health Science, Faculty of Health, Physical Activity and Chronic Disease Unit, York University, Toronto, Ontario, Canada
| | - Loren Yavelberg
- School of Kinesiology and Health Science, Faculty of Health, Physical Activity and Chronic Disease Unit, York University, Toronto, Ontario, Canada
| | - Ali Cinar
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA Department of Chemical and Biological Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Veronica K Jamnik
- School of Kinesiology and Health Science, Faculty of Health, Physical Activity and Chronic Disease Unit, York University, Toronto, Ontario, Canada
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