scholarly journals Exercise Training Intensity and the Fitness-Fatness Index in Adults with Metabolic Syndrome: A Randomized Trial

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Joyce S. Ramos ◽  
Lance C. Dalleck ◽  
Mackenzie Fennell ◽  
Alex Martini ◽  
Talita Welmans ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Cardiorespiratory Fitness ◽  
Mortality Risk ◽  
High Volume ◽  
Moderate Intensity ◽  
Metabolic Equivalents ◽  
The Metabolic Syndrome ◽  
Low Volume

Abstract Background Cardiorespiratory fitness and fatness (notably central obesity) are mediating factors of the metabolic syndrome (MetS) and consequent cardiovascular disease (CVD)/mortality risk. The fitness-fatness index (FFI) combines these factors and has been reported to be a better indicator of CVD and all-cause mortality risk, beyond the capacity of either fitness or fatness alone. Objective This study sought to investigate the effects of different exercise intensities on FFI in adults with MetS. Methods This was a sub-study of the ‘Exercise in the prevention of Metabolic Syndrome’ (EX-MET) multicentre trial. Ninety-nine adults diagnosed with MetS according to the International Diabetes Federation criteria were randomized to one of the following 16-week exercise interventions: i) moderate-intensity continuous training (MICT) at 60–70% HRpeak for 30 min/session (n = 34, 150 min/week); ii) 4 × 4 min bouts of high-intensity interval training at 85–95% HRpeak, interspersed with 3-min active recovery at 50–70% HRpeak (n = 34, 38 min/session, 114 min/week); and iii) 1 × 4 min bout of HIIT at 85–95% HRpeak (n = 31, 17 min/session, 51 min/week). Cardiorespiratory fitness (peak oxygen uptake, V̇O2peak) was determined via indirect calorimetry during maximal exercise testing and fatness was the ratio of waist circumference-to-height (WtHR). FFI was calculated as V̇O2peak in metabolic equivalents (METs) divided by WtHR. A clinically meaningful response to the exercise intervention was taken as a 1 FFI unit increase. Results Seventy-seven participants completed pre and post testing to determine FFI. While there was no significant between group difference (p = 0.30), there was a small group x time interaction effect on FFI [F(2, 73) = 1.226; η2 = 0.01], with numerically greater improvements following HIIT (4HIIT, + 16%; 1HIIT, + 11%) relative to MICT (+ 7%). There was a greater proportion of participants who had a clinically meaningful change in FFI following high-volume HIIT (60%, 15/25) and low-volume HIIT (65%, 17/26) compared to MICT (38%, 10/26), but with no significant between-group difference (p = 0.12). A similar trend was found when a sub-analysis comparing the FFI between those with type 2 diabetes (MICT, 33%, 3/9; high-volume HIIT, 64%, 7/11; and low-volume HIIT, 58%, 7/12) and without type 2 diabetes (MICT, 41%, 7/17; high-volume HIIT, 57%, 8/14; low-volume HIIT, 71%, 10/14). Conclusion Although there were no statistically significant differences detected between groups, this study suggests that the response to changes in FFI in adults with MetS may be affected by exercise intensity, when numerical differences between exercise groups are considered. Further research is warranted. Trial registration number and date of registration: ClinicalTrials.gov NCT01676870; 31/08/2012.

scholarly journals Exercise Training Volume and the Fitness-fatness Index in Adults With Metabolic Syndrome: A Randomised Trial

2021 ◽  
Author(s):  
Joyce S. Ramos ◽  
Lance C. Dalleck ◽  
Mackenzie Fennell ◽  
Alex D. Martini ◽  
Talita R. Welmans ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Cardiorespiratory Fitness ◽  
Mortality Risk ◽  
High Volume ◽  
Moderate Intensity ◽  
Metabolic Equivalents ◽  
The Metabolic Syndrome ◽  
Low Volume

Abstract Background Cardiorespiratory fitness and fatness (notably central obesity) are mediating factors of the metabolic syndrome (MetS), and consequent cardiovascular disease (CVD)/mortality risk. The fitness-fatness index (FFI) combines these factors and has been reported to be a better indicator of CVD and all-cause mortality risk, beyond the capacity of either fitness or fatness alone. Objective This study sought to investigate the effects of different exercise volumes on FFI in adults with MetS. Methods This was a sub-study of the ‘Exercise in the prevention of Metabolic Syndrome’ (EX-MET) multicenter trial. Ninety-nine adults diagnosed with MetS according to the International Diabetes Federation criteria were randomized to one of the following 16-week exercise interventions: i) moderate-intensity continuous training (MICT) at 60-70% HRpeak for 30 min/session (n=34, 150 min/week); ii) 4 x 4 min bouts of high-intensity interval training at 85-95% HRpeak, interspersed with 3-min active recovery at 50-70% HRpeak (n=34, 38min/session, 114 mins/week); and iii) 1 x 4 min bout of HIIT at 85-95% HRpeak (n=31, 17 min/session, 51 min/week). Cardiorespiratory fitness (peak oxygen uptake, V̇O2peak) was determined via indirect calorimetry during maximal exercise testing and fatness was the ratio of waist circumference-to-height (WHtR). FFI was calculated as V̇O2peak in metabolic equivalents (METs) divided by WHtR. A clinically meaningful response to the exercise intervention was taken as a 1 FFI unit increase. Results Seventy-seven participants completed pre and post testing to determine FFI. There was a greater proportion of participants who had a clinically meaningful change in FFI following high-volume HIIT (60%, 15/25) and low-volume HIIT (65%, 17/26) compared to MICT (38%, 10/26), but with no significant between-group difference (p=0.12). A similar trend was found when a sub-analysis comparing the FFI between those with type 2 diabetes (MICT, 33%, 3/9; high-volume HIIT, 64%, 7/11; and low-volume HIIT, 58%, 7/12) and without type 2 diabetes (MICT, 41%, 7/17; high-volume HIIT, 57%, 8/14; low-volume HIIT, 71%, 10/14). Conclusion This study suggests that the response to changes in FFI in adults with MetS is affected by aerobic exercise intensity.

scholarly journals The effect of a novel low-volume aerobic exercise intervention on liver fat in type 2 diabetes: a randomised controlled trial

2020 ◽  
Author(s):  
Angelo Sabag ◽  
Kimberley L. Way ◽  
Rachelle N. Sultana ◽  
Shelley E. Keating ◽  
James A. Gerofi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiorespiratory Fitness ◽  
High Intensity ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Liver Fat ◽  
Moderate Intensity ◽  
Resonance Spectroscopy ◽  
Low Volume

Objective: The aim of this study was to examine the effect of a novel low-volume high-intensity interval training (HIIT), moderate-intensity continuous training (MICT) or placebo (PLA) intervention on liver fat, glycaemia, and cardiorespiratory fitness using a randomised placebo-controlled design. <p>Research design and methods: Thirty-five inactive adults (54.6±1.4 years, 54% male; BMI 35.9±0.9kg/m2) with obesity and type 2 diabetes were randomised to 12 weeks of supervised: MICT (n=12) at 60% VO<sub>2peak</sub> for 45 minutes, 3 days/week, HIIT (n=12) at 90% VO<sub>2peak</sub> for 4 minutes, 3 days/week, or PLA (n=11). Liver fat % was quantified via proton magnetic resonance spectroscopy.</p> <p>Results: Liver fat reduced in MICT (-0.9±0.7%) and HIIT (-1.7±1.1%) but increased in PLA (1.2±0.5%) (p = 0.046). HbA1c improved in MICT (-0.3±0.3%) and in HIIT (-0.3±0.3%) but not in PLA (0.5±0.2%) (p=0.014). Cardiorespiratory fitness improved in MICT (2.3±1.2 ml/kg/min) and HIIT (1.1±0.5 ml/kg/min) but not in PLA (-1.5±0.9 ml/kg/min) (p=0.006). </p> <p>Conclusions: MICT or a low-volume HIIT approach involving 12 minutes of weekly high-intensity exercise may improve liver fat, glycaemia, and cardiorespiratory fitness in type 2 diabetes in the absence of weight loss. Further studies are required to elucidate the relationship between exercise-induced reductions in liver fat and improvements in glycaemia.</p>

scholarly journals The effect of a novel low-volume aerobic exercise intervention on liver fat in type 2 diabetes: a randomised controlled trial

2020 ◽  
Author(s):  
Angelo Sabag ◽  
Kimberley L. Way ◽  
Rachelle N. Sultana ◽  
Shelley E. Keating ◽  
James A. Gerofi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiorespiratory Fitness ◽  
High Intensity ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Liver Fat ◽  
Moderate Intensity ◽  
Resonance Spectroscopy ◽  
Low Volume

Objective: The aim of this study was to examine the effect of a novel low-volume high-intensity interval training (HIIT), moderate-intensity continuous training (MICT) or placebo (PLA) intervention on liver fat, glycaemia, and cardiorespiratory fitness using a randomised placebo-controlled design. <p>Research design and methods: Thirty-five inactive adults (54.6±1.4 years, 54% male; BMI 35.9±0.9kg/m2) with obesity and type 2 diabetes were randomised to 12 weeks of supervised: MICT (n=12) at 60% VO<sub>2peak</sub> for 45 minutes, 3 days/week, HIIT (n=12) at 90% VO<sub>2peak</sub> for 4 minutes, 3 days/week, or PLA (n=11). Liver fat % was quantified via proton magnetic resonance spectroscopy.</p> <p>Results: Liver fat reduced in MICT (-0.9±0.7%) and HIIT (-1.7±1.1%) but increased in PLA (1.2±0.5%) (p = 0.046). HbA1c improved in MICT (-0.3±0.3%) and in HIIT (-0.3±0.3%) but not in PLA (0.5±0.2%) (p=0.014). Cardiorespiratory fitness improved in MICT (2.3±1.2 ml/kg/min) and HIIT (1.1±0.5 ml/kg/min) but not in PLA (-1.5±0.9 ml/kg/min) (p=0.006). </p> <p>Conclusions: MICT or a low-volume HIIT approach involving 12 minutes of weekly high-intensity exercise may improve liver fat, glycaemia, and cardiorespiratory fitness in type 2 diabetes in the absence of weight loss. Further studies are required to elucidate the relationship between exercise-induced reductions in liver fat and improvements in glycaemia.</p>

scholarly journals Optimizing the Interaction of Exercise Volume and Metformin to Induce a Clinically Significant Reduction in Metabolic Syndrome Severity: A Randomised Trial

2020 ◽  
Vol 17 (10) ◽  
pp. 3695
Author(s):  
Joyce S. Ramos ◽  
Lance C. Dalleck ◽  
Caitlin E. Keith ◽  
Mackenzie Fennell ◽  
Zoe Lee ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Exercise Training ◽  
High Volume ◽  
Moderate Intensity ◽  
Similar Proportion ◽  
Post Intervention ◽  
The Metabolic Syndrome ◽  
Low Volume ◽  
The Impact

Insulin resistance is a central mediating factor of the metabolic syndrome (MetS), with exercise training and metformin proven antidotes to insulin resistance. However, when the two therapies are combined there is conflicting data regarding whether metformin blunts or improves exercise training-induced adaptations. The volume of exercise (duration, intensity, and frequency) on the interaction of exercise training and metformin has yet to be investigated. The aim of this study is therefore to explore the impact of a combination of different exercise volumes and metformin on MetS severity. This is a secondary analysis of data from one of the sites of the ‘Exercise in Prevention of Metabolic Syndrome’ (EX-MET) study. Ninety-nine adults with MetS were randomized into a 16-week exercise program completing either: (i) moderate-intensity continuous training (MICT) at 60–70% of peak heart rate (HRpeak) for 30 min/session (n = 34, 150 min/week); (ii) high-volume high-intensity interval training (HIIT) consisting of 4 × 4 min bouts at 85–95% HRpeak, interspersed with 3 min of active recovery at 50–70% HRpeak (n = 34, 38 min/session, 114 min/week); or (iii) low volume HIIT, 1 × 4 min bout of HIIT at 85–95% HRpeak (n = 31, 17 min/session, 51 min/week). Metformin intake was monitored and recorded throughout the trial. MetS severity was calculated as z-scores derived from MetS risk factors assessed at pre- and post-intervention. Sixty-five participants had complete pre- and post-intervention data for MetS z-score, of which 18 participants (28%) were taking metformin. Over the 16-week intervention, a similar proportion of participants clinically improved MetS severity (Δ ≥ −0.87) with metformin (8/18, 44%) or without metformin (23/47, 49%) (p = 0.75). While there were no between-group differences (p = 0.24), in those who did not take metformin low-volume HIIT had more likely responders (10/15, 67%) compared to MICT (6/16, 38%) and high-volume HIIT (7/16, 44%). In those taking metformin, there was a lower proportion of participants who clinically improved MetS severity following high-volume HIIT (1/6, 17%) compared to MICT (2/4, 50%) and low-volume HIIT (5/8, 63%), but with no between-group difference (p = 0.23). Moreover, in those who performed high-volume HIIT, there was a statistically significantly higher proportion (p = 0.03) of likely non-responders with improved MetS severity in participants taking metformin (4/6, 67%) compared to those not taking metformin (3/16, 19%). In individuals with MetS, the effect of high volume HIIT on MetS severity may be blunted in those taking metformin. These findings need to be confirmed in a larger study.

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