To examine prospectively the association between regular exercise and the subsequent development of non-insulin-dependent diabetes mellitus (NIDDM).
Prospective cohort study including 5 years of follow-up.
21,271 US male physicians participating in the Physicians' Health Study, aged 40 to 84 years and free of diagnosed diabetes mellitus, myocardial infarction, cerebrovascular disease, and cancer at baseline. Morbidity follow-up was 99.7% complete.
Incidence of NIDDM.
At baseline, information was obtained about frequency of vigorous exercise and other risk indicators. During 105,141 person-years of follow-up, 285 new cases of NIDDM were reported. The age-adjusted incidence of NIDDM ranged from 369 cases per 100,000 person-years in men who engaged in vigorous exercise less than once weekly to 214 cases per 100,000 person-years in those exercising at least five times per week (P, trend, less than .001). Men who exercised at least once per week had an age-adjusted relative risk (RR) of NIDDM of 0.64 (95% Cl, 0.51 to 0.82; P = .0003) compared with those who exercised less frequently. The age-adjusted RR of NIDDM decreased with increasing frequency of exercise: 0.77 for once weekly, 0.62 for two to four times per week, and 0.58 for five or more times per week (P, trend, .0002). A significant reduction in risk of NIDDM persisted after adjustment for both age and body-mass index: RR, 0.71 (95% Cl, 0.56 to 0.91; P = .006) for at least once per week compared with less than once weekly, and P, trend, .009, for increasing frequency of exercise. Further control for smoking, hypertension, and other coronary risk factors did not materially alter these associations. The inverse relation of exercise to risk of NIDDM was particularly pronounced among overweight men.
Exercise appears to reduce the development of NIDDM even after adjusting for body-mass index. Increased physical activity may be a promising approach to the primary prevention of NIDDM.
"The elderly prefer to exercise at a low to moderate intensity. However, a large amount of exercise performed at a low level of intensity was found to have no relationship with physical fitness (Manson et al., 1992). On the other hand, a study (Morikawa et al., 2011) conducted with 666 participants more than 65 yr old found that walking at a high level of intensity four times in four months significantly improved their BMI, body fat %, blood pressure, glucose, muscle strength, and maximal oxygen uptake. "
[Show abstract][Hide abstract] ABSTRACT: Trekking includes downhill walking and enhances lower limb strength. Muscle fitness is a predictor of mortality and is associated with cardiovascular risk factors in adults. The purpose of this study was to investigate the effects of trekking on cardiovascular health and fitness in older obese women. The participants were randomly assigned to an exercise group (EG, n= 32) and a control group (CG, n= 48). The EG participated in the trekking program for 12 weeks, 3 times per week, and 90 min per session, at a moderate intensity. Cardiovascular health (BMI, percentage of body fat, blood pressure, glucose, triglycerides, and total cholesterol) and fitness (muscle strength, muscle endurance, balance, and flexibility) were measured before and after the 12-week program. A twoway repeated ANOVA was used to compare and analyze the group differences. Body weight, systolic blood pressure, and muscle strength were significantly different between the groups. These results indicate that trekking played a significant role in the reduction of weight and systolic blood pressure in obese women. The results of this study can be utilized to reduce cardiovascular risk factors associated with aging.
"Bed rest (BR) has previously been used as a model to study the effects of sedentarism. Prior BR studies demonstrated that prolonged inactivity leads to reductions in conduit artery diameter , decreased reactive hyperemia (RH) , development of insulin resistance , type 2 diabetes , upregulation of the renin-angiotensin axis , and possibly vascular dysfunction . Brachial artery flowemediated dilatation (FMD) and arterial stiffness measured by arterial tonometry are used to assess vascular function, and when they are impaired, they have been independently associated with increased cardiovascular risk [13e16]. "
[Show abstract][Hide abstract] ABSTRACT: Sedentarism, also termed physical inactivity, is an independent risk factor for cardiovascular diseases. Mechanisms thought to be involved include insulin resistance, dyslipidemia, hypertension, and increased inflammation. It is unknown whether changes in vascular and endothelial function also contribute to this excess risk. We hypothesized that short-term exposure to inactivity would lead to endothelial dysfunction, arterial stiffening, and increased vascular inflammation.
Five healthy subjects (four men and one woman) underwent 5 d of bed rest (BR) to simulate inactivity. Measurements of vascular function (flow-mediated vasodilation to evaluate endothelial function; applanation tonometry to assess arterial resistance), inflammation, and metabolism were made before BR, daily during BR, and 2 d after BR recovery period. Subjects maintained an isocaloric diet throughout.
BR led to significant decreases in brachial artery and femoral artery flow-mediated vasodilation (brachial: 11 ± 3% pre-BR versus 9 ± 2% end-BR, P = 0.04; femoral: 4 ± 1% versus 2 ± 1%, P = 0.04). The central augmentation index increased with BR (-4 ± 9% versus 5 ± 11%, P = 0.03). Diastolic blood pressure increased (58 ± 7 mm Hg versus 62 ± 7 mm Hg, P = 0.02), whereas neither systolic blood pressure nor heart rate changed. 15-Hydroxyeicosatetraenoic acid, an arachidonic acid metabolite, increased but the other inflammatory and metabolic biomarkers were unchanged.
Our findings show that acute exposure to sedentarism results in decreased endothelial function, arterial stiffening, increased diastolic blood pressure, and an increase in 15-hydroxyeicosatetraenoic acid. We speculate that inactivity promotes a vascular "deconditioning" state characterized by impaired endothelial function, leading to arterial stiffness and increased arterial tone. Although physiologically significant, the underlying mechanisms and clinical relevance of these findings need to be further explored.
Journal of Surgical Research 02/2014; 190(2). DOI:10.1016/j.jss.2014.02.001 · 1.94 Impact Factor
"For example, a study by Helmrich et al.  followed 5,990 male graduates of the University of Pennsylvania over 14 years and found that the risk of developing diabetes is reduced by 6% for every 500 kcal increase in weekly exercise. Furthermore, a study that followed 21,271 male U.S. doctors over five years revealed that even a once-weekly bout of exercise at an intensity that is sufficient to cause sweating reduced the risk of developing diabetes . In addition, results from a study that followed 87,253 female U.S. nurses over eight years showed that the group that exercised at least once a week at an intensity sufficient to cause sweating had a relative risk of developing diabetes of 0.84 compared with a group that exercised less than once a week . "
[Show abstract][Hide abstract] ABSTRACT: Obesity is recognized as a risk factor for lifestyle-related diseases such as type 2 diabetes and cardiovascular disease. White adipose tissue (WAT) is not only a static storage site for energy; it is also a dynamic tissue that is actively involved in metabolic reactions and produces humoral factors, such as leptin and adiponectin, which are collectively referred to as adipokines. Additionally, because there is much evidence that obesity-induced inflammatory changes in WAT, which is caused by dysregulated expression of inflammation-related adipokines involving tumor necrosis factor- α and monocyte chemoattractant protein 1, contribute to the development of insulin resistance, WAT has attracted special attention as an organ that causes diabetes and other lifestyle-related diseases. Exercise training (TR) not only leads to a decrease in WAT mass but also attenuates obesity-induced dysregulated expression of the inflammation-related adipokines in WAT. Therefore, TR is widely used as a tool for preventing and improving lifestyle-related diseases. This review outlines the impact of TR on the expression and secretory response of adipokines in WAT.
International Journal of Endocrinology 12/2013; 2013(3):801743. DOI:10.1155/2013/801743 · 1.95 Impact Factor
María Dolores Ugarte, Aritz Adin, Tomás Goicoa, Itziar Casado, Eva Ardanaz, Nerea Larrañaga
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