Physical activity, obesity status, and glycemic control: The ATTICA study

Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
Medicine &amp Science in Sports &amp Exercise (Impact Factor: 3.98). 04/2007; 39(4):606-11. DOI: 10.1249/mss.0b013e31803084eb
Source: PubMed


We aimed to evaluate the relationship of physical activity and obesity with glycemic control and insulin resistance.
A randomized, population-based, cross-sectional health and nutrition survey was conducted in the province of Athens, Greece. Subjects included 1514 men and 1528 women without evidence of cardiovascular or other chronic disease. Participants were classified as inactive, minimally active, or health-enhancing physical activity (HEPA) active based on the International Physical Activity Questionnaire. Insulin sensitivity was assessed by the homeostatic model (HOMA), and overweight or obesity was assessed according to BMI (BMI >or= 25). Related social, biological, and lifestyle factors were also recorded and used as potential confounders.
Five hundred sixty-five (37.3%) men and 493 (32.3%) women were classified as physically active. From the 1058 (34.8%) subjects who were classified as active, 306 (10.1%) met the criteria for HEPA active, and the rest were minimally active. HEPA active and minimally active subjects smoked less and had lower BMI, waist, and waist-to-hip ratio. Lean and overweight or obese subjects with sedentary lifestyle had greater levels of glucose, insulin, and insulin resistance [corrected] However, overweight or obese volunteers with physical activity levels classified as HEPA had similar levels of glucose and insulin sensitivity, with lower insulin than lean inactive individuals. Linear regression analysis between HOMA and physical activity, taking into consideration several social and biological factors, showed that physical activity (MET x min x wk(-1)), age, BMI, and total energy intake are important predictors of HOMA, whereas other factors such as waist circumference did not reach statistical significance.
Our data show that physical activity is a significant factor on insulin sensitivity, whereas increased physical activity may ameliorate the well-known effects of obesity on insulin sensitivity.

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Available from: Costas A Anastasiou, Oct 02, 2015
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    • "CVD incidence is improved by risk factor modification in those who exercise. Alteration in blood lipids [27], blood glucose control [28], hypertension [29], and obesity [30] are improved by regular exercise participation. Risk factor modifications due to exercise provide independent and synergistic improvements in CVD risk [1, 31, 32]. "
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    ABSTRACT: Cardiovascular disease (CVD), including ischemia reperfusion (IR) injury, remains a major cause of morbidity and mortality in industrialized nations. Ongoing research is aimed at uncovering therapeutic interventions against IR injury. Regular exercise participation is recognized as an important lifestyle intervention in the prevention and treatment of CVD and IR injury. More recent understanding reveals that moderate intensity aerobic exercise is also an important experimental model for understanding the cellular mechanisms of cardioprotection against IR injury. An important discovery in this regard was the observation that one-to-several days of exercise will attenuate IR injury. This phenomenon has been observed in young and old hearts of both sexes. Due to the short time course of exercise induced protection, IR injury prevention must be mediated by acute biochemical alterations within the myocardium. Research over the last decade reveals that redundant mechanisms account for exercise induced cardioprotection against IR. While much is now known about exercise preconditioning against IR injury, many questions remain. Perhaps most pressing, is what mechanisms mediate cardioprotection in aged hearts and what sex-dependent differences exist. Given that that exercise preconditioning is a polygenic effect, it is likely that multiple mediators of exercise induced cardioprotection have yet to be uncovered. Also unknown, is whether post translational modifications due to exercise are responsible for IR injury prevention. This review will provide an overview the major mechanisms of IR injury and exercise preconditioning. The discussion highlights many promising avenues for further research and describes how exercise preconditioning may continue to be an important scientific paradigm in the translation of cardioprotection research to the clinic.
    Current Cardiology Reviews 08/2013; 9(3). DOI:10.2174/1573403X113099990033
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    • "A stable life partner could potentially provide a strong social and emotional support for a patient with chronic disease like diabetes, to aid the patient in maintaining a healthy lifestyle and compliance to treatment. Obesity is also a well-known factor associated with poorer glycaemic control [28]. "
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    ABSTRACT: Background The aim was to study the glycaemic control of type 2 diabetic patients, and to identify factors associated with unacceptable glycaemic control (defined as HbA1c >8.0%). Methods Analysis of data collected in a cross-sectional survey of type 2 diabetic patients in eight SingHealth Polyclinics in January 2009. HbA1c value was measured on the day of the survey, while information on patient and diabetic characteristics was obtained through a questionnaire. Odds ratio of having unacceptable glycaemic control was estimated for selected variables using multiple logistic regression models. Results A total of 688 patients were included in the analysis. The mean (± standard deviation) and median (range) HbA1c levels were 7.6% (± 1.35) and 7.3% (5.0% to 14.0%), respectively. 25.4% of the patients had an unacceptable HbA1c level of >8.0% and the odds of this were higher (p < 0.05) in patients with the following characteristics: younger age, longer diabetes duration, presence of insulin treatment, and poorer compliance to medication. Conclusion Younger adult patients were found to have poorer glycaemic control, and hence targeted educational and behaviour modification programmes would be required to effectively manage this group of patients.
    BMC Endocrine Disorders 06/2013; 13(1):18. DOI:10.1186/1472-6823-13-18 · 1.71 Impact Factor
    • "Patients receiving normal dosages of non-steroidal anti-inflammatory drugs (NSAID) remained in the study as all KOA patients receive these treatments. Controls had healthy knees (the physical therapist and orthopedics of our research group determined the musculoskeletal health of their lower limbs prior to participation in the study), were physically inactive based on their responses on physical activity questionnaire [15], and they were not consuming antioxidant supplements and pharmacological agents. The family physician of control women verified their normal health status. "
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    ABSTRACT: BACKGROUND: Obesity is associated with osteoarthritis and it is accompanied by chronic inflammation and elevated oxidative stress. Strengthening-type exercise is used in knee osteoarthritis (KOA) rehabilitation. This study determined how acute isokinetic exercise influences inflammatory responses of obese middle-aged women with KOA. METHODS: Ten obese women with KOA and 10 age/weight-matched controls performed an isokinetic exercise protocol. Assessment of performance (knee extensor/flexor torque), muscle soreness (DOMS), knee flexibility (KJRM), and pain, and blood collection were performed pre-exercise, post-exercise, and at 24h post-exercise. Blood was analyzed for creatine kinase activity (CK), lactate dehydrogenase activity (LDH), CRP, leukocytes, uric acid, IL-6, TBARS, lipid hydroperoxides (LPX), protein carbonyls (PC), oxidized (GSH) and reduced glutathione (GSSG), total antioxidant capacity (TAC), catalase activity, and glutathione peroxidase activity (GPX). RESULTS: Physical function remained unaltered by exercise (only torque at 90°/s decreased at 24h). Exercise increased DOMS throughout recovery but KJRM and pain remained unchanged. CK, LDH, and uric acid increased similarly in both groups. CRP remained unaffected by exercise while IL-6 increased only post-exercise. TBARS, PC, LPH, GSSG, and TAC increased only post-exercise in both groups. GSH and GSH/GSSG declined post-exercise and normalized thereafter. Catalase and GPX increased only in patients post-exercise. CONCLUSION: Isokinetic exercise induces only a mild inflammatory response of very short duration (<24h) without affecting physical function and pain in KOA patients suggesting that moderate strengthening-type exercise may be safe for this patient cohort. These results indicate that KOA patients may be able to receive another exercise stimulus after only 48h. CLINICAL RELEVANCE: Isokinetic exercise produces minimal inflammation and pain in knee osteoarthritis patients, could be performed every 48h during rehabilitation, and up-regulates patients' antioxidant system.
    The Knee 12/2012; 20(6). DOI:10.1016/j.knee.2012.10.020 · 1.94 Impact Factor
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