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Light physical activity determined by a motion sensor decreases insulin resistance, improves lipid homeostasis and reduces visceral fat in high-risk subjects: PreDiabEx study RCT.

Herzig KH, Ahola R, Leppäluoto J, Jokelainen J, Jämsä T, Keinänen-Kiukaanniemi S - Int J Obes (Lond) (2013)

Bottom Line: In contrast, changes in fasting and 2-h insulin (-3.4 mU l(-1), P=0.035 and -26.6, P=0.003, respectively), homeostasis model assessment-estimated insulin resistance (-1.0, P=0.036), total cholesterol (-0.55 mmol l(-1), P=0.041), low-density lipoprotein (LDL) cholesterol (-0.36 mmol l(-1), P=0.008) and visceral fat area (-5.5 cm(2), P=0.030) were significantly greater in the intervention than in control subjects.The overall effects of PA were analyzed by quartiles of daily steps of all subjects.There were significant reductions in total and LDL cholesterol and visceral fat area between the highest (daily steps over 6520) and the lowest quartile (1780-2810 daily steps).

View Article: PubMed Central - PubMed

Affiliation: 1] Institute of Biomedicine, Department of Physiology and Biocenter of Oulu, Oulu University, Oulu, Finland [2] Medical Research Center Oulu and Oulu University Hospital, Oulu, Finland.

ABSTRACT

Objective: To examine physical activity (PA) thresholds affecting glucose, insulin and lipid concentrations and body fat composition in high-risk patients for type 2 diabetes (T2D).

Intervention: A total of 113 subjects of both genders having abnormal glucose levels in the oral glucose tolerance test were contacted. A total of 78 subjects with age 58.8±10.4 years and body mass index 31.7±5.3 kg m(-2) were randomly assigned to intervention and control groups. INTERVENTION consisted of a supervised walking (60 min three times weekly) for 3 months. All the subjects received standard care for PA and weight reduction and wore an accelerometer during the whole wakeful time.

Results: Over 80% of the daily steps clustered at an acceleration level of 0.3-0.7 g (2-3 km h(-1) of walking) and were 5870 in the intervention and 4434 in the control group (P<0.029). Between 0 and 3 months no significant changes were observed in fasting and 2-h glucose, body weight or maximal oxygen uptake. In contrast, changes in fasting and 2-h insulin (-3.4 mU l(-1), P=0.035 and -26.6, P=0.003, respectively), homeostasis model assessment-estimated insulin resistance (-1.0, P=0.036), total cholesterol (-0.55 mmol l(-1), P=0.041), low-density lipoprotein (LDL) cholesterol (-0.36 mmol l(-1), P=0.008) and visceral fat area (-5.5 cm(2), P=0.030) were significantly greater in the intervention than in control subjects. The overall effects of PA were analyzed by quartiles of daily steps of all subjects. There were significant reductions in total and LDL cholesterol and visceral fat area between the highest (daily steps over 6520) and the lowest quartile (1780-2810 daily steps). The changes associated with PA remained significant after adjustments of baseline, sex, age and body weight change.

Conclusion: Habitual and structured PAs with the acceleration levels of 0.3-0.7 g and daily steps over 6520, equivalent to walking at 2-3 km h(-1) for 90 min daily, standing for the relative PA intensity of 30-35% of the maximal oxygen uptake, are clinically beneficial for overweight/obese and physically inactive individuals with a high risk for T2D.

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Related in: MedlinePlus

Changes in fasting (a) and 2-h insulin (b), LDL cholesterol (c) and visceral fat area (d) in the physical activity quartiles: I 1780–2810, II 2940–4010, III 4010–6020 and IV 6520–21 000 daily steps. Changes in P-values represent significance between the lowest and highest quartiles. Step data were taken from the acceleration levels 0.3–0.7 g. Data were log-transformed and adjusted to baseline, sex, age and weight changes. Original values are used in the figures. In the violin box plot the black horizontal line is mean, orange area 95% confidential limits, narrow box II and III quartiles and green area dispersion of the observations (n=17 in each quartile).
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fig4: Changes in fasting (a) and 2-h insulin (b), LDL cholesterol (c) and visceral fat area (d) in the physical activity quartiles: I 1780–2810, II 2940–4010, III 4010–6020 and IV 6520–21 000 daily steps. Changes in P-values represent significance between the lowest and highest quartiles. Step data were taken from the acceleration levels 0.3–0.7 g. Data were log-transformed and adjusted to baseline, sex, age and weight changes. Original values are used in the figures. In the violin box plot the black horizontal line is mean, orange area 95% confidential limits, narrow box II and III quartiles and green area dispersion of the observations (n=17 in each quartile).

Mentions: In order to analyze closer the observed significant effects of the intervention on insulin, LDL cholesterol and visceral fat, we pooled the variables in the control and intervention groups into one group, adjusted them by body weight change and analyzed their differences between the quartiles of the daily step numbers. There were no significant differences between the quartiles of fasting glucose/insulin, 2-h glucose/insulin or HOMA-IR (only insulin data are shown, Figures 4a and b). However, in the highest active quartile there was a highly significant reduction in the adjusted LDL cholesterol and visceral fat area when compared with the lowest one (Figures 4c and d). The reductions when the number of daily steps exceeded 6520 were for LDL cholesterol 0.7 mmol l−1 (95% confidence interval 0.1–1.2 mmol l−1) and 16 cm2 (7–25 cm2) for visceral fat area.


Light physical activity determined by a motion sensor decreases insulin resistance, improves lipid homeostasis and reduces visceral fat in high-risk subjects: PreDiabEx study RCT.

Herzig KH, Ahola R, Leppäluoto J, Jokelainen J, Jämsä T, Keinänen-Kiukaanniemi S - Int J Obes (Lond) (2013)

Changes in fasting (a) and 2-h insulin (b), LDL cholesterol (c) and visceral fat area (d) in the physical activity quartiles: I 1780–2810, II 2940–4010, III 4010–6020 and IV 6520–21 000 daily steps. Changes in P-values represent significance between the lowest and highest quartiles. Step data were taken from the acceleration levels 0.3–0.7 g. Data were log-transformed and adjusted to baseline, sex, age and weight changes. Original values are used in the figures. In the violin box plot the black horizontal line is mean, orange area 95% confidential limits, narrow box II and III quartiles and green area dispersion of the observations (n=17 in each quartile).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4125749&req=5

fig4: Changes in fasting (a) and 2-h insulin (b), LDL cholesterol (c) and visceral fat area (d) in the physical activity quartiles: I 1780–2810, II 2940–4010, III 4010–6020 and IV 6520–21 000 daily steps. Changes in P-values represent significance between the lowest and highest quartiles. Step data were taken from the acceleration levels 0.3–0.7 g. Data were log-transformed and adjusted to baseline, sex, age and weight changes. Original values are used in the figures. In the violin box plot the black horizontal line is mean, orange area 95% confidential limits, narrow box II and III quartiles and green area dispersion of the observations (n=17 in each quartile).
Mentions: In order to analyze closer the observed significant effects of the intervention on insulin, LDL cholesterol and visceral fat, we pooled the variables in the control and intervention groups into one group, adjusted them by body weight change and analyzed their differences between the quartiles of the daily step numbers. There were no significant differences between the quartiles of fasting glucose/insulin, 2-h glucose/insulin or HOMA-IR (only insulin data are shown, Figures 4a and b). However, in the highest active quartile there was a highly significant reduction in the adjusted LDL cholesterol and visceral fat area when compared with the lowest one (Figures 4c and d). The reductions when the number of daily steps exceeded 6520 were for LDL cholesterol 0.7 mmol l−1 (95% confidence interval 0.1–1.2 mmol l−1) and 16 cm2 (7–25 cm2) for visceral fat area.

Bottom Line: In contrast, changes in fasting and 2-h insulin (-3.4 mU l(-1), P=0.035 and -26.6, P=0.003, respectively), homeostasis model assessment-estimated insulin resistance (-1.0, P=0.036), total cholesterol (-0.55 mmol l(-1), P=0.041), low-density lipoprotein (LDL) cholesterol (-0.36 mmol l(-1), P=0.008) and visceral fat area (-5.5 cm(2), P=0.030) were significantly greater in the intervention than in control subjects.The overall effects of PA were analyzed by quartiles of daily steps of all subjects.There were significant reductions in total and LDL cholesterol and visceral fat area between the highest (daily steps over 6520) and the lowest quartile (1780-2810 daily steps).

View Article: PubMed Central - PubMed

Affiliation: 1] Institute of Biomedicine, Department of Physiology and Biocenter of Oulu, Oulu University, Oulu, Finland [2] Medical Research Center Oulu and Oulu University Hospital, Oulu, Finland.

ABSTRACT

Objective: To examine physical activity (PA) thresholds affecting glucose, insulin and lipid concentrations and body fat composition in high-risk patients for type 2 diabetes (T2D).

Intervention: A total of 113 subjects of both genders having abnormal glucose levels in the oral glucose tolerance test were contacted. A total of 78 subjects with age 58.8±10.4 years and body mass index 31.7±5.3 kg m(-2) were randomly assigned to intervention and control groups. INTERVENTION consisted of a supervised walking (60 min three times weekly) for 3 months. All the subjects received standard care for PA and weight reduction and wore an accelerometer during the whole wakeful time.

Results: Over 80% of the daily steps clustered at an acceleration level of 0.3-0.7 g (2-3 km h(-1) of walking) and were 5870 in the intervention and 4434 in the control group (P<0.029). Between 0 and 3 months no significant changes were observed in fasting and 2-h glucose, body weight or maximal oxygen uptake. In contrast, changes in fasting and 2-h insulin (-3.4 mU l(-1), P=0.035 and -26.6, P=0.003, respectively), homeostasis model assessment-estimated insulin resistance (-1.0, P=0.036), total cholesterol (-0.55 mmol l(-1), P=0.041), low-density lipoprotein (LDL) cholesterol (-0.36 mmol l(-1), P=0.008) and visceral fat area (-5.5 cm(2), P=0.030) were significantly greater in the intervention than in control subjects. The overall effects of PA were analyzed by quartiles of daily steps of all subjects. There were significant reductions in total and LDL cholesterol and visceral fat area between the highest (daily steps over 6520) and the lowest quartile (1780-2810 daily steps). The changes associated with PA remained significant after adjustments of baseline, sex, age and body weight change.

Conclusion: Habitual and structured PAs with the acceleration levels of 0.3-0.7 g and daily steps over 6520, equivalent to walking at 2-3 km h(-1) for 90 min daily, standing for the relative PA intensity of 30-35% of the maximal oxygen uptake, are clinically beneficial for overweight/obese and physically inactive individuals with a high risk for T2D.

Show MeSH
Related in: MedlinePlus