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 - PubMed (original) (raw)

Randomized Controlled Trial

. 2014 Aug;38(8):1089-96.

doi: 10.1038/ijo.2013.224. Epub 2013 Nov 28.

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Free PMC article

Randomized Controlled Trial

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

K-H Herzig et al. Int J Obes (Lond). 2014 Aug.

Free PMC article

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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Figures

Figure 1

Figure 1

Flow chart of the PreDiabEx study participants and dropouts from the study.

Figure 2

Figure 2

Individual distribution of mean daily steps of all the subjects (_n_=33 intervention and 35 controls) by magnitude order (control subjects, gray; intervention subjects, white). Please note the intervention effects in subjects 20–60 and two highly active subjects.

Figure 3

Figure 3

Number of daily steps (means and s.e.m.) in the five acceleration classes in intervention and control subjects. An asterisk denotes P<0.05 between intervention and control groups.

Figure 4

Figure 4

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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