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- Title
Effects of Weight Loss and Exercise Training on Insulin Resistance and Cardiometabolie Risk Factors in Older Adults.
- Authors
Dube, John J.; Amati, Francesca A.; Stefanovic-Racic, Maja; Toledo, Frederico G.; Rossi, Andrea; Goodpaster, Bret H.
- Abstract
Lifestyle modification, including a combination of weight loss and exercise, is especially effective in reducing the incidence of type 2 diabetes (T2DM) in older, high-risk individuals. However, the effects of exercise and diet-induced weight loss on insulin resistance and other cardiometabolic risk factors in older adults are not clear. The purpose of this study was to examine effects of weight loss and exercise, either alone or in combination, on insulin sensitivity and other cardiometabolic risk factors. Twenty-nine overweight/obese (BMI 31.8±3.2 kg⋅m[sup -2]) older (67.6±4.1 years) men (N=1 5) and women (N=14) with impaired glucose tolerance or newly diagnosed, drug-naïve T2DM were randomly assigned to one of the three lifestyle interventions: diet-induced weight loss (WL, N=9), exercise (EX, N=6) or combined weight loss and exercise (WL+EX, N=14). Insulin sensitivity, determined using a hyperinsulinemic (40 mU⋅m[sup -2]⋅min[sup -1]) euglycemic clamp, was improved (P<0.05) by each intervention: WL (23%), EX (26%) and WL+EX (31%). Fat mass, determined by DEXA, was decreased (P<0.05) following each intervention: WL (-18%), EX (-6%) and WL+EX (-19%). While no changes were observed in serum cholesterol or triglycerides, both systolic (WL -12%, EX -12% and WL+EX -11%) and diastolic (WL -8%, EX - 13%, and WL+EX -15%) were decreased (P<0.05) following intervention. C-reactive protein was decreased in WL (-28%) and WL+EX (-41%), but increased in EX (13%), all P<0.05. Changes in physical fitness (VO[sub 2max]) better predicted (r²=0.23, P<0.05) changes in insulin sensitivity than changes in fat-mass (r²=0.03, P=ns). In conclusion, diet-induced weight loss and exercise training independently, but not additively, improve insulin resistance, hypertension and inflammatory status in older adults with or at risk for developing T2DM. Additionally, enhanced aerobic fitness is a better predictor of improved insulin action than are changes in overall fat mass. ADA-Funded Research
- Subjects
INSULIN resistance; WEIGHT loss; EXERCISE physiology; TYPE 2 diabetes; BLOOD cholesterol; TRIGLYCERIDES; C-reactive protein
- Publication
Diabetes, 2007, Vol 56, pA279
- ISSN
0012-1797
- Publication type
Article