Post-meal Exercise and Glycemic Control in Aging

餐后运动和衰老过程中的血糖控制

基本信息

批准号：
7535457
负责人：
LORETTA DIPIETRO
金额：
$ 17.12万
依托单位：
GEORGE WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-15 至 2010-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7535457
关键词：
Age Aging Body Composition Cardiovascular Diseases Cell physiology Cells Chronic Disease Condition Eating Effectiveness Exercise Financial compensation Food Gestational Diabetes Glucose Health Benefit Hyperglycemia Insulin Insulin Resistance Knowledge Measures Metabolic Muscle Contraction Non-Insulin-Dependent Diabetes Mellitus OGTT Older Population Peripheral Physical activity Population Protocols documentation Public Health Purpose Rate Relative (related person)Reporting Risk Sampling Secondary to Standards of Weights and Measures System Testing Time Training Visceral Walking Woman abdominal fat base burden of illness clinically relevant day design disorder prevention glucose monitor glucose tolerance glucose uptake glycemic control impaired glucose tolerance improved insulin secretion men novel older men prescription document prescription procedure programs response sex subcutaneous

项目摘要

DESCRIPTION (applicant's description): Glucose tolerance declines progressively with aging, and this decline in metabolic resiliency can be attributed primarily to factors secondary to aging, such as changes in body composition and low levels of physical activity. Insufficient insulin secretion is also an important contributor; however, as impaired ¿-cell compensation to aging- and disuse-related insulin resistance may indeed accelerate the risk of developing post-challenge hyperglycemia and consequent type 2 diabetes and cardiovascular disease in older age. The purpose of this proposal is to examine the extent to which different exercise protocols impact post-prandial and 24-h glycemic control (measured using a continuous glucose monitoring system; CGMS) in older people at risk for type 2 diabetes. Specific aims are: 1) To compare the short-term effectiveness of a traditional exercise condition involving 45 min of sustained walking at lower intensity (~3.0 METs) performed in the morning (TEM), with the same condition performed in the afternoon (TEA) on improvements in postprandial and 24-h glycemic control in inactive older people with impaired glucose tolerance (IGT); 2a) To compare the short-term effectiveness of a novel "Eat and Move" exercise condition [EM; 15 min of walking (~3.0 METs) performed 30 min after each of 3 standard meals] with TEM and TEA on improvements in glycemic control in these same older people; and 2b) To determine the influence of sex and of abdominal fat on post-meal exercise-related improvements in post-prandial and 24-h glycemic control in these older men and women. While a post-meal exercise paradigm has been used as an effective strategy for gestational diabetes, its potential among older populations with compromised ¿-cell function has not been studied. The clinical relevance of shorter, but more frequent, bouts of lower-intensity exercise is substantial as older people are far more likely to engage in that type of physical activity on a regular basis. Given the excess disease burden associated with hyperglycemia in older age, and the recognized value of chronic disease prevention, there are enormous public health benefits to designing exercise programs that are enjoyable and effective within the populations needing them the most. PUBLIC HEALTH RELEVANCE: Post-prandial hyperglycemia may represent the rate-limiting factor in slowing the progression from impaired glucose tolerance toward frank type 2 diabetes and cardiovascular disease. Post-meal exercise may be an effective strategy for supplementing endogenous insulin action for improved post-prandial and 24-h glycemic control in older age. The clinical relevance of shorter, but more frequent, bouts of lower-intensity exercise is substantial as older people are far more likely to engage in that type of physical activity on a regular basis. Given the excess disease burden associated with hyperglycemia in older age, and the recognized value of chronic disease prevention, there are enormous public health benefits to designing exercise programs that are enjoyable and effective within the populations needing them the most.

描述（申请人的描述）：葡萄糖耐量随着衰老而逐渐下降，并且代谢弹性的这种下降主要归因于衰老的继发因素，例如身体成分的变化和身体活动水平低也是一个重要的因素。 ; 然而，由于受损 ¿ -细胞对与衰老和废用相关的胰岛素抵抗的补偿确实可能会加速老年人发生挑战后高血糖以及随之而来的 2 型糖尿病和心血管疾病的风险。该提案的目的是检查不同运动方案的程度。对有 2 型糖尿病风险的老年人的餐后和 24 小时血糖控制（使用连续血糖监测系统；CGMS 测量）的影响具体目标是： 1) 比较短期疗效。一项传统的练习条件涉及 45 分钟的低强度（约 3.0 MET）持续步行上午（TEM），下午（TEA）进行相同条件，以改善糖耐量受损（IGT）不活动的老年人的餐后和24小时血糖控制2a）比较新型药物的短期有效性； “吃和动”运动条件 [EM；3 顿标准餐后每 30 分钟进行 15 分钟步行 (~3.0 MET)] 使用 TEM 和 TEA 改善这些老年人的血糖控制2b) 确定性别和腹部脂肪对这些老年男性和女性餐后运动相关的餐后和 24 小时血糖控制的影响，同时使用餐后运动范式。作为妊娠期糖尿病的有效策略，它在患有糖尿病的老年人群中具有潜力 ¿细胞功能尚未得到研究，较短但更频繁的低强度运动的临床意义是很大的，因为考虑到过度的疾病，老年人更有可能定期进行这种类型的身体活动。由于老年人高血糖带来的负担以及慢性病预防的价值得到认可，设计对最需要锻炼的人群来说令人愉快且有效的锻炼计划对公共卫生有巨大的好处：餐后。高血糖可能是减缓糖耐量受损向 2 型糖尿病进展的限速因素，而餐后运动可能是补充内源性胰岛素作用以改善餐后和 24 小时血糖控制的有效策略。在老年人中，较短但更频繁的低强度运动具有很大的临床意义，因为考虑到与疾病相关的过度负担，老年人更有可能定期进行此类体育活动。老年人的高血糖以及慢性疾病预防的公认价值，设计对最需要锻炼的人群来说有趣且有效的锻炼计划可以给公共健康带来巨大的好处。