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Radhika Aditya Jadhav, Animesh Hazari, Ashma Monterio, Sampath Kumar and Arun G. Maiya

Background:

Prediabetes is a strong risk factor for the development of Type2 Diabetes Mellitus (T2DM). Modification in lifestyle plays an important role to avoid the prognosis of T2DM and its complications in future. The aim of our study was to focus on the effectiveness of physical activity (PA) intervention program on different outcome measures in individuals with prediabetes. The effort of the present review was to contribute to the existing literature by strengthening the evidence pointing toward the positive impact of physical activity in individuals with prediabetes.

Methods:

Studies have been identified through database like PubMed, Scopus, and ProQuest. Randomized and nonrandomized controlled trials have been included. Nineteen articles have been selected for the qualitative analysis and 08 for meta-analysis.

Results:

PA intervention showed a favorable effect on improving oral glucose tolerance (Risk ratio [RR] –0.26, 95% CI –0.06 to 0.07) and fasting blood sugar (RR –0.05, 95% CI –0.14 to 0.04). It also showed the favorable effect on glycated hemoglobin (HbA1C), maximum oxygen uptake (VO2max), and body composition.

Conclusion:

Present review suggests that the PA promotion and participation can help to slow down the progression of disease in individuals with prediabetes and thus reduces the morbidity and mortality associated with T2DM.

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James H. Rimmer, David Braddock and Glenn Fujiura

A body mass index (BMI) greater than 27 has been cited as a risk factor for heart disease and diabetes mellitus resulting from excess weight. The purpose of this study was to determine the association between BMI (>27) and two other obesity indices–height-weight and percent body fat–as well as to investigate the relationship between BMI and three blood lipid parameters–total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in 329 adults with mental retardation (MR). Males were significantly taller and heavier than females, but females had a significantly higher BMI. Kendall’s Tau-C revealed a significant association between BMI and each of the following: height-weight, percent body fat, LDL-C, and HDL-C. However, there were a significant number of false negatives and false positives on each of the criteria. The congruence between at-risk BMI and two other obesity parameters (height-weight and percent body fat) in a population of adults with MR is not strong. Professionals should employ the BMI along with skinfold measures to assess a person’s at-risk status for excess weight.

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Steven K. Malin, Brooke R. Stephens, Carrie G. Sharoff, Todd A. Hagobian, Stuart R. Chipkin and Barry Braun

Exercise and metformin may prevent or delay Type 2 diabetes by, in part, raising the capacity for fat oxidation. Whether the addition of metformin has additive effects on fat oxidation during and after exercise is unknown. Therefore, the purpose of this study was to evaluate the effect of metformin on substrate oxidation during and after exercise. Using a double-blind, counter-balanced crossover design, substrate oxidation was assessed by indirect calorimetry in 15 individuals taking metformin (2,000 mg/d) and placebo for 8–10 d. Measurements were made during cycle exercise at 5 submaximal cycle workloads, starting at 30% peak work (Wpeak) and increasing by 10% every 8 min to 70% Wpeak. Substrate oxidation was also measured for 50 min postexercise. Differences between conditions were assessed using analysis of variance with repeated measures, and values are reported as M ± SE. During exercise, fat oxidation (0.19 ± 0.03 vs. 0.15 ± 0.01 g/min, p < .01) and percentage of energy from fat (32% ± 3% vs. 28% ± 3%, p < .01) were higher with metformin than with placebo. Postexercise, metformin slightly lowered fat oxidation (0.12 ± 0.02 to 0.10 ± 0.02 g/min, p < .01) compared with placebo. There was an inverse relationship between postexercise fat oxidation and the rate of fat oxidation during exercise (r = –.68, p < .05). In healthy individuals, metformin has opposing actions on fat oxidation during and after exercise. Whether the same effects are evident in insulin-resistant individuals remains to be determined.

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Stanley Sai-chuen Hui

Promoting regular physical activity has been considered one of the most important aspects of preventive medicine in recent years. This is due to the fact that tremendous evidence has been found about the positive association between increasing physical activity and desirable health effects. Findings have been summarized in a number of review documents; however, most of these reviews emphasize findings retrieved from research conducted in Western countries. Few papers were found to summarize findings in physical activity and health of the Hong Kong Chinese population. Epidemiological studies revealed that there exists distinct diverse health status among different ethnic groups due to culture, beliefs, genetic makeup, health practices, and behaviors in these highly diverse groups. This chapter reviews what is known about the association between physical activity and health in the Chinese population of Hong Kong. Current health issues including coronary heart disease, obesity, diabetes, cancer, osteoporosis, and so on, that are specific to the Hong Kong situation are reviewed. Moreover, findings in physical activity participation levels of Hong Kong adults and children are introduced. Results indicate that the associations between physical activity and health found in the Chinese population of Hong Kong share similar trends as those reported in Western countries. Three quarters of Hong Kong children and adults are not physically active enough to achieve health benefits. The physical activity level for the Hong Kong Chinese population remains low. The need for promotional and intervention programs on physical activity participation is pressing.

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Leandro Fornias Machado de Rezende, Fabiana Maluf Rabacow, Juliana Yukari Kodaira Viscondi, Olinda do Carmo Luiz, Victor Keihan Rodrigues Matsudo and I-Min Lee

Background:

In Brazil, one-fifth of the population reports not doing any physical activity. This study aimed to assess the impact of physical inactivity on major noncommunicable diseases (NCDs), all-cause mortality and life expectancy in Brazil, by region and sociodemographic profile.

Methods:

We estimated the population attributable fraction (PAF) for physical inactivity associated with coronary heart disease, type 2 diabetes, breast cancer, colon cancer, and all-cause mortality. To calculate the PAF, we used the physical inactivity prevalence from the 2008 Brazilian Household Survey and relative risk data in the literature.

Results:

In Brazil, physical inactivity is attributable to 3% to 5% of all major NCDs and 5.31% of all-cause mortality, ranging from 5.82% in the southeastern region to 2.83% in the southern region. Eliminating physical inactivity would increase the life expectancy by an average of 0.31 years. This reduction would affect mainly individuals with ≥ 15 years of schooling, male, Asian, elderly, residing in an urban area and earning ≥ 2 times the national minimum wage.

Conclusions:

In Brazil, physical inactivity has a major impact on NCDs and mortality, principally in the southeastern and central-west regions. Public policies and interventions promoting physical activity will significantly improve the health of the population.

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Charbel El Bcheraoui, Marwa Tuffaha, Farah Daoud, Hannah Kravitz, Mohammad A. Al Mazroa, Mohammad Al Saeedi, Ziad A. Memish, Mohammed Basulaiman, Abdullah A. Al Rabeeah and Ali H. Mokdad

Background:

With the lack of appropriate data, we conducted a large household survey in 2013 to determine current rates of physical activity in the Kingdom of Saudi Arabia (KSA).

Methods:

The Saudi Health Interview Survey is a national multistage survey of individuals aged 15 years or older. We used a multivariate logistic regression model to measure association between sociodemographic and selected characteristics and meeting the recommended levels of moderate and vigorous weekly physical activity.

Results:

Of a total of 12,000 households contacted, 10,735 (89.4%) participants completed Saudi Health Interview Survey. An estimated 4.5 million (34.5%) Saudis aged 15 years or older reported no weekly physical activity, while only 1.7 million (12.9%) meet the recommended levels of moderate physical activity (MPA). The likelihood of meeting MPA decreased with age, education, among women, those with a history of diagnosis of select chronic conditions, including diabetes. Similar results were found for the likelihood of meeting the recommended levels of vigorous weekly physical activity.

Conclusions:

We found very low levels of physical activity in KSA. Perhaps, KSA can challenge communities or employers to devise solutions and reward those with the best results. These solutions would be of great value to other Gulf countries, as well.

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Yan Wang, Lea A. Cupul-Uicab, Walter J. Rogan, Merete Eggesbo, Gregory Travlos, Ralph Wilson and Matthew P. Longnecker

Background:

Pregnant women who are physically active have a lower risk of preeclampsia and gestational diabetes than women who are less active. One possible mechanism is a reduction in low-grade inflammation, as measured by plasma concentrations of C-reactive protein (CRP). The association between exercise and CRP in pregnant women, however, has not been adequately investigated.

Methods:

A total of 537 pregnant women, enrolled around the 17th week of gestation in the Norwegian Mother and Child Cohort Study in 2003 to 2004, were studied. Self-reported recreational exercise was recalled for both 3 months before pregnancy and early pregnancy. The total energy expenditure from recreational exercise (total recreational exercise, metabolic equivalent of task [MET]-hr/week) was estimated, and low-, moderate- and vigorous-intensity exercise was defined. Plasma CRP concentrations were measured during pregnancy.

Results:

In adjusted linear regression models, mean CRP concentration was 1.0% lower [95% CI = –1.9% to 0.2%] with each 1 MET-hr/week of total recreational exercise before pregnancy. In addition, vigorous-intensity exercise before pregnancy was more strongly related to a reduction in CRP levels than low- or moderate-intensity exercise. However, we observed no association between recreational exercise during pregnancy and plasma CRP levels.

Conclusion:

Recreational exercise before pregnancy, especially vigorous exercise, may reduce the risk of maternal inflammation during pregnancy.

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Cynthia M. Ferrara, Susan H. McCrone, David Brendle, Alice S. Ryan and Andrew P. Goldberg

The metabolic changes associated with the addition of 4 months of resistive exercise to an existing aerobic exercise program (AEX+RT, n = 7) were compared to a maintenance aerobic exercise program (AEX, n = 8) in overweight, older men. The subjects in this study had recently completed a 6-month aerobic exercise program (treadmill walking, 45 min/d, 2 d/wk). The AEX+RT group added 6 exercises on upper- and lower-body pneumatic-resistance machines (2 sets, 15 repetitions each, 2 d/wk) to an aerobic exercise program at ≥ 70% heart rate reserve for 30–40 min, 2 d/wk on treadmill, while the AEX group continued the same maintenance treadmill AEX program. There were no baseline differences in body weight, VO2max, or glucose metabolism between groups. The AEX+RT group increased upper- and lower-extremity strength by 28 ± 4% and 46 ± 6%, respectively (p < .05), despite a 9% decrease in VO2max (p < .05). VO2max did not change in the AEX group. There was no change in the fasting glucose or insulin levels, or the 3-h glucose responses to an oral glucose load in either group. The insulin responses decreased by 25 ± 4% in the AEX+RT group (p < .01) but did not change in the AEX group. In conclusion, the addition of resistive exercise training to an existing aerobic exercise program may improve insulin sensitivity in overweight, older men, and thus prevent the development of type 2 diabetes.

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Paul D. Loprinzi and Manish Kohli

Objective:

Independent of previously recognized clinical factors influencing prostate-specific antigen (PSA) levels (eg, age and race-ethnicity), sedentary behavior has recently been reported to be associated with higher PSA measurements. The extent of interaction of putative clinical factors with sedentary behavior and their impact on PSA levels is unknown. We examined the interaction of previously known PSA influencing demographic patient characteristics with patient sedentary behavior on PSA levels.

Methods:

Data from the 2003–2006 National Health and Nutrition Examination Survey were used. Sedentary behavior was objectively measured using an accelerometer in 1690 participants who were included in the analytic sample. Multivariate linear regression analysis across potential clinical and biological modifiers of PSA levels were used to examine the association between sedentary behavior and PSA levels.

Results:

After controlling for covariates, a positive association between sedentary behavior and PSA was detected among distinctive patient groups, including non-Hispanic whites, overweight/obese subjects, hypertensive participants, and participants with evidence of diabetes and those reported to have benign prostate hypertrophy.

Conclusion:

These results suggest that patients with distinct clinical characteristics engaging in sedentary lifestyles are likely to have higher PSA levels.

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Alon Eliakim

The Pediatric Exercise Science Year That Was section aims to highlight the most important (to the author’s opinion) manuscripts that were published in 2016 in the field of endocrinology and pediatric exercise science. This year’s selection includes studies showing that 1) Induction of T4 to T3 conversion by type 2 deiodinase following aerobic exercise in skeletal muscles was associated with concomitant increase in peroxisome proliferatoractivated receptor-γ coactivator-1α, and mitochondrial oxidative capacity and therefore plays an important mechanistic role in the muscle adaptation to exercise training. 2) Hypothyroidism in fetal and early postnatal life was associated with impaired spatial learning and memory and with reduced hippocampal brain-derived neurotrophic factor in male and female rat pups. Forced (treadmill) and voluntary (wheel) exercise alleviated all these biochemical and neuro-cognitive deficits. 3) The relationship between different exercise intensities and carbohydrate requirements to maintain euglycemia at basal insulin levels among adolescent and young adults with Type 1 diabetes are nonlinear but rather inverted- U with no exogenous glucose required to maintain stable glucose level at high-intensity exercise (80%). The implication of these studies to the pediatric population, their importance and the new research avenues that were opened by these studies is emphasized.